What Does a Postpartum Doula Really Do, Anyway?
If you haven't worked with a doula before, it can be pretty hard to grasp what it is exactly that doulas do. And while birth doulas have been gaining in popularity, postpartum doulas are still a mystery to most expecting parents.
(Birth doulas are not mainstream by any stretch of the imagination. In a 2012 survey, only 6% of US parents who responded said they had used a doula during their labor. But they're definitely more well-understood than postpartum doulas!)
Before we start, we just want to clarify one thing: the word "postpartum" means "after birth." It doesn't mean postpartum depression, unless the word "depression" is added after it. Postpartum doulas work with parents who've had a baby sometime in the past few months, helping them to navigate the often overwhelming practical and emotional challenges of life with a newborn so they feel more supported and cared for along the way.
Since postpartum doula support can make such a huge difference for new parents and since so many people have no idea what it is postpartum doulas can help with, we thought it was time we wrote a post about this! We'll hear from Marlee who is a postpartum doula serving our clients in Orange County and Long Beach, CA.
A few things to keep in mind about postpartum doulas:
First of all, it's important to know that a postpartum doula comes to you. Wherever you're living at the time you hire a postpartum doula, that's where they'll support you. Usually that means a doula is coming to your home, but I've also served parents who are staying with family or friends after birth, or even Airbnbs. This means that there is a certain amount of intimacy that comes along with working with a postpartum doula. When new parents are healing from birth, breastfeeding, and getting lots of delicious skin-to-skin with their newborn babies, postpartum doulas are used to seeing families in various states of undress... not to mention sometimes a certain amount of household chaos.
Postpartum doulas do not expect you to host them. Please don't worry about cleaning your house before your doula comes over! And you don't need to offer your doula something to eat or drink - Marlee is definitely comfortable getting herself a glass of water in a client's home if she's thirsty. That's not to say that sharing a snack or meal together with your doula during a shift isn't lovely... in fact, some of our clients ask Marlee to help them become more comfortable venturing out into the world with their baby, so going to lunch together can be great practice! Just please don't prioritize making food or drink for your doula over taking care of yourself and your little one(s).
If you're working with an overnight postpartum doula, they may let you know of any sleeping arrangements ahead of time. But not all overnight postpartum doulas sleep while the baby sleeps, so that doesn't apply across the board.Another thing to know is that postpartum doulas can work with you during the day or overnight. Some postpartum doulas offer one or the other (I only offer daytime support), and others offer a mix of both. It's sometimes difficult to find postpartum doulas who offer both because working an overnight schedule can wreak havoc on your body. That means that if you want both daytime and overnight support, you might end up finding two different postpartum doulas - one to work with you during the day, and another to come overnight.
Postpartum doulas are not medical professionals, unless they also hold an RN or other medical license. The term "baby nurse" has been used in reference to postpartum doulas, but in California the law prevents the term "nurse" from being used if someone doesn't actually hold a nursing license. If you have a medically complicated newborn and want extra in-home care from someone who is a medical professional (like an RN), you should search specifically for postpartum doulas who are also licensed medical professionals.
Postpartum doulas are well-versed in normal newborn behavior and appearance, and normal postpartum healing. They can't diagnose medical issues or mental health issues, but they can point out things that don't seem normal to them so that parents can get an opinion from the appropriate professional.
Often there are times when parents ask a pediatrician questions about normal newborn stuff that pediatricians aren't necessarily trained in. A postpartum doula is a great person to talk to for questions about diaper rashes, nail clipping, diaper brands, and so much more. (That's not to say a pediatrician will refuse to answer those questions necessarily - their answers just might be coming more from stories they've heard or their own parenting experience than from any specific training or education.)Postpartum doulas are great at referring. When there is an issue where an International Board Certified Lactation Consultant (IBCLC), pelvic floor physical therapist, chiropractor, massage therapist, counselor, new parent support group, etc. could be helpful, chances are your postpartum doula will have some recommendations for who you can work with. Of course this depends on the person you're working with and how well they're acquainted with the help available in your community. I'm always assessing when I'm with a family to see if the things they're really needing help with are things another professional will be more helpful for resolving than I will. And I'm passionate about getting to know the providers I refer to, so I know my clients have the best chance at having a great experience and getting the help they need.
Every postpartum doula is different. We each have our own unique practice, and many of us have particular areas of interest. For instance:
My postpartum doula practice has evolved to include a LOT of hands-on breastfeeding and bottle feeding support, because I'm also a lactation counselor.
I also have a child development background and love to help new parents learn to relate to and play with their newborns.
I love the peer counseling aspect of being a postpartum doula. I enjoy helping parents work through the decision-making process when facing a challenge, providing context, fostering meaningful communication, and helping parents come up with their own strategies for getting through whatever they're facing.
My postpartum doula support mainly focuses on education, problem solving, and supporting parents emotionally through their postpartum journey. When families are primarily looking for hands-on household help or care for their older children, I recommend other (cheaper) services that can meet those needs, like nannies, house cleaning services, or “mother’s helpers.”
This is why it's important to make sure someone you want to hire as your postpartum doula is a good fit for you. Many postpartum doulas (myself included) offer free in-person consultations for this reason.
So... what does a postpartum doula actually DO?
With all this in mind, I want to give you a glimpse into what a postpartum visit with me looks like. (And I'm specifying "with me" here because like I said, we all have our own unique ways of doing things).
So without further adieu, here is what you can expect during a postpartum doula visit with me:
Talking & listening
Postpartum doulas get it. They understand that you're going through a lot, that you may have ups and downs, and that you're running short on sleep. Sometimes a postpartum doula is worth their weight in gold just by listening deeply and without judgment to what you're going through, when not many others in your life are able to.
Answering questions about what's going on with baby (is it normal when they ____? Does their umbilical stump look ok? Are there any ways to help them nap for a little longer? How can I keep them awake during feedings?)
Talking about postpartum recovery. Often there are so many facets of this experience: breast health, perineal healing, incision healing, hemorrhoids, neck/shoulder/back pain from "new parent posture" (think staring down at baby for many hours a day), etc. Often there aren't many other people in my clients' lives they can share this part of their experience with, so it's important to me to offer a safe place to talk about the realities of living in a body that just gave birth.
Figuring out ways to manage postpartum life with a little more ease. Sometimes finding a rhythm when so much is new (and you're running on much less sleep than usual) can feel daunting - I'm here to help!
Debriefing after pediatrician or other medical visits. Often parents realize only after they’ve left the doctor’s office that they have about three hundred questions they had meant to ask. Sometimes talking with a postpartum doula about what happened during the appointment, what questions they had before, and what questions they have now can be really helpful in gathering their thoughts in preparation for their next steps with their care provider.
Talking about baby product options. From baby shampoo to sunscreen to nail clippers (and more), many parents love to get a postpartum doula's feedback on the products they're using on/with their newborn. Many postpartum doulas (myself included) are working with dozens of families a year, so we’ve seen how various products have worked for various families. There usually isn’t one right answer here, but a postpartum doula can share what they’ve seen working for other families to help you make a decision.
Offering resources and referrals when needed (from pelvic floor physical therapy to house cleaning services to information on newborn jaundice, and so much more). This is a HUGE reason to work with a postpartum doula! Especially if you don't have a lot of other people in your life who recently had kids nearby where you live and are familiar with all the options and resources available to new parents.
Talking about the huge transition that is new parenthood. Especially for first-time parents, it can be so important to have someone to talk to about the big life and identity changes that happen when you bring a new baby into your family. Like I said above, I really love the peer counseling aspect of this work, and these conversations with parents are one of my favorite things about my job. I love to witness the transformation that happens from expecting parent to new-parent-who-is-actually-responsible-for-a-tiny-human - it's so rewarding to see new parents find their sea legs in this new phase.
Hands-on help
Breastfeeding support is definitely the biggest thing here. There's only so much you can learn from reading about breastfeeding or talking to others - sometimes the best help is hands-on with the assistance of an experienced lactation support person. When I work with breastfeeding clients, I find that seeing the situation in person and being able to provide assistance in the moment - even through tiny adjustments - makes a huge difference.
Bottle feeding can be a great thing to work on hands-on too. I often teach parents "paced bottle feeding," which can be very difficult to learn from reading or watching videos. It's much easier to practice with your own baby with help from an experienced support person.
Getting comfortable feeding baby in different positions. This might include different ways to hold baby during a feeding, or ways to get comfortable feeding in other areas of your home than the primary area you probably find yourself in most of the time. We can also work on feeding in bed to help parents get more sleep overnight!
Bathing baby. Many new parents are pretty intimidated by the thought of giving their tiny little baby a bath. I can help families figure out where and how in their home baths might be easiest for all involved. I'm also full of tips and tricks to help bath time be more enjoyable for babies and parents alike.
Trouble-shooting diaper changes. This is a primary area of concern for many new parents. It can be surprisingly difficult to keep everything clean down there! I can also assist with care of both intact and circumcised babies, as sometimes there are questions around penis care. I can also help get you set up with a more ergonomic diaper changing area if you're finding that it's not very convenient for you.
Helping to heal a diaper rash. Sometimes this happens, and sometimes it's fairly easy to remedy. But sometimes, it's not. And it can feel overwhelming (and sad!) to see your little one feeling so much discomfort and feel like there isn't anything else you can do to help. If your baby has a stubborn rash, we can work together on some ways to heal it.
Babywearing. I'm not a babywearing educator or specialist by any means. But I'm well-versed in babywearing safety and if you have a carrier you've been using, we can make some adjustments together for a safer and more comfortable carry. (If you're in Orange County or Long Beach and are looking for babywearing help, check this out.)
Car seat education. Some postpartum doulas are certified Child Passenger Safety Technicians (CPSTs) and can help families learn how to install and use their car seat(s) properly. (Remember - most postpartum doulas are NOT certified CPSTs, so this isn't a service every doula will offer.)
Giving you a rest
If there's time during our visit together, I'm happy to care for your baby while you take a nap, take a shower, or have some alone time. I think it's really important for new parents to have a chance to reconnect with themselves and their partner (if there is a partner in the picture), so this is something I love to do. I can even draw you a bath with Epsom salts or sitz bath herbs if you'd like.
Practical household assistance
Usually the first three categories are the primary focus of my postpartum doula visits. But if we have time left, I'm also happy to help catch you upon dishes or laundry, neaten around the home, help you organize baby stuff or set up your nursery, make you a snack, or get a meal started for you.
In general, most of my postpartum doula visits are spent answering (a lot of) questions, helping with breastfeeding (often the primary focus of the visit) and/or bottle feeding, and chatting about how parents themselves are doing. That's a LOT of talking! That's why most of my client visits are around 2-3 hours - enough time for all that talking and hands-on support, plus usually some extra time at the end for me to hold baby while parents get a nap, shower, or some alone time.
If this is all sounding like something you want in your life, reach out to some local postpartum doulas to chat about ways they support families. And if you're in the Orange County or Long Beach area, I'd love to talk with you!
To read a list of reasons why people choose to work with postpartum doulas, check out this blog post.