Monday, June 14, 2010

Post Partum Doulas

In a world where the goal of SuperMom reigns supreme, tender new mothers are often left feeling overwhelmed by the expectations they have of themselves. Women often feel if they are not actively managing their post baby weight, contributing to the family financially, keeping a clean orderly home, creating meals, tending to all the physical and emotional needs of all family members, being an attentive friend with a social life, enjoying sexual relations with her partner, succeeding at having her baby trained to sleep most of the night, and with a wealth of energy to complete even some of these tasks immediately postpartum, they are not succeeding as the mothers they hoped they'd be.

The reality looks more like this: a new mama is TIRED. Breastfeeding sometimes has a few glitches that take a little while to work out. She is often left feeling quite tender physically and emotionally after the birth experience. Just getting enough to eat and finding the time to nap to make up for those all night nursing marathons are challenges. The reality sets in after a few days home with Baby that she can either shower OR do the dishes in a day....probably not both. For a woman used to being a multi-tasking, high-achieving dynamo, feeling exhausted, tearful, confused, spit-up stained and leaky-breasted can be quite a shock, no matter what all the books say.

In days of old, we used to live tribally or in close contact with extended family. The home and hearth would be tended to by other members of the family community, and new mothers would be able to focus on healing after birth. Most importantly, they would have ample time to fall in love with and bond with their new babies, receiving experienced, wise guidance from other women in the tribe about breastfeeding and baby care. The new mother would grow solidly into her role without being overwhelmed by needs beyond hers and her baby's, and her confidence would blossom in the light of the loving support of her elders. In some traditional cultures, mothers are sequestered for about 40 days after birth skin to skin with their babies, receiving daily massages and being fed special foods prepared by other women. Contrast this image to our expectations of SuperMom, and we can begin to understand why the postpartum experience is often feared, and high rates of depression reported.

I would like to introduce you to the important, beautiful work of the postpartum doula. A postpartum doula is a woman who is experienced in supporting mothers in the days and weeks following the birth of a baby. It is a role which is very simple in its intent: to ensure a new mother has what she needs to feel good about motherhood, and to help build confidence in her mothering skills. How does the postpartum doula achieve this? By giving Mom freedom to focus on bonding with her baby and family. To achieve this goal, a postpartum doula's skills are many and varied. She provides knowledgeable breastfeeding support, usually encouraging breastfeeding on demand and helping with basic breastfeeding challenges. She answers general baby care questions. Nutritional support is provided by doing some cooking of wholesome meals and snacks for the family. Organizing and light cleaning can help take some of the strain off Mom so she has an orderly environment within which to hang out with her baby. The postpartum doula can integrate siblings into sharing in the care of the newborn, and she can care for them while Mom naps with Baby.

The mother's partner and other adult family members, such as grandmas and aunties, greatly benefit from a postpartum doula's care as well. They learn, through the doula's example, how to confidently physically and emotionally support the mother's unique needs. They learn evidence based information about breastfeeding and baby care, and also get time to rest and bond with Baby when other basic needs are met. Very often, the other parent is also overwhelmed by the needs of a freshly birthed mother and baby. As sleep deprived new dads/moms, they are often still expected to provide financially, do some of the household tasks and cooking, care for other children, and weather the ups and downs of the emotional landscape of new parenthood. A postpartum doula ensures partners also feel cared for, which allows them more time and energy just to relax with their partner and forge their own relationship with Baby.

A postpartum doula nurtures the new parents with her loving, wise presence. While she may bring food, wear the baby in a carrier or sling, and do some laundry while the parents nap, provide breastfeeding support, gently guide visitors to limit their time when she notices Mom is getting tired, and help parents sort out what information is good for them and what isn't, the postpartum doula is primarily someone who listens. She can hear the deeper concerns behind questions, and provide a non-judgemental space within which parents can process their experience. She helps sort out feelings surrounding a difficult birth experience. She reassures the emotional ups and downs are normal, and can help to guide parents to appropriate resources when things veer outside of that range. She is a wealth of resourceful information, able to help the couple choose products that are appropriate for their lifestyles, help them find parenting groups to alleviate the sense of isolation new parents sometimes experience, and can guide them to a myriad of professional resources.

It is important to note that a pospartum doula is not a Baby nurse. A doula cannot “diagnose” or “treat” anything, nor provide any medical advice about a mother's or baby's health. In her experience, however, she can gage when something is a concern, and guide the parents to the proper resources to get things checked out. She can, however, use safe, holistic remedies to help with the basic challenges of breatfeeding and postpartum recovery, such as recommend warm compresses and cabbage leaves for engorged breasts, sitz baths for perineal tears, or massage for “new parent neck”.

Millie Tresierra, Senior Postpartum Doula of MotherWit Doula Care in Montreal, has been a parent/baby supporter for many years. She says, “Rest and nutrition are the two vehicles that will carry Mom and Baby through the first few months together. Everything else will fall into place around these two things.” Her job is to ensure the integrity of these vehicles, and says sometimes she literally tucks the whole family into bed for a few hours while she tidies, encouraging them that emails and phone calls to enthusiastic family and friends can wait. She likens her doula work to holding a little boat (the family unit) tenderly in her hands, supporting it as it learns to navigate the unpredictable waters. Little by little, she releases her hands until that boat learns how to weather the changes in the waters with confidence, and is able to float all on its own.

Typically, Millie meets couples before the birth of the baby to learn what is important to them. What do they like to eat? What makes them feel rested? What are their parenting ideas? What challenges may they have with visitors and unsolicited advice from well meaning friends? What are their fears and concerns? She outlines a schedule that will suit the couple, and then she'll wait for their phone call informing her that the baby or, in the cases of multiples, the babies are born and that it's time for her to get to work and settle the parents into their new and exciting journey.

If a mom admits, “You know, I wouldn't tell this to just anyone, but all my partner and I want to do is sit here and stare at our baby for hours and block the rest of the world out for awhile. Is this normal?” you will most likely hear a postpartum doula respond, “Honey, that is music to my ears.”