Two years ago I was asked to speak on a panel about pregnancy support. In our conversation on postpartum care and support I was asked “What do mothers need in the postpartum period. I swiftly said “We don’t need you to come and hold the baby. We need you to come and hold the mommas.” I did not think of how profound the statement was until people kept starting nearly every conversation with me for 3 weeks about that very statement.
I surely meant it when I said it, and as a doula and mom of 2 I surely knew it was accurate. The more I thought about it I realized how our community truly needed to hear these words. This shift in mindset on postpartum care and support is the true magic. Placing the mother/birthing person at the center of care and attention during this vulnerable time is what will also help us shift from the narrative of maternal mortality to vitality. Of course the baby’s needs are important. If we do not surround the mother with love, education, compassion, and support we run the risk of losing her mentally, emotionally, and/or physically, the baby’s best known source of love and care.
The Commonwealth Fund notes that “Nearly two of three maternal deaths in the U.S. occur during the postpartum period, up to 42 days following birth.” 11-23% of these deaths were due to mental health issues, mostly resulting in suicide and substance abuse. A large portion of these deaths were preventable. Some would say “How?” In my experience I would have to say “with better care and support.”
Too often parents enter into this new phase of life without any education, and I don’t just mean pamphlets and a quick hospital video. They do not know how to bathe their baby, how to keep them warm, common conditions, symptoms of concern, or when to seek medical help. And that’s just the baby! Lest we forget there is very little of the same on what the birthing person will experience after delivery in relation to hormones, physical changes, bleeding, and when to seek medical help. My clients will all attest to hearing me say this “Your mom is cool and all. But is she prepared to answer these questions for you and advocate for you in the time of uncertainty…at 3:00 am? This is why you need a postpartum doula.”
The role of the postpartum doula is very similar to that of a birth doula. We are there to educate, advocate, and to provide emotional and physical support. Postpartum doulas are not nannies, housekeepers, or cooks. While many offer a scaled down version of some of these services: cleaning pump parts, warming up a meal, changing the baby’s laundry/carrying it to the nursery, or helping your partner prep meals for 2 days; this is not the core of our work. Those are in addition to “holding the mommas”; which looks like your doula addressing the following during your prenatal visit:
- Outlining your postpartum visits
- Scheduling your first home postpartum visit
- Helping you create a postpartum plan that includes support from your loved ones that may include caring for other children, cleaning your home, cooking, and shopping.
- Giving you a list of recommended supplies for you and your baby, ranging from pads to coconut oil.
- Sharing recommendations for an infant feeding specialist, pelvic floor therapist, andpediatrician
- Providing you with tools and resources on infant feeding, bathing, general care; vaginal/wound care, bleeding, and preeclampsia
Once you have delivered your baby they should show up within 24 hours to complete a wellness check of you, baby, and your partner. They will help answer any questions you may have on the physicality of this beautiful transition and/or the piles of paperwork you have to complete, and advocate for anything that you feel is missing.
Your home visits will begin in the same fashion, with a wellness check and an opportunity for anyone in the home to ask questions. Now listen, your tenured doulas are going to invite everyone into the room for the check-in and Q&As. Why? Because they understand that those are the folks that will be in the home most of the time. So, they also need to know what to look for and what to do.
As time permits in the visit your doula may prepare a meal for you, wash some bottles, teach you how to bathe and swaddle your baby,put together the swing, help bind your belly (if trained), and keep an eye on the baby so you can shower. But their priority is making sure that you are mentally and physically well, and you have the knowledge necessary to care for yourself and your baby.
This level of wisdom sharing, care, and support is essential to the birthing person feeling prepared and empowered. Together it provides a level of confidence necessary to make it through the tough moments. If they know up front what cradle cap looks like and how to care for it…what’s the appropriate amount of lochia and what to do if she exceeds that they are less likely to panic or miss critical cues for immediate care. This is what it looks like to “hold the mommas”. Wrap them in love, wisdom, care, intentionality, and compassion. This is something we all can do whether we’re a doula or not. That’s the real magic of true postpartum care.
Contributed by ONAtley
PSS: Cultivated Care for Perinatal Wellness