Post partum doula care – Why it matters more than you think

When you are a tired, cranky, bleeding, hormonal, hot milk factory taking care of a tiny helpless human, things get difficult. You have trouble remembering what you’ve read about baby care in those fat books and websites with judgy mom-forums. (Is my baby going to die or get cancer because I used that store-bought lotion on her instead of organic virgin coconut oil??)) You don’t remember the tips your doula gave you in your prenatal meetings about taking care of yourself. (It’ll be ok if I go to Target to get this one little thing even though I have to waddle and can’t figure out how to nurse without flashing everyone.) You are having conniption fits because your house has gone to crap and you HAVE to have it clean. And what is this bottle of water for again that you’re supposed to squirt — where?!?! when you pee?

That, in a nutshell, is why I do postpartum visits with my clients.

And somewhere out there, some first-time mom just thought, “Well, that won’t be me. I know what I’m doing. I studied plenty of this stuff and I am PRE. PARED. I don’t really need a postpartum doula visit.”

I hope you are right. But just in case you are a normal human being like the rest of us, let me explain what I do at postpartum visits, why it’s different from what your regular visitors do, and why it matters.

Here are some common issues that arise during the first few weeks after having a baby and some things I do at postpartum visits with my clients:

  • Breastfeeding problems
    • Some people don’t have any, which of course is the best!
    • Engorgement, mastitis, tongue ties, latch difficulty are what I most commonly see of those who do have problems.
    • Teaching how to use a pump if she isn’t sure how
  • Difficulty getting rest
    • We talk about her options for sleeping arrangements, and how to do it more safely if she chooses to go a different route than the standard modern advice
    • We talk about side-lying to nurse so she doesn’t have to be up
    • We talk about a postpartum basket she can have nearby. If she doesn’t have one, sometimes I go around her house and fill it with the stuff she needs.
    • We talk about baby slings to keep a happy baby (unless you are a lucky one whose baby hates all slings ever invented).
  • Overworking/heavy bleeding
    • I remind her about the list in the binder I gave her where she can jot down what tasks are most pressing in her mind, and how we can convey these needs to the family and friends who come to visit.
    • I review why resting in bed or on the couch for the first three weeks is important. (Your energy stores are being used to repair the blood vessels in your uterus, replenish blood that has been lost, and make milk for this human child you just birthed – something that has been compared to running a marathon when it comes to the calorie consumption needed to birth a baby.) Resting as much as possible and letting others do the work around your house will help make the remaining weeks of recovery go much better. Take it from someone who did it both ways…rest for the first 3 weeks!!
    • Sometimes I end up finding what is in her cabinet’s and making dinner for them that they can easily warm up later. Even if she hasn’t had someone grocery shop for her, I can make something delicious out of very few ingredients. It’s a personal skill.;-)
  • Mood swings
    • Hormonal mood swings happen around the time a woman’s milk “comes in.” It’s normal and it’s ok! I encourage her that these feelings are temporary and there is light at the end of the tunnel. That sounds like nothing to some people right now, but it’s a big deal to be reminded of that in the moment.
    • If some of her mood swings stem mostly from sleep deprivation (which also seems to escalate hormonal mood swings for some of us), we talk about her sleeping arrangements and solutions to catching up on sleep that has already been missed. Sometimes I end up keeping an eye on the baby and rocking him or her back to sleep so mom can get a solid nap. Sometimes we talk about when she can express some milk and have her husband or breastfeeding-supportive relative give the baby a bottle of mother’s milk so mom can continue sleeping and get at least one good 4-hour stretch of sleep in per 24-hour cycle.
  • Her birth story
    • I ask her what she thought of her birth or if she had any questions after having some time to process it. Most moms love to tell their birth stories (unless they were traumatic – then she may not want to…but some feel better after they do! It just depends on the mom.) And I want to hear them tell it from their perspective, not only because it’s interesting but because I’m listening for keywords that may be signs of post partum mood issues or traumatic interpretations of her birth.
    • I keep a log of notes from her birth that I give her. Sometimes we have to fill in the holes together if it was a really fast, intense birth and I didn’t have time to write down everything in the moment. Moms have told me this has been really helpful for them to remember what happened when, because labor and birth can be a blur. You are in the ZONE when you’re laboring. It’s nice to have notes to look back on later while you sort out the details of this crazy event they call birth.
    • Sometimes moms have questions about why the doctor or nurse did something. We talk about it and write down anything you might want to ask them about at a later date.
  • Needing referrals
    • Sometimes moms and their families don’t recognize when they need additional professional services. Sometimes it take a fresh eye to pinpoint a problem, bring it to the forefront, and give you the right names that can help you deal with the issue.
    • My most common referrals are to chiropractors, tongue and lip tie revisions, and certain IBCLCs with many years of experience if it’s an issue beyond what I can help with. Sometimes it may be a professional counselor/therapist for a traumatic birth, or a cranial-sacral therapist for an issue the baby may be having with feeding/colic.

Can you see that I’m not just coming to see your baby and all that adorable spit-up? (Although I’m sure I will tell you how cute he is while I’m there.) A postpartum visit wraps things up. It helps move you in the right direction. It encourages you in your mommyhood, because – let’s face it – it’s rough sometimes! I can fold some towels, switch the laundry over, warm up dinner, or hold your baby while you shower and dress in Real People clothes so you feel somewhat normal again. But I’m really there for so much more!

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