Doulas, Apprentices & Midwives: Eight Ways to Help New Families Create Lovely, Healthy, Normal Postpartums
It may seem obvious that midwives and doulas are devoted to guiding families on their birth journeys. You are also are positioned to have an extraordinary affect on the postpartum period of families, and I would argue therefore on the launching of the family’s entire parenting experience.
In the US, families who have hired homebirth midwives and doulas are the only families who are also having routine professional postpartum contact in their home. This uniquely positions midwives and doulas as trusted birth professionals to also guide parenting foundations during both the prenatal and postpartum period. Your impact echos deeply in women’s lives forever for reasons beyond the actual birth. There are now many voices raising awareness about how an empowered birth helps leads to less on-going trauma and more empowerment in other areas. But as Harriette Hartigan, homebirth midwife and one of the first ever birth photographers has said, “Birth lasts a day or two, but parenting is forever!” Here’s eight starting points to help your families protect their postpartum period as much as their birth, to amplify those positive benefits dramatically, and long-term.
1. Encourage contact between mothers-to-be and new mothers to help them shape more realistic expectations of postpartum life. Prenatal clients can attend local (often free) support groups such as La Leche League as part of their preparatory education. Final postpartum appointments might be planned so that they overlap with another client who is due soon.
2. Use language that shares your expectations and gives parents a vocabulary to articulate the demanding needs of their new infant.
This may be basic to many midwives, but many new parents do not have this understanding. The year of having a baby can be helpfully reframed by explaining that the newborn’s first three months are really “the fourth trimester.” Accordingly, what the baby needs is a “womb with a view.” (This is a good time to lighten the mood.) Breastfeeding consultants have illustrated this concept by explaining to their mothers that the “natural habitat” for a newborn is on the mother’s chest between her breasts.
3. Remind new parents that most cultures around the world have some sort of a “lying-in period,” typically lasting 30–60 days or more. I remind parents that just as we’ve found healthy birth to be exactly opposite to mainstream expectations so can we expect healthy postpartum to be the opposite of common expectations. Resting in bed, being quiet, limiting visitors and taking frequent naps are all healthy.
4. Suggest that mamas aim for a week in bed, a second week on the bed, and a third week near the bed. Matter-of-factly inform the family, especially the extended family (if you have your client’s permission), that mama is going to be encouraged to stay in bed for a while after the birth and that she’s not “being lazy!” This also happens to naturally limit stairs (and aid perineal floor recovery) in the early recovery period. Dads and relatives often pitch in more enthusiastically during this postpartum period when they understand its value in helping to speed recovery (there’s that time issue again!) and in minimizing infections, relapses and breastfeeding problems.
5. Remind them that a true six-week postpartum window allows for the placenta site to fully heal and supports minimized bleeding and stronger recovery. It can be helpful to illustrate with your hands the size of a small dinner plate, and point out that if this healing site (placenta wound) was on the outside of the body, it would be easier to understand the need to move back into normal responsibilities slowly and with awareness. Women are more likely to take responsibility for their own recovery when they understand that if their bleeding picks up or get brighter red again, it means that the placenta site has been disturbed and suggests that they’ve been doing too much.
6. Tell first-time parents that this window of time is really a once in a lifetime shot.
Should they have another baby, there won’t be this comparative oasis of time available to adjust and bond—they’ll have a needy toddler or preschooler running about! Use Sheila Kitzinger’s description of the “baby moon,” that wonderful analogy that compares the postpartum period with a honeymoon: the purposeful use of privacy, seclusion, being served and protection from distractions while you celebrate and expand into love.
7. Advocate exploring how to maximize their maternity leave to protect their newborn, recovery and family adjustment. Many of my clients initially expect very limited maternity leave, either from financial constraints or job demands. Inform them about the Family Medical Leave Act and encourage them to check with their human resources department at work regarding time off. If they work for a company with over 50 employees, they may apply for 12 weeks of maternity leave and return to their old job or an equivalent. When the value of recovery and bonding time is normalized and encouraged, many times families find creative solutions for protecting or extending mom’s postpartum time with her newborn. I’ve seen many women find ways to negotiate and problem-solve at work for additional accommodation that initially seemed impossible.
8 . Encourage preparation for postpartum success, and help them strategize! Here in the West, there is typically a great naivety and disregard for family needs in the first weeks of caring for a newborn. And that it will be normal to be up most of the night in the first weeks.
Protecting time to rest and bond for all members of the family can be done in so many ways: planning ahead, accepting offers of help or hiring a postpartum doula. Some families have a potluck baby shower and ask everyone to make a double recipe, bringing one dish to pass and another to freeze. Their considerations need to include how mom will avoid stairs if there is no bathroom on the same level as her bedroom, daytime naps, childcare for older sibling(s), and how the other adults will also be getting extra rest.
The extraordinary bond that develops between mothers and their doulas and midwives is often transformative and treasured. Listen to them. Laugh with them. Tell them stories. Love them.