The Cost - and Worth - of a Doula

Many people may wonder about a doula's fees. Here is a GREAT article breaking down doula fees. Here is an exerpt:

If you charge $400 per birth, this is a simple breakdown to consider:
Time with parents – 5 hours (prenatals and phone calls)
Time at birth – 10 hours (sometimes much longer, sometimes much shorter, but 10 is a midline average).
Time in postpartum – 3 hours
Postpartum visits if you offer 2 – 3 hours
Driving time – 3 hours average.
Prep and research time – 2 hours
At 26 hours, you’re rate is approximately $15.38 an hour.

This is just an example, but you can see that doulas are not getting rich in our line of work. I can only speak for myself to say that I do this work because it is my passion to help families have the best birth and postpartum experience they can have!!

As for the WORTH of a doula, I would have to say (in my unbiased opinion, ha ha) that we are priceless! You can never get back your birth experience. You can never get back the first few precious weeks of your baby's life. Yet you will always remember them, and wouldn't it be wonderful if you could experience and remember them with joy and no regrets? This is not to say that doulas are a magic pill or cure all, but evidence does show that they contribute to a better birth experience, increased breastfeeding success and reduced rates of postpartum depression. I once read that hiring a doula is making an investment in your family. I couldn't agree more! Beginnings matter, and you and your baby deserve the best beginning possible!

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If you are having a hard time financially and want to have a doula, try asking your friends and family to put money towards one for your baby shower. Or forego some of the baby products we all think we need but then only use once or twice (wipe warmer, diaper genie, swing, port-a-crib, 10,000 onesies). You may also look for doulas who offer discounted rates or a bundle charge for multiple services (as I do with combined Birth and Postpartum services).

New Mama Myths

I found this great handout on Penny Simkin's site and wanted to share it with all of you! Would you agree with these myths?

NEW MAMA MYTHS

By Timara Freeman-Young

Myth

Mothers fall in love with their babies upon first sight.

Truth

There is a wide range of reactions that mothers have upon meeting their baby on the outside for the first time. Some birth mothers have a rush of warmth and elation. However, surprise is the feeling most commonly reported by mothers upon seeing their child for the first time. It is not unusual for it to take days or weeks for a mother to feel love for her new child.

Myth

Breastfeeding is easy and painless

Truth

While some new mother/baby pairs have early and easy success with nursing, a great number of them require some support and/or skill building before breastfeeding becomes secondhand. It’s normal and expected to need some lactation consultation so set yourself up for success by knowing who you’re going to call ahead of time. Also, in the interest of full disclosure, breastfeeding can be painful in the beginning (though the pain DOES go away within days or weeks). Most women report a deep enjoyment of the act of breastfeeding once they and their babies have adjusted to the new skills.

Myth

Babies sleep

Truth

Some babies do, most don’t. Hence the 3 zillion “how to get your baby to sleep” parenting books. It would probably make more sense for someone to write a “how to survive without much sleep for the first year” book since that is the more likely scenario for most new parents. If your baby wakes up after every 40 minute sleep cycle or has confused day and night, know that you are in the norm. There are many great books to read written by authors with diverse parenting values so you’ll likely find one that works for you and yours. But remember that babies have very different sleep patterns from adults and that any behavior change takes time and patience (including with oneself).

Myth

It’s lazy to lie around after the birth. “I should be doing something.”

Truth

First, a reminder, you ARE doing something. In fact, you’re doing a lot of things. Most of them new and all of them in a somewhat altered state. Congratulations!

Some new mothers are compelled to return to their “normal” routine or to get out in the world soon after their baby is born. Others are content to snuggle in bed with baby for days. If it feels healthy and good for mommy and baby to get out of the house then by all means, get some fresh air. Kick your heels up (with doctor/midwife approval, of course)! But remember that, in the grand scheme of things, you are doing a huge amount by caring for your infant and yourself as you go through this gigantic adjustment period. If you want (and are able) to stay in bed for 3 weeks then dig in and catch as many zzzzs as you can.

Myth

Parents (especially mothers) will instinctively know how to parent

Truth

While the act of becoming a parent may seem sudden (especially for partners who don’t have the physiological 9.5 month transition period), it can take months or years to discover who you are as a parent. Some new parents move into parenting quickly and seamlessly while others do so more gradually. Faced with decision upon decision, new parents may find themselves reflecting on their own parents’ choices and decisions, looking to friends and family, or searching through books for insights on how to best parent their child. Many parents (especially the primary caregiver) benefit from a close community of other mothers and caregivers to gain support, ideas, and companionship during this time, either in the form of family, friend groups, or programs structured for new parents. Even if you’re a do-it-yourself kind of gal, now’s the time to find some other DIYers to sort it out with.

Myth

Parents will be in a state of bliss and have only fond feelings for their new child

Truth

Being a parent, especially if you haven’t done it before, can be really frustrating at times.  While some new parents feel like having a newborn is joyful and fun, it is perfectly normal to feel frustration, sadness, jealousy, and/or anger about your new situation or this new member of your family. 10-20% of mothers experience postpartum depression and a number of fathers struggle emotionally with the adjustment to parenthood. If you’re feeling blessed as a new parent, then celebrate your good fortune, if you’re feeling not so blessed, know that your day will come and remember to be kind to yourself and ask for help.

Bottom line, mamas, whatever you are feeling is OK. Motherhood is a huge adjustment and takes time, love, and patience with yourself, your baby, and your partner. Don't forget it is essential to ask for help and get support during this important transition. 

A Postpartum Doula's Promise

I loved the doula's promises from yesterday's post and wanted to make a list of postpartum doula promises. Here they are. What would you add?

A Postpartum Doula's Promise:

1. I will never judge you

2. I will always respect your privacy

3. I will be there to cushion you during your transition from woman to mother. I will listen and comfort you through the lows and celebrate with you through the highs.

4. I will honor your instincts and support your choices in parenting. 

5. I will connect you with the resources you need when you need them. 

6. I will do my best to work myself out of a job - leaving you confident and empowered in your new role - mommy. 

What is a Postpartum Doula?

Since discussing postpartum traditions in other cultures, I wanted to talk about what a postpartum doula is.

The roll of the postpartum doula is, in my humble opinion, essential. In our society, most of the people who would normally provide support to new mothers must work full time. Grandparents may be able to come stay for a week or two, but what about after that? Having a new baby is hard work! New mommies should not have to go through this fragile time alone. This is where the postpartum doula comes in. She fills in the gaps of care that a mother and baby need in the fourth trimester. She is a loving, supportive, and non-judgemental presence in the house. She is there not to take over care of the baby (as would a baby nurse), but to help ensure that the mother is rested, confident, and informed in how to take care of her own baby.

According to the DONA website, research shows parents who receive support can:

• Feel more secure and cared for
• Are more successful in adapting to new family dynamics
• Have greater success with breastfeeding
• Have greater self-confidence
• Have less postpartum depression
• Have lower incidence of abuse

Some of the things a postpartum doula does:

• Mothers the mother so she can rest, relax, and recover from her pregnancy and birth
• Gives the new mama precious time and freedom to take a shower, a walk, and or a much needed nap
• Helps with non-medical baby care including:
• Bathing
• Diapering
• Baby-wearing
• Umbilical cord care
• Soothing techniques
• Assists with breastfeeding
• Prepares nutritious meals
• Assists with older sibling care
• Helps with light housekeeping such as:
• Laundry
• Dishes
• Vacuuming
• Baby nursery set-up and maintenance
• Surface cleaning
• Runs errands or accompanies the mother on errands such as grocery shopping or doctor visits
• Provides local resources for pediatricians, lactation counselors, support groups, and parenting classes

Doula care can range from a few hours a day to around the clock, depending on the needs of the family. They can also be especially helpful with multiples, recovery after a surgical birth, a mama suffering from postpartum mood disorders, and homes with older siblings. 

The goal of postpartum doula care is to help the mother feel empowered,  supported,  and confident in her new role. This applies whether it is her first baby or 5th. Mothers deserve help throughout this transition!! 

For more information, see the DONA article here. 

If you are interested in postpartum care in the Inland Empire, CA - I am currently taking clients! Check out my website for more info :) 

Postpartum Rituals: Western Society and Other Cultures

As we know, pregnancy and birth are one of the most important times in a woman's life. They are life changing events, and are typically treated as such. Women and their partners spend months in awe over the change of the woman's body and the life growing inside. They have rituals like baby showers to celebrate the new life of their child. They (hopefully) prepare for childbirth to the best of their ability by reading, researching, and taking classes about the best way for them to give birth. They set up the nursery, wash the baby clothes, and eagerly anticipate their precious baby's arrival. As it should be.

But what about AFTER the baby is born? How often are we prepared for the time after we come home from the hospital or birth center? I know I wasn't. Sure, I arranged for my ride home, and my mom stayed with me for a week. But beyond that, I had no idea of what to expect or how I was going to "do it all". I think this is true for a lot of parents in our society. We assume that we will not need help, that we can do it all ourselves.

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I believe that mothers know how to care for their baby, instinctively. Does that mean we know how to do everything and need no outside help? No!! It has been common practice throughout history for many women to surround a new mother and instruct her in the art of mothering her child.

And what about the rest of it? The meals, the laundry, the showers, the first baby bath, the breastfeeding? Our society has such an attitude of the idea that women should be able to do it all, and 3 days postpartum, no less! I believe that this expectation of mothers causes immense undue stress, which can lead to lack of confidence in caring for her baby, postpartum anxiety, and even postpartum depression.

The author Suzanne Arms asks "Is ours not a strange culture that focuses so much attention on childbirth--virtually all of it based on anxiety and fear--and so little on the crucial time after birth, when patterns are established that will affect the individual and the family for decades?"

In other cultures, the postpartum woman is well taken care of. In Korea, mothers are cared for 21 days postpartum. They are on bed rest and keep their baby with them in their room at all times (source).

In India, the postpartum woman is kept in seclusion "and attended to by female relatives. The Rajasthani enforced rest, physical and emotional support during the establishment of maternal bonding and lactation may be crucial in preventing or relieving postpartum depression, and are similar to those observed in Nepal which are also considered to manage postpartum stress" (source) .

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In the North African Amazigh tribe, women are kept secluded and attended by a midwife for 7 days after birth. They are painted with henna and eye kohl, and perform some of the same familiar rituals as their wedding time. "The effect of these ritual actions was to allow the mother to rest and be cared for by an experienced attendant during the 10 day period required for her estrogen, progesterone and prolactin levels to stabilize and for her to recover her strength. Neither mother nor child were washed with water during this period, but were cleaned with oil and henna." (source) These rituals and care continue for 40 days postpartum, and the mother and baby are kept together constantly so that the maternal - baby bond can be established. The mother is also excused from all household chores during this time.

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In China and Nepal, "very little attention is paid to the pregnancy; much more attention is focused on the mother after the baby is born. This has been described as "mothering the mother." For example, the new status of the mother is recognized through social rituals and gifts" (source).

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In rural Guatemala, and the Yucatan, "ritual bathing, washing of hair, massage, binding of the abdomen, and other types of personal care" are common postpartum practices done for the mother (source).

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How does this compare to the postpartum care of mothers in America? Can we even imagine being doted on, tended to, having our hair washed, all our meals prepared and brought to us, being massaged, being "made up" to look beautiful, not having to worry or focus on ANYTHING but our new baby?

Typically a new mama will come home 1 or 2 days after giving birth in a hospital or birth center. Her husband (if she has one) may stay home for a week if possible, and her parents may be able to come to help for a week or two. For the most part, however, new mothers are left to fend for themselves, due to the nature of our society where it is rare to have support people who do not work full time. Mamas are supposed to recover from the birth, take care of their new baby, take care of their other children (if they have them), breastfeed successfully, cook for themselves and their family, keep the house clean, do the laundry, do the dishes, and try to rest. This is such an unrealistic expectation of our postpartum women. It does them and their babies a GREAT disservice by causing incredible stress because it is just not possible to do it all.

This is where postpartum doulas come in. My next blog post will discuss what a postpartum doula is and how she can help our precious postpartum mamas. :-)

Here are the articles where I got my information - very interesting, I recommend you read them!

Traditional Postpartum Rituals of India, North Africa, and the Middle East - Catherine Cartwright Jones

Korean Postpartum Rituals (21 Days) 

Postpartum Rituals and the Prevention of Postpartum Depression: A Cross Cultural Perspective - Kathleen Kendall-Tackett, PhD, IBCLC