Every New Mama Deserves a Postpartum Doula. Who Are They? What Do They Do?

Jacqueline Sears

The steps you take in pregnancy are your first steps in mothering, and those nine months are a huge investment of time and energy and emotional growth as you prepare to meet your baby. Many families here in Richmond choose to hire a professional birth doula to support, empower, educate, and advocate for them through this exciting and overwhelming time.

But did you know there are professional doulas trained to help families after the baby arrives? They are called postpartum doulas and they are a fantastic resource to be aware of as you begin to think about and coordinate Your Postpartum Plan.

I sat down with McRae Brittingham, CPD (toLabor, CAPPA) and Erica Angert, PCD (DONA)—two certified postpartum doulas serving Richmond families—to better understand the role of the postpartum doula and why you may want to consider hiring one to fill in the gaps for your family’s needs as you transition into life with your new baby.

What is a postpartum doula and in what ways can postpartum doula services benefit a new family? How do you see the postpartum doula as integral to a healthy postpartum transition?

A postpartum doula is an expert trained to provide emotional, physical, and evidence-based informational support to new families as they transition into life with their new baby. We are trained in topics of postpartum mood disorders, bonding and attachment, breastfeeding, mothering, and newborn care. We empower parents to trust their instincts and to make their own decisions and we gradually step back as mom recovers from birth and as everyone in the family adjusts. Studies have shown that when new parents have support, they have fewer instances of postpartum depression, they bond better with their babies, and they feel more empowered through the transition. Many people rely on family and friends for help, which can be really wonderful, but one benefit of hiring a postpartum doula is that you’re getting a professional who won’t take your parenting decisions personally and who really is solely there to support you in your role.

What does a typical shift look like for you?

We are hired to help meet the immediate needs of our parents and to help them accomplish whatever is important to them during the time we are there, things that can be difficult to get done while also caring for a newborn, like meals and light housework or taking a shower. Along with the hands-on help that’s so needed in those early weeks we also have an eye on the longterm, and we try to bring everyone into their new roles by making space for them to process.

Our shifts vary greatly by family. We may spend time just talking about how things are going and discussing questions a client has, or information they have heard from others, to help them to navigate all the various options. Mom or Partner may take a nap or a shower while we work on dishes, laundry, or organizing baby items. If there are older children in the home, we’ll spend some time with them as well, talking with them—at an age appropriate level—about how things are going with their new baby around.

For an overnight shift we might arrive between 10pm and 12pm to establish a plan with the family for the evening—if mom would like the baby brought to her to nurse, or if she’ll be pumping or bottle-feeding at a certain interval. We’ll discuss any chores the parents would like us to do while baby is sleeping or if they prefer that we sleep while baby sleeps or some combination of the two. If mom is up nursing or pumping we may chat about how things are going, or we’ll take that time to get a few chores done if mom is nursing in bed next to a sleeping partner. While nightshifts can be less interactive by their very nature we are also available to our clients outside of the time we are in-home. Nighttime parenting has so little support in our society, having someone right there with you while the rest of the world sleeps can be really reassuring.

What is the average hourly investment for a postpartum doula here in Richmond and how do families typically contract postpartum doula services?

The average hourly rate is $20-35/hour depending on training and experience, and most postpartum doulas are open to as few as 2 hours per shift up to 8-hour overnights. Some clients want to start with as much as 4-5 hours a day every weekday, while others may only need one or two days a week. Some families will contract more hours up front and taper off care as time goes by. We’re really open to a lot of different schedules and budgets.

What are some of the reasons a family might be unsure about hiring a postpartum doula? Or maybe they could use some talking points to communicate the benefits with their partner, or other family members, who don’t yet see value in the investment—what would you say to them?

A lot of new parents just don’t realize how little they’ll be able to get done, how much of their mental and physical energy is going to go toward their baby, and how crucial it really will be to have help. Many new families don’t live near to their parents or extended family members who would traditionally help out in those early months. Grandparents and In-laws who live far away—and want to provide new parents with the support they need but aren’t able to be there in person—often pay for our services. Asking for postpartum doula hours as a shower gift or as part of a registry, and having a conversation with parents or in-laws about anticipated needs and the different ways those needs can be met once the baby is born is a good place to start. Friends and family can be helpful at bringing food and offering to hold the baby, but they have lives too, so having someone in your home who’s there just for you when you really need them, is pretty fantastic.

Share your top three misconceptions about postpartum doula work and what are the facts?

Sometimes people think postpartum doulas are just for women in crisis, like those who have postpartum depression—we can help anyone through the postpartum transition, and our clients don’t need to have postpartum mood disorders or extenuating circumstances to hire us. It also really makes sense to hire a postpartum doula before baby arrives so that we can be there from day one or day two, rather than waiting a few weeks, which is a breaking point for a lot of new parents. Moms experience a hormone crash around 3 weeks postpartum, and that’s also when a lot of help is typically drying up and the lack of sleep is catching up with the parents. We get a lot of calls around 2-3 weeks from desperate parents, and we’re happy to take those clients as our schedules allow, but it’s great when people hire us prenatally and don’t have to get to that point of complete crisis.

Another common misconception is that postpartum doulas are hired to take over baby care like a nanny or a baby nurse. A postpartum doula’s job is really to help empower the family as a whole. We may take the baby for an hour or two at a time while the parents get a much-needed break, but we’re always trying to work ourselves out of a job, making sure the parents are feeling supported and are gaining their own confidence in caring for their baby (or babies) on their own.

The word “doula” often gets associated with a certain kind of birth and parenting, one that tends to be more “crunchy” for lack of a better word, so people may think that we only support women who are passionate about breastfeeding or planning to parent in one specific way. Just like birth doulas support families through births of all kinds—unmedicated to planned cesarean—postpartum doulas make space without judgment to support all parents as they find their own paths.

When a new baby is born, parents and extended family (grandparents, aunts/uncles, etc.) are also learning to navigate their new roles and a new family dynamic. How do you view your role within this delicate context and what are your goals for your client families?

One thing that can be challenging for older generations to understand is how much medical advice has changed since they raised their children, and if a client makes a different decision than their parents did, for example, it can start to feel personal—like a judgment on them—even if it’s not at all. Bringing grandparents into their roles is important to us as well, just like bringing in parents and older siblings, so we also try to make connections with them to discuss how things are going. We can marvel at how much things have changed in 30 years without making better/worse statements. Everyone needs to feel heard and appreciated, especially during such a dynamic transition like having a new baby around. Long after we leave a particular family, they will remain intimately connected, so nurturing these important relationships at their start is a priority for us.

I often hear the catchphrase “Every Mother Deserves a Doula” and these days it usually describes the essential nature of hiring a birth doula. Does every mother deserve a postpartum doula?

Yes, everyone deserves to have the support they need during such a transformative time in their lives. Friends and family are busy, or may live far away, and as much as they would like to help it can be hard to rely on others. Postpartum doulas are hired to serve their clients, so there is an arrangement that can be found for every family and it doesn’t have to be a huge investment if that’s really not in the budget. We also stay available and in-touch with our clients outside the hours we are in their home—checking in by phone/email/text, answering questions, sending links to local resources, celebrating successes, and helping to troubleshoot.

What is one of your biggest challenges in your work? How about your greatest achievement?

It can be challenging when our clients are reluctant to seek out help or to make that first phone call to reach out to other resources that we know could benefit them. If we see breastfeeding issues, for example, we can offer our own wisdom and tips, but if the client needs the help of a board-certified lactation consultant (IBCLC), we provide names and numbers and have to hope that she’s going to reach out and make an appointment. The same goes for mental health professionals, physical therapists, physicians, support groups, and all sorts of other community resources. Finding time to make phone calls can feel completely overwhelming to someone stuck in the beautiful storm that those early weeks can bring, so we just keep encouraging our clients to reach out, and help them to find the time and energy to get the help they need. We’re even happy to go along on an appointment to help with the baby or older kids, if leaving the house feels like too much for a mom to handle on her own.

For both of us, I think the major payoff for this job comes when working with a family from the first week or two—when parents are stressed and sleep-deprived and have hundreds of questions they may be afraid to ask—through a few weeks or months later when they’ve grown more confident, they’re rested, and happy with how everything is going. They’re really ready to parent confidently at that point, which is bittersweet for us because we know our time with them has come to an end, but at the same time we know we’ve done good work.

What is the most rewarding aspect of your work?

Making a deep one-on-one connection with every client is pretty amazing. There are so few jobs that offer this level of intimacy and personal connection every day that we go to work, and that is really rewarding. Developing these meaningful relationships with our clients allows us to better serve them, to help them to listen to their instincts, and to find their own voice.

What are your best tips for families as they transition with their new baby in the postpartum period?

Trust your instincts. Take what you want from all the advice you’re getting, and leave the rest. If you can figure out a diplomatic way to respond when people give you advice that sounds insane to you, it can make it easier to let it just roll off your back and stay focused on the relationships in front of you. You know what’s best for you, your baby, and your family.

What would you like to see for Richmond moms, and Richmond’s birth scene, where postpartum doulas are concerned?

We would like families to know they don’t have to struggle through the postpartum time alone, and that they can hire a postpartum doula to support them in their experience.

In the coming years, we hope to see more care providers recognize the value of postpartum support and postpartum doulas, and encourage their patients—before their babies are born—to consider their plans for help and resources in the postpartum period. Birth doulas and lactation support professionals are in a great position to understand the unique role of the postpartum doula and to recommend our care services to their clients.

Awareness for postpartum doulas has improved greatly in the last couple years, but we still spend a lot of time explaining to people what we do, and the overwhelming response is always, “Wow, where were you when I had my babies?” We would love to see Postpartum Doula become a household word.