What does a postnatal doula do?
It’s a fairly common occurrence these days that I tell someone I am a postnatal doula and a slightly blank look passes over their face before they tell me that they’ve heard of a doula being involved in birth but didn’t realise you could be involved after baby is born as well.
Doulas as a whole are a relatively new concept - they took off in the States in the 1990s and Doula UK was started here as a network of doulas in 2001. Training solely as a postnatal doula is an even more recent thing - some birth doulas go through spells of only working with families after birth, doulas focusing solely on the postnatal period are a new but growing group. Working as a postnatal doula is ideal for me. As much as I would love to be able to support women during birth, that wouldn’t work with my family at the moment. I have no-one who can come and look after my children if I disappeared off to a birth for a couple of days! With the postnatal work, it is possible to plan it in advance a little more and fit it around my childcare responsibilities. That’s not to say it’s always plain sailing when there are small children involved - my first postnatal job had a delayed start after my younger two caught chickenpox!
The Doula UK website has a section summarising the evidence in support of doulas here. It’s fair to say there isn’t a huge amount of evidence yet focused on the role of the postnatal doula - there is good evidence that being supported by a companion during childbirth benefits both the woman and the baby and it seems reasonable to think that some of these benefits will continue once baby has been born. A recent Cochrane review(1) looked at the ways women are supported by a doula or birth companion during childbirth. These included through providing information, advocating for women and offering emotional support - all of which continue to be valuable after birth.
what is the role of a postnatal doula?
The training I did with Younique Postnatal was structured around the pillars of support that a doula can give - emotional support, physical and practical support and information. The balance between these pillars will be different for each client, and will likely change over the time that we are working together as everyone settles into their new roles.
The first visits with a new client might involve more emotional support, giving them a chance to share their birth story and talk about the challenges coming up for them with a new baby. It can be invaluable knowing that you can download what you are feeling to someone who will listen to you without judgement, and without jumping in with their own experiences. Many women are finding that their birth was not the simple, straight-forward experience they were expecting - starting to share that story after birth can really help to begin to process the experience. For some women, having their story heard and validated by someone like a doula will be enough, for others it can be the start of a journey to find further support.
We live in a world where we are drowning in information - I was talking to a client recently about how the social media algorithms had worked out she had given birth and were showing her all sorts of posts about how her baby should be behaving and the myriad of products she could buy to help. But it can be difficult to pick through all of this information, to find what is backed up by evidence or is the most up-to-date advice.
This is where a doula can be hugely beneficial - giving you an informed view without having a vested interest in selling you a particular product or trying to convince you that there is one right way to do something. I aim to be objective and evidence-based when sharing information with clients because this is what is most useful (I knew that economics degree would come in useful at some point!). But I also know from my own experience with my four children that there is rarely one way or a ‘right’ way to do things - every baby is different and it is about bringing together what evidence there might be, the different strategies or techniques that you could try and what works for you and your baby.
There is the practical support that a postnatal doula can offer as well. There might be some jobs around the house that make it really hard for you to relax when they aren’t done. Maybe it’s hoovering the floor around the sofa where you sit to feed - for me, it was always the stack of washing up next to the sink. Or maybe it’s having two hands free to write some thank you cards for all the new baby gifts - no-one is expecting you to find the time to write them with a new tiny baby but you know it will bug you until they are done. We can get on with some hoovering or washing the bottles from last night for you, or cuddle baby while you get those cards written! As time goes on and new families grow in confidence, the support can naturally switch from focusing on emotional support to more practical support.
I wish I had hired a postnatal doula
My eldest is 11 now so postnatal doulas would have been in their infancy when he was born. I didn’t want a birth doula when I had him but I wish I had known it might have been an option to have some support after the birth - I really believe it would have changed how I found the first few months of motherhood. When he was born, all the family were really supportive and came to see him in the first few weeks but then they had to go back to their normal working lives. The downside of having fairly young grandparents is that they were all still working when he was a baby! I would have found it really valuable to bounce my thoughts and worries off someone with more knowledge - despite having had plenty of experience with babies with my younger siblings, I felt very uncertain with a new baby of my own and doubted my instincts and decisions. Some days I would have used a doula visit to take the opportunity to have a nap - it turns out he was a pretty good sleeper (compared to his brothers at least!) but having such a long labour had taken its toll. It might have helped as well with some of the basics - despite doing several antenatal courses and having the experience of looking after my siblings I can still remember getting to about day 5 or 6 and finally realising that he wasn’t just going to put himself to sleep when he needed a nap!
When I had the others, it would have been really helpful to talk to someone about the challenges of having two (or more) and to help with the constant physical challenges - maybe reading a story to an older one while I fed the baby or preparing some food for the ever-hungry toddler. I felt more confident with the younger ones - I had managed to look after a new baby once so must be able to do it again - but they all threw up their own worries and challenges. In particular, they all had very different sleeping habits and having a sounding board to talk about strategies for naps or someone to just cuddle the baby while I played with the older ones would have been great.
is a postnatal doula worth it?
There’s no hiding the fact that hiring a doula does cost a chunk of money - it is an investment but it can have such a positive impact, both emotionally and physically, when you become parents for the first time or when you are welcoming another sibling into the family. Many of us will spend a lot of money kitting out the nursery or buying a comprehensive travel system before baby arrives but it might be that we could buy less stuff for baby to begin with and instead invest more in ourselves as parents.
References
(1) Perceptions and experiences of labour companionship: a qualitative evidence synthesis (2019) Bohren, M., O Berger, B., Munthe-Kass, H., Tuncalp, O. available here