Planning for Postpartum: Help is Not a Luxury

In the absence of our families and tribal support systems, we need postpartum doulas.

The idea of a couple growing a family in isolation is new to human society. What we need, in the absence of our families and tribal support systems, is postpartum doulas.

Each of my postpartum experiences was different. For one I was largely dazed and happy, for another I felt upset and overwhelmed, and during one I was losing touch with reality. What they had in common was that I felt unanchored. Adrift. Lost in a sea of beautiful dreams and haunting nightmares that I felt obliged to keep to myself.

Surely this is just how it is. You struggle on, alone. Your triumphs are yours alone. Your grief and anger is yours alone. If you felt you could share, no one could understand anyway. Motherhood is a box.

For many of us, this is how it feels to enter into motherhood for the first or fifth time. You go to your box, sort yourself out, and occasionally over the next few months you’ll venture a peek outside, save up for a short staycation. But mostly, you are the box. You need the box and boy does the box need you.

Or not.

This is not how reproduction or motherhood was intended to be experienced. We were not meant to have children in insular families. The idea that two adults strike out on their own, away from all their support, and grow a family in isolation is new to human society. For millennia we lived in large family groups, tribes, or at least multi-generational homes. Having a baby was a group project, one where the family group circled around to provide physical and emotional support.

And still today, in many places a family is given weeks of continuous support and rest for the new mother. “In the Far East, Southeast Asia, India, many nations of South America and Africa and in Muslim societies around the world, there are varying practices for the postpartum time. They go by different names, a few being confinement (English term used in Asia) and zuò yuèzi (Mandarin for sitting moon), ansei (Japanese for peace and quiet),” writes Allie Chee, author of New Mother: Using a Doula, Midwife, Postpartum Doula, Maid, Cook, or Nanny to Support Healing, Bonding and Growth. These practices provide rest and support for the mother, sometimes for months.

In places where there is a strong tradition of postpartum support, it’s not just for the wealthy, and not just for live birth. There’s a 20-60 day routine and continuous support (physical and emotional) provided for every pregnant woman. Often the people providing the support are female relatives, but sometimes they are hired.

The routines for postpartum care often have specific rules for the postpartum woman to abide by. Avoiding exertion or certain foods or exposures top the list. They also include specific, nutritious food to help the woman recover her strength, natural remedies specific to the needs of postpartum women, assistance with bathing and personal care, nursing support, an extra pair of arms, and encouragement for gentle exercise. In China, Ms. Chee reports, these exercises carry inspiring names such as “Get Rid of Big Fat Butt” and “Improve No Saggy Breast.”

postpartum meals

In Western countries the idea of an extended resting period after birth or a restoring confinement is seen as a luxury, even a sign of weakness. This country was built by pioneers, loners, and cowboys: needing help after having a baby would have been a huge burden in most places. So we made do, and we did alright. We’re still here. Sort of.

We have some of the highest rates of postpartum mood disorders on the planet. More than half of us have mild depression postpartum. (My quick, sarcastic ‘big deal’ thought as I typed that is indicative of just how unhealthy our thinking about the needs of postpartum women has become.) Up to 20% of women experience actual postpartum depression, a debilitating and soul-crushing disease that is 100% treatable and probably 99% avoidable. And most cases go unreported. Because we’re too proud, too overwhelmed, too sad. The prevalence is just too high to ignore anymore.

Some western countries have tried to make up for our lack of postpartum support by giving extended parental leave times. This is a huge step forward. But just having time off work is not enough. We need help getting back to ourselves, body, mind, and soul. What we need, in the absence of our families and tribal support systems, is postpartum doulas.

A postpartum doula offers a good slice of the care required to get back in the saddle. She brings an open mind, willing heart, and vast array of knowledge about recuperation. She can help with healthy food preparation, nursing, natural remedies, home and baby care, processing your birth story, exercises, and local references when needed. Just like a birth doula, a postpartum doula makes the experience smoother for partners as well. Each doula is her own person and offers slightly different services and stores of knowledge, and you get to pick the one that best matches your needs. It’s the cowboy’s answer to postpartum care in a wealthy, hard-working country.

postpartum doula for help

The fees charged by doulas vary as much as their personalities, but in my mind this is what money is for. If I could go back in time, I know a postpartum doula would have saved me from the ravages of PP OCD, from mind-numbing exhaustion that threatened my marriage, and from loneliness. Feeling better during those sweet newborn days is worth every penny. Some of us don’t have the cash to even think about hiring postpartum help, and I dearly hope that someday it will be covered by insurance. In the meantime, might I suggest:

  • If you’re planning a baby shower, consider donation to a postpartum doula fund in lieu of gifts that may be cute and…may be used. A gift should be something that a person could not or would not get for themselves. Otherwise, it is simply an admission of how much money you feel is prudent to spend on them at that time. Use the money to pool for a doula fund.
  • If you’re going to have a baby yourself, save money for the postpartum doula and other postpartum care. Consider programs and aids for pelvic and abdominal strengthening, physical therapy, chiropractic, a therapist specializing in mama issues, take out and freezer meals, cleaning ladies, mother’s helpers. A postpartum doula can help with all these. It’s really not a luxury. Limping around without it may be normal, but it’s not natural.
  • If hiring help is completely out of the question, make a postpartum self-care plan with your partner. Line up 5-8 people who are willing to bring meals when you need them. Make a list of friends you can call anytime to talk. When people say “let me know if I can help” ask them when they can come over just to have adult conversation or hold your baby while you shower. It seems so small but, as many of us can attest, the benefits of this cannot be understated.

It’s best to hire your postpartum doula before the birth so your support is all lined up and ready to start immediately. You don’t want to interview people while you are in the thick of it, anyway. Meet more than one. Meet five if you can. Pick someone you feel safe sharing with, someone you feel will anchor you.

An anchor, after all, is not a luxury. It’s not a feature of only certain, ‘cultural’ boats. An anchor is a necessity. You don’t set sail without an anchor.

Image credits via Flickr CC: ahza collectionudeyismailWong’s Bokehgraphy


9 thoughts on “Planning for Postpartum: Help is Not a Luxury”

  1. I find this exaggerated and too dramatic-sounding. Sure, having a baby means a lot of work, is a major change in one´s life, and is both physically and emotionally intense. But: It´s not THAT hard as to require professional help for daily life. Unless there are physical complications or underlying psychological issues, nature has designed us to manage this intense time just fine. I think what´s crutial is to prepare properly for time after the birth, and to have a very supportive partner. And then, when the baby has arrived, to prioritize only yourself and your baby – everything else can wait or should be reduced to an absolute minimum. Of course, asking for help is fine, it´s not a weakness. But motherhood comes with the hormones to get you through sleepness nights, it comes with maternal instincts that help you care for your baby, it comes with incredible strength that makes you feel like a superwoman who has achieved a miracle. And personally, I must say, that despite the help that I received from my midwife (and that I am grateful for), I wouldn´t have wanted to have anyone around all (or much of) the time as the weeks and months with a newborn child are so precious and intimate and private. And I´m sure that that time is crutial for bonding with the baby, and anyone but the most immediate family would have been in the way for that.

    1. While I am sure its entirely possible for a new mother to manage on her own, spurred on by a cocktail of hormones, and adrenalin, postpartum help should not be considered a luxury. If your partner is adequate in meeting your needs, good for you! Many partners must go back to work after a few days. Leaving a hormonal new mother home alone, hungry, tired, and emotional, surely must contribute to the high rates of PND. Not all mothers have a journey that is filled with sleepy little baby smiles and a wave of oxytocin induced euphoria. Some just need a little help to ensure that they are eating properly, that their latch isn’t going to lead to cracked and bleeding nipples, that their baby’s seemingly constant need for attention, doesn’t have to fall on her, but can be taken care of by someone else.

  2. I really enjoyed this! I’ve been a DONA-certified labor doula since 2008 and love attending births, but having worked as a postpartum doula for the last year and half I have to say that providing this service to new parents is very dear to my heart.
    When my first son was born 15 years ago, both grandmothers (and both grandfathers, and then a brother and his wife and their dog) descended on our house and stayed with us, off and on, for the first month. Honestly it’s a blur — my baby was very high needs, couldn’t be put down, had food allergies and sensitivities, and breastfeeding was difficult (and no one had any experience with that). All the visitors must have helped but it was really pretty awful. To have had a postpartum doula instead — someone with no emotional ties, who knew what needed to be done and would just do it, who could provide useful advice and help with newborn behavior and breastfeeding — my experience would have been completely different and so much easier.
    I find that the mothers I work with have lots of different reasons for hiring a postpartum doula, ranging from partners who work long hours to babies who don’t sleep to just recognizing they need some extra help those first days and weeks. But one thing they all have in common is that they feel isolated, and that no one else feels like they do. The normalizing presence of a postpartum doula who provides small talk and clean dishes and TLC makes such a difference — the work is not usually difficult but the effects and rewards are huge.

  3. Great Article! as a Newborn Care Specialist and Postpartum Doula it is wonderful to see articles like this, so many people are not aware that services like ours exist! Living in the DC Metro area where so many are living away from extended family it is so important that they know who to contact and reach out for help.

  4. Good Morning,
    I have been a member of DONA (Doulas of North America) for approximately 15 years. These years have been the most gratifying years of my life…and the most enjoyable. My love of newborns together with their parents have given me an added dimension to my life. I have love and warmth to give as my three children are grown and on their own with their families. Doula work is “work” but the most enjoyable of time for the new parents. I would be happy to share in your joy and teach you what is needed for the new baby when returning home from the hospital or perhaps a home birth. I have recommendations from many new parents and will be happy to share those names with you. Warmly, Doula Carole Kahn

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