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, particularly in the days and months that baby is born is postpartum doulas. And, the notion of planning for your own needs once the baby is born should not be one only considered by those who can afford it. Planning for postpartum help should not be a luxury, as it can make such a difference in the health and welfare of baby and mother.
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.
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. We laugh and use “It takes a village,” nominally as we thank another mother for picking up a toy at the playground for us, or for loaning a carrier to give a try to, but it’s the truth. Until recently, in modern and mostly Western countries, it has taken a village to offer support and care and child-rearing.
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. This is particularly important for those who suffer from any type of pregnancy loss–the honoring of not only a woman’s role as mother, but her needs as a grieving mother whose body is not sure of what’s just happened.
In these places of belief in strong pospartum support, 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. Whether they are family or paid support, the necessity of their care for the mother and child is not ever really debated.
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.”
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. Additionally, more are working toward advocacy for the need of better postpartum care. When women are dying, and often at exponentially higher rates than their peers of different color, there is no excuse for an advanced society to boast such statistics. Finally, though slowly, it seems as if some are realizing the importance of postpartum care and encouraging it through old-school but highly advantageous practices.
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.
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.
But postpartum care , despite being worthy, is not always affordable. Some of us don’t have the cash to do much of anything extra in our food and shelter expenses, much less consider hiring postpartum care. As more advocacy and awareness of the benefits continue to increase, I dearly hope that someday it will be covered by insurance.
Until it’s not, though, if you’re having a baby, or planning to have a baby, here are a few suggestions we’re offering in the hopes that it might make postpartum planning a little easier. For your health, your mental strength and your wallet.
- 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 five-to-eight 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. And really, that’s the best way to build your community for even after the postpartum stages happen. You want to have your postpartum period be as easy on you and baby as it can be, but part of that also comes in the form of building the group on which you’ll depend as you continue to raise your child(ren) and do life with.
When you’ve decided that a postpartum doula is in your plan for the 4th trimester, 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. Discuss the things you know will be of importance to you when the baby is here, and you might not have the same brain power to discuss them. A good postpartum doula’s focus is making your postpartum period one in which you and your baby thrive, so be sure to think about what that would look like to you and then share with those you are interviewing.
And remember, this person will be your postpartum anchor. 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.
At least not if you’re planning to do anything but drift.