A Midwife, Doula, and Postpartum Help for Healthier, Happier Mom, Dad & Baby
Who uses a doula, midwife, and postpartum help?
Barefoot hippies? Hollywood divas?
Yes, and millions of everyday, hardworking people around the world who have decided either through their cultural heritage or personal research that for them, a natural childbirth and postpartum care with the support of a midwife, doula, and other services makes for the healthiest, safest, and happiest ways to give birth to and care for the new spirit in their lives.
Natural childbirth in a hospital, homebirth, and postpartum care have become so uncommon in the U.S. (and increasingly in other countries) that they are now considered by many to be too difficult, unnecessary, or even frivolous.
But, just a glance at the number of women in the U.S. who fail to have a natural childbirth (when that’s what they intended), fail to breastfeed (even when they wanted to and tried), and who suffer from mild to severe postpartum depression offers a clear indication that the now standard, mechanical template of childbirth and postpartum care is gravely inadequate.
And it’s not that millions of women wouldn’t want a natural childbirth or magical postpartum time of healing and bonding.
It’s that a great majority have no idea what hospital protocol they’re up against when they enter Labor & Delivery, or what kind of postpartum care is considered standard and necessary in countries around the world (and that women experiencing loss—miscarriage or stillbirth—also have postpartum leave and care[i]).
Countless women go into labor having said for nine months, “I want a natural childbirth.” And they mean it. But then what happens?
Here’s a look at just a few of the standard procedures upon entering the hospital:
This is all assuming that you’re not put on additional drugs to speed labor (if in their estimation you’re taking too long). While 24 hours or longer is a common length of time for a mother to labor—especially with her first baby—many hospitals encourage drugs to speed the process if it passes 12 hours.
It is also assuming that nothing has happened to encourage the doctor to perform a cesarean section (now at 30-50% of deliveries in the States, varying by doctor and hospital).
The placenta will be taken to an incinerator.
Postpartum care? Women are sent home from the hospital with a few formula samples and a diaper bag.
That’s how we care for new families?
The most sacred rite of passage has become cold, mechanical and offensive.
Fortunately, the pendulum is swinging back.
Many new parents are discovering the mind/body/spirit benefits of hiring various support/services to help them on their journey either at home or in the hospital.
There are many (and increasing numbers of) people who serve new mothers in pregnancy, delivery, and postpartum, and I wrote about several—doulas, midwives, postpartum doulas, maids, cooks, and nannies—in my book New Mother. Since publication and through interaction with readers, I’ve discovered even more services.
For example, a service called Best Fed Babies offers breastfeeding support with a certified lactation consultant 24/7 via phone or Skype to mothers anywhere in the world. I would have loved to call them when I woke one morning at 3:00 AM with a plugged duct—and how many of us have similar questions or issues in the early days and wee hours of nursing!
Mother’s Concierge services are another wonderful and flexible source of help. One company called Pampered Mamas in Baltimore, Maryland offers in-home pre/post natal massage; nap Nannie; in-home baby proofing consultations and much more.
A company in Los Angeles, CA called MotherBees doesn’t just deliver any old regular meal to postpartum mothers, but combines traditional postpartum foods with locally sourced seasonal ingredients. Replenishing and restorative foods—at your door!
In our modern culture with nuclear families living in isolation, many new parents lack knowledge of what will happen during childbirth, what procedures they can accept or decline (in the hospital), what they’ll need postpartum, or what is available to support them. Just knowing the names and types of services will help mom and dads-to-be to research better and find exactly what they need to create their childbirth vision.
Ora na azu nwa, or It takes a village to raise a child, is a Nigerian Igbo proverb made popular by Hillary Rodham Clinton’s book published in 1996. Birthing and raising healthy happy children does require support, but we don’t live in villages.
However, we can create our village—hopefully with the support of nuclear and extended family members and long-time friends, and also with the help of people trained, experienced, and specializing in mother and baby care. With so many different services available, everyone can find the perfect fit for their needs, budget and desire.
May you be surrounded by love and support, and may you experience abundant peace and joy on your blessed journey of motherhood!
*No affiliation or compensation associated with the services mentioned in this article.
Illustration, I See You, used with license from Healing Art, Jane Delaford Taylor
 Abridged excerpt from New Mother, by Allie Chee, Hestia Books & Media, 2012
 Pushed: The Painful Truth about Childbirth and Modern Maternity Care, Jennifer Block, Da Capo Press: A Member of the Perseus Books Group, 2007
[i] Read more on this subject— AFTER MISCARRIAGE: Postpartum Care for Mothers Experiencing Loss
People in the US are rediscovering the mind/body benefits of a 30-40 day postpartum recovery period for new moms during which they rest, are cared for, eat special foods for rejuvenation, and are supported by family and postpartum care providers. This, of course, leaves mom better able to care for and bond with her new baby, and to return to her old strength, if not even an increased vitality—quickly!
In China the term for this time is called “sitting moon” (zuo yuezi in Mandarin—one month being “one moon”), but cultures throughout Central Asia, Southeast Asia, and the Far East have similar practices, each with their own special techniques and care providers. This postpartum care is not considered something only for the wealthy or indulgent. It is considered vital to the mother’s recovery, her long-term health, and her ability to care well for her baby and easily produce abundant milk.
The affects of the neglect that postpartum mothers and new babies experience in the US are obvious. Just a glance at the statistics for postpartum depression and mothers failing to nurse (when they wanted to) tells of the need for a new look at this ancient practice of a “sitting moon.”
It was long ago, but this need was recognized at one time in the US, and postpartum recovery practices were followed. In Marriage & LOVE, published in New York in 1894, Ruth Smythers writes:
“After the birth of the baby, the mother…should not get out of bed for ten days or two weeks. The more care taken of her at this time, the more rapid will be her recovery.”
But today, the majority of women in the US do not receive the postpartum care and nutrition that is considered a fundamental part of a family’s experience around the world.
Worse, the most neglected and forgotten mothers in our culture are those who lose their baby preterm.
Statistics vary, but Western and Traditional Chinese Medicine (TCM) doctors will tell you that up to 40-50% of all conceptions end in miscarriage—many of them before a woman realizes she is pregnant, and she simply has a “period” that is a few days late. However, the number of women who miscarry further into their pregnancy—after the body is in full swing of its myriad, major changes—is still enormous. In the US the estimate for annual miscarriages is 900,000-1,000,0000.
How are these women treated? How are they cared for?
Being immersed in the “birthing world”, I hear tales often of the cold nonchalance with which these women are handled, and I’ll offer two examples from personal experience.
When I had a miscarriage, not knowing what was happening other than pain that left me unable to walk, I went to the hospital. Very quickly, with profuse bleeding, what was happening became apparent, yet the staff still wanted to “check” me. After extensive probing with an internal sonogram device, I asked the tech what she had to report to me. She said, “I’m not allowed to say anything.”
About an hour later as I sat shivering and bleeding in the ER, the doctor came in and said, “You’ve had a miscarriage.” (As I’d told them earlier, I knew that.) Then he said, “On the way out, the girl at the front desk will give you a paper you need to read.” And he left. Apparently recognizing the void of feeling in the exchange, the tech then approached me, patted my arm and said, “Hopefully we’ll see you in the L&D next time.”
The paper they provided contained the headline, “YOU HAVE EXPERIENCED A PRETERM LOSS OF YOUR PREGNANCY” and had a list of side-effects I should watch for, and return to the hospital if I believed I was experiencing, as they could be fatal. And that was it.
A friend experienced her loss at approximately five months. Because of her baby’s size at that time, she actually had a full L&D experience. They allowed her to see her baby (she had to fight for this) and because he was just a few weeks below the cutoff age to be given to the parents for burial, he was taken away from her and the body was disposed of according to hospital procedures. She’d known she was losing him, and had planned in her mind a funeral on the beach and a proper burial, but she was denied that, and sent home, again with a list of “things to watch for.” And that was it.
Though miscarriage is extremely common—a woman holding in her hands the body of what she thought would be her lifelong love and devotion, and saying goodbye—it is trauma.
Our treatment of mothers experiencing this loss is unconscionable, but I believe it is—for the most part—simply a lack of knowledge that there are intricate and loving traditions practiced around the world to help speed postpartum moms of miscarriage to a healthy and happy recovery (that also, according to TCM, increase the likelihood of her having a successful pregnancy the next time she conceives).
While our “system” provides no guideline for postpartum care for mother’s who miscarry, at least, sometimes, family and/or friends come to care for the mother—for a day or two. Sometimes, women don’t even receive this emotional or physical assistance.
But according to the precepts of TCM, a postpartum mother who’s miscarried requires more attention and care than a mother who delivered her full-term baby. Amy Wong, an internationally acclaimed expert in this field, writes that, “Natural delivery requires at least 30 days of rest, while Cesarean delivery, miscarriage, and abortion require at least 40 days.”
Why would a woman who’s had a miscarriage require more support and recovery time?
She’s experiencing an enormous spiritual loss—few things are harder for a mother than losing the child who has entered her life, even if briefly.
Her body has made the enormous, taxing hormonal and other physical shifts of pregnancy.
To experience strong shifts of mind, body, and spirit simultaneously, and then to be left alone and expected to return to life as usual in the next few days…many moms do “bounce back.” However, it is a formula for depression, anxiety, and panic attacks—which, in fact, afflict many mothers who even have the joy of holding their new baby in their arms postpartum.
I see—frequently—mothers who have miscarried and are asking for help and guidance on social websites.
Of course the Internet and people we meet online can be wonderful resources, but…
we can do better for these women.
For those interested in learning more about the traditional practices used for postpartum mothers who delivered full-term or miscarried—doulas and midwives can offer great support, and there are several books I’d recommend as a start:
A final thought for postpartum mothers who’ve experienced loss:
Gratitude is powerful medicine. It is helpful if we can focus (with enormous effort) on feeling gratitude for having been pregnant even briefly, since so many of our dear sisters who want to be mothers may never experience that profound blessing.
May we all grow in love and compassion through our challenges, and experience health and joy on our journey!
Read the second part of this article CONCEIVING AFTER MISCARRIAGE: When to Try Again & Increasing Ability to Carry Full Term to learn more.
 Real Advice from 1894 Marriage & Love, Ruth Smythers, Spiritual Guidance Press, New York City, 1894; republished by Lyons Press, Guildford, CT, 2011, p. 92
Whenever I think of postpartum care, I think of an article I once read (and please forgive me for not remembering the title or where I read it!) about an expecting couple in a village in Singapore (well, I recall being a country starting with “S”, anyway. If I’m wrong, I promise to own it but like I always say “pregnant brain never goes away”!). I will retell their story to the best of my ability.
This story has been so richly ingrained in my mind, but more importantly, my heart and soul. I didn’t just read this story, I tasted it. I felt it. I longed for it. It stands in stark contrast to what we see in many countries today.
The husband and wife lived in a small village where several midwives were vowing their full attention to the birth of this child. The midwives went through an interviewing process, I believe, in front of the entire village. Once a midwife was selected, a celebration was held along with ceremonies, rich in community. The midwife gave her promise to not only prepare the woman for birth, but to care for her the entire six weeks after. What dedication!
It was no new news to the father that he was expected to care for the children, cook and clean and tend to the mother’s every need during this time. When and if he had to work outside of the village, other villagers would come to care for the children and mother.
The mother was expected to lie in bed. The sanctity of birth is well regarded there. Resting, eating, nurturing, loving, and nursing were her top priorities. Establishing the mother-child bond and healthy breastfeeding relationship was essential to the family and village.
The glorious midwife, bless her, made warm, nourishing soups full of healing herbs for the mother, daily. Immediately after birth, she would belly bind the mother’s weakened abdominal muscles. This is a common practice among many cultures around the world. This midwife would use healing oils and lengthy massages for the new mother and then re-bind her wrap, daily. She would also make sure the baby was nursing well and gave specific attention to that little bundle of joy as well. This daily gift of love and attention would continue for six whole weeks! Can you imagine?!!
In our country today, this would be seen as completely unnecessary, especially when you see newborns and postpartum mamas in Walmart, 24-48 hours after birth! Postpartum care is not as deeply respected compared to that little village. That little village, which exists somewhere in the land of “S” (wherever that may be, and let’s hope I remembered correctly and it is in Singapore), has done more for society in one, six week postpartum care treatment, than our industrialized nation has done in two or more entire generations!
What spoke to me so clearly through the ancient practices so beautifully illustrated in the article, is that getting the family off to the best start possible, is not only good for the family, but good for the entire community! A first-time mother and father walk somewhat blindly into the process, having never experienced it before. It can be a time of uncertainty and fear. What better way to adjust, than to have a nurturing, caring and loving path laid before you?
Postpartum care and how a woman is treated during labor and delivery, deeply impact a woman’s psyche and can make or break how she feels about children and family for the rest of her life. In my opinion, the birthing process and postpartum care are single-handedly the most vulnerable a woman will ever be, not only physically but emotionally.
Physically, the healing process after birth is usually painful as the uterus begins shrinking and the wound where the placenta once was begins healing. If mama is nursing that can make uterine contractions much stronger but also helps it shrink faster and return to pre-pregnancy size. It is very important to rest, do as little as possible, keep your feet up, urinate frequently, sleep when baby sleeps, stay hydrated, have a snack while you’re nursing, and avoid foods that decrease milk supply like junk foods and soda.
Emotionally, the healing process, I believe, takes a bit longer. Getting adjusted to having baby outside of the womb can take up to the entire first year. According to Dr. Sears, author of the attachment parenting bible, The Baby Book, pregnancy is viewed as “nine months in, nine months out.” Between mother and child learning to nurse and baby’s ever-changing needs in the first year, the words of wisdom I always rely on are: “Just when you think you’ve got a predictable schedule with baby, something always changes.” Whether illness or teething sets in, we must always be ready to adapt to every circumstance. The constant changes, coupled with the hormonal rebalancing and adjustment of a mother’s body are much better dealt with, when time and patience for this healing, are allowed.
The importance of support during the postpartum period is clearly shown to be beneficial to the mother and child in the crucial bonding period necessary after birth to promote optimal survival, both physically and emotionally. The mother and baby need to be surrounded by supportive people who are dedicated to caring for the pair and responsible in helping to prevent postpartum infection and other complications, as well as prevent postpartum depression. Rigorous postpartum care and observation by medical providers, midwives, doulas, family, and consultants can benefit not just the mother and child, but the community as a whole.
Bringing home your baby for the first time is one of the unexpected joys of motherhood. Introducing him to the dogs, the bed, the couch, the bouncy seat: it is fun to start doing all of those “firsts” with the baby! The comfort of being able to snuggle and nurse my boys in my own bed while watching Star Trek and drinking my tea (yes I’m a super Trekkie) was probably the best time for me. I spent days in bed just taking in every little bit of them while enjoying integrating them into my life and introducing them to the things I loved. Eventually though, you start to get back into your usual responsibilities and if you are anything like me, you may find yourself doing all sorts of crazy housework. If you have other children who are home, this “back to reality” may come even quicker. I had the luxury of my mother taking my oldest for a week after I delivered my second so that I could recover and not be quite so tired and sore while trying to handle two little ones. It was a huge help, but of course, I also missed my oldest and it was great to have him back home.
There are many things about postpartum recovery that you may hear, and many things you won’t. You’ll probably hear a lot about other women’s accounts of their levels of pain and soreness after coming home. The key to remember is that there is no way to predict how your body will handle the return home. Being in the hospital afforded me the opportunity to sit around and do nothing if I so chose. But once I returned home, the dishes, laundry, and dogs were staring at me wondering why I was being so lazy and after a few days, the guilt got to me and I started getting “back to work.” Here’s where you want to accept any and all help you can get; if someone wants to come see the baby, ask them if they can throw in the laundry for you, take out the garbage, or watch the baby while you take a shower. We often don’t ask for help, even when we need it, so here’s your opportunity to ask for it without feeling like you are imposing. Your activity level will be dictated by how you are feeling physically and emotionally, so try to take it easy on yourself on both accounts. I realized I was doing too much physical activity when on my 4th day home, I began bleeding much heavier than I had since I had returned home. When I called my OB, she told me that it was my body’s way of telling me to slow back down. This wasn’t something anyone had warned me about, but it was nice to know that my body was trying to send me a message and trying to “push through the pain” (I had a 3rd degree tear so I was incredibly sore and in a lot of pain) was actually doing more harm than good. My OB instructed me to slow down and continue to rest with ice packs between my legs to help relieve some of the discomfort. Within a day of moderating my activity and tuning back into my body, I was feeling much better.
You Will Likely Be Exhausted.
I always tell people that even though I was never a big party person as a young adult, my late nights of socialization and nights where I got nearly no sleep, got up and went to work just to come home and go socialize again were NOTHING compared to the “tired” I felt as a new mom. This too shall pass though. Again, your body just did an amazing thing by giving birth; your body feeling tired is its way of telling you to take it easy so it can regenerate and recover. Nap when the baby naps, (this is how I became a huge proponent of safe co-sleeping) and don’t go on a spree of doing chores. Break it up into small tasks and do them every so often. Don’t unload the dishwasher, re-load it, clean the counters, take out the trash, sweep and mop the floor, sort and start laundry. Unload the dishwasher after breakfast and don’t worry about putting the dirty ones in until after lunch. Sort the laundry and let the next person who comes to visit you and the baby carry the basket and throw the load in.
Taking it easy is going to allow your body and mind to recover, as well as facilitate bonding and the nursing relationship (if you are breastfeeding). The more time you spend with the baby, (even if it’s just sitting next to him reading a book while he sleeps next to you - or in my case on my chest) is beneficial. Babies who are breastfeed and have ample opportunities for attachment and bonding their moms are at an advantage. Babies who do not get these things as often are at greater risk for attachment issues, social interaction difficulties, intellectual challenges, and many more.
If You Are Physically Able, Wear Your Baby!
Oh I can’t tell you how much easier it was to get stuff done when I wasn’t running back and forth between wherever I was doing something and where the baby was sleeping. I had a video monitor and I still had to check on #1 every few minutes because I was just beside myself with joy and worry (the worry eventually subsided a little bit once I got used to being a mom.) I had a Moby wrap, a generic sling, and a Baby Bjorn, all of which got a ton of use. Plus, if my son was a bit fussy, he usually calmed down pretty quick by the motion of being carried around while being able to rest his head on my chest. Here is a great article on babywear.
Use That Peri-Bottle (And Put Witch Hazel In It)!
I still have mine, and I STILL use them occasionally! Especially if you have stitches, you’ll love the relief of being able to rinse yourself with the peri-bottle both after using the toilet, as well as when you’re in the shower. I didn’t want anything to do with putting pressure much less touching myself below the waist after I gave birth, so it was nice to have a clean alternative to relying on wiping to clean up. Of course a little pat dry was necessary, but much less terrifying than the thought of wiping anything.
Try to make some time for yourself, and for your partner. Especially if you are nursing, you are going to be literally attached to that baby for the next few months (at least). It’s easy to get wrapped up in the love and responsibility of motherhood, but don’t lose yourself in it. Ask your partner or another support person to watch the baby so you can take a long shower or bath, or go to the store to grab milk. Even as little ten minutes to yourself each day where you aren’t responsible for running to the baby if he wakes up will help you retain some sense of your individuality. Also, remember that your partner may be feeling a bit sidelined now that the baby is here. It’s okay that you are paying so much attention to the baby, and it’s okay that your partner feels a bit left out; this is all part of trying to figure out and adjust to the dramatic change that your lives and relationship have just gone through. Trying to make a point to spend some time together each day will allow you to retain (or potentially restore) your intimacy and relationship so that nobody feels left out.
Here’s where I’m going to get on my soap box...
You can find my full article on Postpartum Depression here, so I won’t get too in depth here since this is about general recovery. It is imperative that you keep your eyes and ears open to your mind and body; if you are not beginning to feel as though you are getting back to normal, talk to your practitioner. Bringing a baby into this world is full of wonderful and challenging events. There are a number of symptoms of PPD, but not all are required for an official diagnosis. It is normal to feel tired and overwhelmed, but if you are feeling significantly exhausted and down for more than a few weeks, it may be in both you and your baby’s best interest to seek the help of a licensed mental health counselor. As a counselor in training, a mother who had PPD, and as a student who just completed a major research project on PPD, I can’t stress enough that it is not something you need to suffer through alone. If your practitioner just wants to put you on medicine, consider asking for a referral for a counselor in addition to meds (and ask if you can try counseling without using the medicine first.) We often feel alone (even when we are surrounded by support) and sometimes just having someone to vent to that won’t judge you or feel hurt by your feelings can make a world of difference. One of the most shocking things about the postpartum period for me was that it put a lot of strain on my relationship with my husband. Luckily, we managed to get through, but it wasn’t easy. PPD can also affect your baby’s development; if you are having a difficult time bonding or caring for the baby, the baby’s physiological and psychological development is potentially at risk. Of course, not every woman will get PPD, and their babies are not necessarily at a huge risk of being damaged; but there are ways to help yourself feel a bit better which will only benefit your baby even if you aren’t suffering from PPD, but still feel a little overwhelmed and isolated.
Everything may be wonderful and stay that way once you arrive home. If it isn’t though, that’s okay too. Having a baby is a life changing event in ways you can’t truly understand until it happens for the first time. Postpartum time is your time to reevaluate and adjust your life. This may take a while, and that’s okay too. Just like your EDD was estimated your recovery time is not set in stone so take the time you want and need to ensure that you can enjoy this journey of motherhood as you should-the best way that is right for you!
Go back to: Step #8: Initiating & Maintaining Breastfeeding
Go to: Birthing Methods Menu
You will have a visit from your provider 24 hours after the birth and then 72 hours after the birth, and then once a week thereafter typically anywhere from 6 to 12 weeks postpartum. If you are having any issues make sure you are candid with your care provider. See if you can have friends or family set up a meal and cleaning train for you. The more you can rest the faster you will recover. If you are having breast feeding difficulties your provider may recommend seeing a Lactation Consultant and never forget there is the La Leche League which is a free breastfeeding support group available worldwide.
Go back to: Step #11: Birthing Day
Go to: Birthing Methods Main Menu
Do this only if you feel it is necessary but listen to your body. You may be subjected to a number of procedures you may not want, and they may take your baby from you and admit him or her to the NICU.
This largely depends on the hospital, the staff, and perhaps if you were to have a tiny baby or not. Child Protective Services may or may not become involved if you refuse any treatment they want to do to your baby as this has occurred in other unassisted birth instances. Remember your rights.
At this point, you can also call your midwife to come check in on things.
Here is the story my unassisted birth with my twin girls.
Go back to Step #13: Cutting the Cord
Go next step Step #15: Whether to See a Pediatrician
Go to Birthing Methods Menu
When I had my sixth child, I tried an herbal bath mix in my early postpartum. Not only was it incredibly soothing, it helped me heal faster! I even brought my new baby into the bath with me. He loved the warm water and I loved the relief! It’s an easy recipe full of healing herbs that promote healing and help reduce inflammation and bleeding. It’s specifically for women who have had vaginal deliveries. It helps heal tears and bruising. This herbal bath mix is now a must on my list for postpartum supplies!
This bath mixture can be prepared ahead of time and stored in a large container ready for the bath. Remember to refrigerate or freeze it if you are preparing it several days in advance.
Add the first 5 ingredients to 10 cups of water. Simmer the tea and let set for some time before straining. Simmer the tea leaves again to get their full benefit. Cover, label, and set aside. Add to the warm bath water when desired (add salt to the bath at the time of the bath). Freeze the tea if you are planning to keep it for more than two days. You can also use the mixture in a peri bottle or a sitz bath. This herbal bath mix is help in the recovery of vaginal births. Not recommended for deep surgical wounds as would be the case with a caesarean section delivery.
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