As postpartum doulas, one of our primary roles is that of communicator/coach/adviser. The skills we develop to successfully fulfill this role can greatly enhance our support as we engage in family life. This role of spokesperson/coach/counselor allows us to be one of the best lines of defense against some of the emotional and medical problems that can follow pregnancy and birth. Using our communication skills that include asking open-ended questions; reflective and active listening; and reframing. We can help our clients positively process some of the overwhelming emotions they experience during the vulnerable time after birth. These include the following:
Sadness
It’s normal for them to cry over little things, like not knowing how to change a diaper very well—or when they find out Netflix stopped airing their favorite series before they had a chance to see the finale. They are usually part of the baby blues, a temporary state of mood swings that last no more than a few days or weeks.
Fear
They’ll quickly find that being a mother brings a whole new set of fears, even if they’re not the worry-wart kind. From small fears to more complex ones, the feeling of fear can be overwhelming for many expectant mothers in the early stages of parenthood. They’re not alone in this one…scared that they won’t do the right thing for their child because they don’t know the first thing about babies and parenting.
Joy
They knew their baby would bring great joy to their lives, but they didn’t know how much that joy would be until their little one was born. Their positive emotions are magnified after delivery just like their negative ones, and this overwhelming happiness often finds its way into the mix, making them feel an incredibly natural “high” at times. It is almost unbelievable that something so small, with so little to do, can give them so much joy that it makes them cry.
anger
Perhaps no one will admit it, but it is completely normal to have some feelings of anger in the days after giving birth. Whether it’s being mad at themselves for not knowing the first thing about breastfeeding, or completely mad at the world for not knowing how to get their baby to stop crying…it’s normal. If their symptoms prevent them from coping and your support isn’t enough, refer them to their OBGYN or midwife or to mental health providers in your area.
The Jitters
They may find themselves on edge in the weeks after giving birth. They may be more easily startled, very tense, or even very anxious. This can be disturbing to someone who has never felt this way in life before. Let them know that this is unusual. They don’t sleep, they worry…oh yeah, and they just gave birth!
Hypersensitivity
A very normal feeling after giving birth is sensitivity. They can feel a strong emotional impact on anyone and everyone. Watching the news can bring them to tears, leaving them deeply saddened for strangers. Their emotions are all over the place, and their caring nature can come into play.
Doubt
Not many birthing people will admit it, but feeling insecure—like wondering if they should have a baby or if they can do the job—is perfectly normal. We tend to think that parenting is an instinct so that we know exactly what to do when our babies are born, but that is not the case. Although these feelings are normal, let them know not to be too hard on themselves. The weeks after giving birth are a learning process for both the birthing person and the baby.
Although the above mood swings are common for most postpartum women after the birth of a child, at least 15 to 20% experience more significant symptoms of depression or anxiety. Some studies show that 25% of postpartum people seek treatment for these mood disorders. It is important for postpartum doulas to understand and recognize more severe symptoms and refer clients to medical professionals as needed. Women of every culture, age, income level and race can develop perinatal mood and anxiety disorders. Symptoms can appear at any time during pregnancy and in the first 12 months after delivery. There are effective and well-researched treatment options to help them recover and the support of a postpartum doula at home can be a critical part of their recovery.
The postpartum doula role includes nurturing, guiding, and validating parents during a very difficult time, providing important continuity of emotional support for births, especially those at high risk. Postpartum doulas help clients develop a solution that includes more sleep for the birth mother, more time spent outdoors, a referral to a support group, or an appointment with a medical provider or therapist; however, doulas cannot diagnose or treat mental health issues, only provide referrals and empower the client to seek help. Our non-judgmental communication, empathy and support provides a safe space for parents to express their concerns and fears, and increases the possibility for them to connect with appropriate professionals if necessary.
“Across all cultures and countries there is a universal message that is given to women and their families who experience pregnancy-related mood disorders. It is expressed in three simple phrases: 1) you are not alone (validation ), 2) you are not to blame (certainty), and 3) your experience is real, it is treatable and you will be fine (hope). This message reflects the dynamic process and principles of cooperation and support. social (Honikman, 2002).Postpartum doulas provide these exact messages and not only help normalize the situation, but allow our clients to process their concerns and explore solutions.
According to the British Health Visitors program, the six main elements in preventing postpartum depression are: 1) continuity of care, 2) social support, 3) preparation for parenthood, 4) stress management, resolving problem, and an action plan , 5) referral to additional resources, and 6) education about emotional reactions to pregnancy, birth, and parenting. Postpartum doulas are trained in each of these areas and can walk with their clients through all of these steps.
CAPPA postpartum doula training covers perinatal mood disorders with definitions of symptoms and risk factors, as well as practical support doulas can provide. More information and support is available through Postpartum Support International.
Resources
About the Author
Carolyn’s birth philosophy is quite simple: Women’s bodies are created to have birth as naturally as possible. When they trust their bodies, amazing things can happen. That said, supporting women in their births can be different and as personalized as each woman. This is their birth and can look many different ways…Carolyn is there to help make it the best way for the birth mother. She supported many types of birth including all natural, medicated, C-sections, adoption and relinquishment, and surrogacy. Carolyn believes that if women and their support people are educated about birth and all the variables, they can make more informed choices and be more empowered, creating more joy in their births, whatever happens.
