Fourth Trimester Podcast Episode 91: What To Expect From A Doula Providing Postpartum Care At Home
In a recent episode of the Fourth Trimester podcast, hosts Sarah Trott and Esther Gallagher discussed the role of doulas, with a focus on postpartum doulas. They provided insight into the types of care provided by doulas and the importance of their support for new parents.
Types Of Doulas And What They Do
There are different types of doulas, including birth doulas, night doulas and postpartum doulas.
- Birth doulas support parents during the labor and delivery process
- Postpartum doulas provide care after the birth, focusing on the healing and recovery of the new family
- Night doulas provide care during night hours and primarily focus on caring for the infant while parents sleep.
Postpartum Care At Home
Postpartum doulas offer a wide range of support to new parents. They can help with practical tasks such as meal preparation, laundry, and running errands. They also provide emotional and physical support, offering a listening ear and providing comfort measures like light massages. They ensure that the basic needs of the parents and the baby are met, such as providing meals and ensuring hydration. Sleep and rest are prioritized, and doulas can support parents in establishing healthy sleep habits for themselves and their baby.
Postpartum doulas can also assist with breastfeeding support, helping parents identify feeding cues and providing guidance on proper latch and positioning. They can offer resources and referrals for further support, such as counseling or bodywork.
Typical Postpartum Doula Visit
During their visits, postpartum doulas conduct an initial assessment of the home and the family’s needs. They prioritize the most pressing needs, such as sleep and food, and provide support accordingly. The length and frequency of visits may vary, but a typical visit can last around three hours. Some doulas may provide longer visits or daily visits, depending on the needs of the family.
Listen to the full episode or read the transcript below for more detailed examples of the day in the life of a doula.
Holistic Care At Home
It is important to note that not everyone can access or afford doula care, but for those who can, it is highly valuable. Doulas provide holistic support that can greatly ease the transition into parenthood. They act as a quarterback, observing the situation, providing guidance and coaching, and ensuring that both the physical and emotional needs of the family are met.
Overall, doulas play a vital role in supporting new parents during the postpartum period. Whether it is practical help, emotional support, or guidance, they make a significant difference in the well-being and adjustment of the family.
“Hopefully your postpartum care provider is somebody who helps you sort out and reinforce your intuition, your power and agency around your parenting journey.”
— Esther Gallagher
Questions To Ask A Doula During An Interview
As discussed on the episode, here is a summary of some key questions to ask a doula when interviewing them: Doula Interview Questions
Connect with Esther Gallagher esthergallagher.com
Sarah Trott: [00:00:01] Hi, Welcome back to the Fourth Trimester podcast. I’m Sarah Trott and I’m so excited that I have Esther Gallagher as my co-host with me today.
Esther Gallagher: Hi Esther. Hi Sarah. Glad to be back.
Sarah Trott: I’m so thrilled that we’re back together again. It’s been a long time, so this is a bit of a special reunion episode. And for this episode we’re going to talk all about the topic of what doulas do. We’re going to spend a lot of time focusing on postpartum doulas in particular, so that’s going to be our topic. And so anyone who is curious about this topic, what doulas do, how they help you, any questions like that? If we don’t answer your questions, reach out to us afterwards and we can help answer your follow ups. We are on Instagram, we are on TikTok now as well. You can find us at Fourth Trimester Podcast, so you can look for our handle. And our website is fourthtrimesterpodcast.com. So come check us out. So we’re also on Facebook. So Esther, you’ve been a doula for how long?
Esther Gallagher: [00:01:08] Well, I’ve been a doula in San Francisco since 1992, and I started out in the city doing specifically postpartum care. I was quickly recruited to be a childbirth educator and then quickly recruited by my students to be a birth doula. And prior to that I had training as a home birth midwife. So all my sort of skills and, and I was a parent by that time as well.
Esther Gallagher: [00:01:40] So, all of those things sort of coalesced into the larger topic of being called to duty. And I’ve been a parent for 46 of those.
Esther Gallagher: [00:01:55] What called me to be a doula. Well, the universe called me pretty early when I was about eight years old. I started getting very curious about my own having been born and my mom’s stories of giving birth and, you know, did she breastfeed and all that kind of stuff. So my mom was great. You know, she just always just gave me the facts and, you know, always had a little bit of feeling in there about things, but without ever no heavy handed like fear or anything like that. And so, so I had opinions quite early myself about how, how babies get born and what would be nice for babies.
Esther Gallagher: [00:02:45] My mom said to me, I wish I’d had two births at home, but nobody did that when I was having you. And I was like, I’m having my kids at home, you know, And, you know, I wanted to breastfeed you, but it wasn’t working out. And I was like, I’m going to breastfeed.
Esther Gallagher: [00:03:05] So I learned, you know, by kind of jumping in and doing those things like, oh, yeah, this is another way to do things. It’s valid, it’s supported and nice and, and all of these things are still challenging, you know, it’s not like you get out of it if you choose something over another thing. Parenting is an individual and collective journey that we’re going to take if we choose to. And it’s, it’s a big thing.
Esther Gallagher: [00:03:41] And I recognized how, at least in my mind, having not experienced the difference, how little support there was, both familial and and community support for pregnancy, birth, postpartum and parenting in general, how little there had been for my own parents and how that hadn’t changed at all when I decided to become a parent. So all of those were my motivations. Thanks for asking Sarah.
Sarah Trott: [00:04:22] I hired you as my doula for birth and then postpartum as well. I didn’t know what a postpartum doula was, so let’s answer that question next. So in your own words, Esther, what is a postpartum doula?
Esther Gallagher: [00:04:39] A postpartum doula is a helping person, doesn’t have doesn’t gender is not necessary in this space at all. Who shows up to provide care to the new family while they are healing and recovering and adjusting to early parenthood. And there are different ways that people who call themselves postpartum doulas operate in that space.
Esther Gallagher: [00:05:12] There are night doulas who show up 10 to 6 and are happy to just take over baby care for the night and have you sleep. Maybe they bring the baby to you for breastfeeds or body feeds, whatever you’re doing, maybe they feed your baby alternatively with a bottle or something like that while you’re sleeping. That’s not what I do.
Esther Gallagher: [00:05:38] And then there are daytime doulas. That’s sort of the broad categories. Daytime doulas are people who are going to show up during daytime hours and. Help with things like the practical meal preparation, laundry, errands, but in my opinion, more importantly, show up for you. With the actual healing and recovery, both physiological but also emotional. Social. Healing and recovery. Period. So. Beginning as early as the day you give birth. Or the day you come home from the hospital if you’ve had a hospital birth or sometime soon after. A postpartum daytime doula is going to show up in your home and offer you social, emotional and physiological care and support with meal preparation, sitz bath preparation if you’ve delivered vaginally. Comfort measures like something as simple as a light kind of lymphatic style massage for your legs.
Esther Gallagher: [00:07:00] If your legs are swollen as a result of over-hydration or surgery or something of that nature. They’re going to show up to do these things, whether it’s feeding you or getting you into a sitz bath or massaging your legs, perhaps while you’re feeding your baby. All of those things can happen, by the way, while you’re feeding your baby.
Esther Gallagher: [00:07:29] Be present. Emotionally present to listen to. To offer emotional support of whatever kind. A hug. You know, just being held sometimes is what we need at this moment. Right? to maybe beyond that, think about what other resources would be available to you right now that might be really, really helpful, whether it’s, you know, therapeutic. So maybe a counselor, maybe some bodywork of some sort, be it anything from acupuncture to massage to any number of things.
Esther Gallagher: [00:08:17] Maybe it’s fresh air and sunshine. You know, maybe you just have felt so locked down indoors that you need nature therapy. So how do we get that happening appropriately so that you’re not setting yourself back physiologically but can enjoy the therapeutic nature of, of any of these things. and the list goes on in terms of possible resources and referral there, making sure your basic human needs are met. So often parents set aside their own physiological and emotional needs. While taking care of a baby. They get so subsumed under baby care. That they just forget literally to drink enough fluids.
Esther Gallagher: [00:09:15] So hopefully your postpartum care provider is somebody who attends to that and helps you see whether, oh, gosh, you know, actually I felt so depressed I was dehydrated. You know, maybe you just feel better.
Esther Gallagher: [00:09:33] And then there’s the issue that we always come back to, which is sleep and which is why I see so many people. Concerned to pay a lot of money for a nighttime doula. Thinking that that’s going to cure their sleep problems as a new parent. And for some people, maybe it does. But I think learning to sleep while your baby sleeps, learning to rest when your body is telling you with some clear signals that you’re probably ignoring. No, no. I actually need to lay flat right now. I need to put down the phone, turn off the movies, the television, you know, do the things that are going to make for me getting the physiological rest that I require. You can’t do this in four hours, right? Sarah, like you quickly start to erode. And unfortunately, what I find is parents start to focus on the baby as the cause. Right rather than just a co conspirator in this family space of like, we all need sleep and we all need food and we all need the things and we need to adjust our expectations around how those things come to us when there’s a new baby who’s doesn’t work a 9 to 5 or and then sleep from 10 to 6, right? Like, that’s not what they can do.
Esther Gallagher: [00:11:03] So, and then the other thing a postpartum care provider can. Can help with a sense of empowerment around making parenting decisions. So often we’re kind of tuned to who’s the expert that I can throw this problem at. Get the prescription and fill it out. Right. A little bit of my brain telling me around. How to respond in this situation with these people and. Of course, people with a lot of knowledge and experience come in really handy. If we’re really out to sea and need somebody who can reel us in and say, okay, little fish out of water, you know, how about we try this, this and this? But often what we need is help with just quieting down. Enough so that we can be present. And bring our intuition to bear around. How do I be with this new little body? How do I be in if I’m in a triad or bigger? Who are the other people who are part of this family, who are involving themselves in this moment or choosing not to involve themselves in ways that feel difficult for me? Right. We may have had expectations and now those aren’t being met. How do we work with that? So, yeah, all of that is. Actual and potential things that a postpartum care provider might help with.
Sarah Trott: [00:13:01] Thank you. It’s such a wide array of potential support, practical support in the home with meals or cleaning or holding baby while mom goes to take a shower, that kind of thing. Mental, emotional support. Having someone to talk to. Having someone to hold their hand. Having someone to ask questions. If you’re feeling unsure about what a doctor or a nurse or someone else has said. Providing that sounding board for additional information. It’s just, it’s quite a lot.
Sarah Trott: [00:13:34] And there are a lot of people who still have never really heard of this or this concept, and they get so surprised when they are gifted some support and how much they love it and how valuable it is. So I can’t emphasize this enough. If you think you even have an inkling that it might be helpful, just try it because it will probably blow you out of the water and you won’t be able to imagine what life was like without it.
Sarah Trott: [00:14:01] And it’s not something everyone can afford and access. And I understand that. So it’s really if you’re in a position to do it. I would also urge the United States healthcare system to start accepting this care as part of a part of a formal health care service that’s provided to parents because it’s really, really valuable and helps support parents and families in lots of different ways.
Esther Gallagher: [00:14:29] They have it in other countries. Yes, it does exist as a cultural feature all over the world. It’s just us that says, no, we don’t value this enough to provide it to every family, which is very sad now.
Esther Gallagher: [00:14:48] And along those lines, Sarah, I always like to include in this podcast what our friends and family can do for us. So maybe you have friends and family who you would ask for these forms of support, maybe not all in one person, but maybe there’s somebody that you really like, how they approach food and you know, it’s super nourishing and you can ask them, Hey, would you be willing to cover meals for me one way or the other for 2 to 6 weeks while I’m healing and recovering? Hey, I really love your touch. We’ve always had a nice, intimate relationship. Would you be willing to stop in once or twice a week while I’m healing and recovering and just. Just show up and snuggle my body a little bit, help me feel a little physically better.
Esther Gallagher: [00:15:39] Or, you know, everyone can have a registry for a baby shower. You don’t need a lot of baby clothes. They grow out of them really fast. You don’t need fancy doodads, you don’t need a lot of flowers. Even those things are all nice. But maybe people who’ve been invited to be part of gifting you, showering you with gifts would be willing to coalesce a fund that helps pay for somebody who’s got this base of knowledge and skills and is able to come in and be the person for the new parents.
Esther Gallagher: [00:16:24] I also want to mention, you know. Some partners are super in there and don’t need a lot of coaching around what to do. Right there, just making sure things are covered and they’re snuggling in and they’re supporting, feeding the baby and all the things. And as we say, like it’s been more than 30 years that I’ve been doing this and. I still see the same recurrence of partners who just are kind of taken aback by the whole event of birth. Haven’t really figured themselves out in it at all. And I think that often the Mo there is to just move away, right? Just move away. A postpartum doula who’s comfortable with it can be a person who can help you move in, like with simple little things, like why don’t you just sit beside each other while that baby’s getting fed and oh, here’s you’re not comfortable with burping that baby in between breasts. Like, let me help you get comfortable with that. I see you feel a little awkward with the diaper changes. What if we try this? I want to try that. You know, these little teeny, somewhat silly from the standpoint of they’re just little tasks to most people. Or feel like just a tacit thing that has to get done.
Esther Gallagher: [00:18:07] You burp the baby, you change the baby, right? You feed the baby? These are the ways that we make. Connection. And if we’re feeling like we’re not skillful at those things, we’re clumsy. We’re worried. We’re anxious about how to do them without, you know, maybe it’s really hard for us when we hear a baby cry. We need help, right? Because. This is where the relationship begins. And you know, our children. Benefit from a sense of safety in the presence of parents, right? Like, oh, this person has me. They’re comfortable. They’re not skyrocketing into anxiety. They can, you know, handle a little snuggling and holding and burping and changing. So I think starting there and going from there with resources for parents, right? Resource support, if if it’s a deeper thing that needs to be addressed by maybe a more professional in the field of psychotherapy or something of that nature, your postpartum doula is going to be a resourceful person who is willing to find resource for you if they don’t have it in their back pocket for you already.
Esther Gallagher: [00:19:36] So again, this is a family affair. It’s not only for the birth giver or. Again, we’ve talked about adoptive parents on this podcast. You know, not everybody comes to the presence of a tiny baby and feels comfortable with it, regardless of their gender identity. So. We can help.
Sarah Trott: [00:20:04] Yes. It’s almost like the postpartum doula is acting like the quarterback helping observe everything, call some shots, help give some coaching, some support along the way.
Esther Gallagher: [00:20:16] Yeah. And hopefully you don’t end up feeling like the football at the end.
Sarah Trott: [00:20:21] Yes.
Esther Gallagher: [00:20:23] Hopefully we feel like dancing, doing the touchdown dance. Yeah. There’s a lot to sort out and it doesn’t have to be all at once. You know, you’re going to be a parent for the rest of your life now that you’ve done this thing. So, you know, this is your parenting journey. It’s a long one, presumably not for everybody, but for most people. And. Little by little, you’re working it out. And there are people in this world who have made it part of what they do to guide and support you
Sarah Trott: [00:21:13] Lovely Esther. Let’s talk through a day in the life of a doula. So let’s say you’re going to visit someone. What? What is that like?
Esther Gallagher: [00:21:24] Yeah. So come in the door. Wash my hands. After maybe greeting the dog. Who wants attention first? Wash my hands, say hello, and do kind of a broad observation. Right? Like, what’s going on in this space? A little bit. Is it super tidy? Is it super? Not tidy. Now, no judgments about either. But that’s information, right? Somebody has been spending time doing this. Who was it? Mom, who’s still bleeding and hasn’t gotten a milk supply up to speed yet, Right? Like, okay, then that’s something. I know I’m going to need to massage a little. the next thing I want to know is. Are people getting fed and watered? When’s the last time parents had some food? I will make a note of that. Very high on the agenda. But co-located with do parents eat is when’s the last time the baby fed and what’s the baby doing? Is this a baby who’s sleeping? Is this a baby who is showing feeding cues and needs to be fed, but parents aren’t really aware of that yet? They haven’t quite figured out what’s a feeding cue.
Esther Gallagher: [00:22:56] So breastfeeding support is high on the list when it’s appropriate when babies are in a state of readiness. Is this baby a baby who’s going to show readiness? If not, then we have another way that we’re going to be addressing feeding this baby. That’s a whole topic for a podcast, which we will do. What’s sleep been like? Let’s talk about that. Right. Maybe during a breastfeed and then, of course, somewhere in there, I probably will have thrown a pot of water on the stove to make this sitz bath herb tea that’s going to go in the bath tub for the birthgiver to soak in and do another breastfeed during that.
Esther Gallagher: [00:23:42] Or maybe I just leave them alone quietly with a snack, a little mini meal to just chill out and get some time to themselves. and maybe while that’s happening, I’m doing a download with the partner and finding out like, how are you coping, how are things going for you? Is there anything that’s particularly maybe a little stressful for you in this zone? Is there something you’d like to feel like you could be better handling? Let’s talk about that And. In the case where everyone can settle in for a little snooze. I’m also preparing food in that space now.
Esther Gallagher: [00:24:31] I managed to hit all those notes in a three hour visit. That includes maybe having thrown a load in the laundry and switched it out to the dryer, or on a day when that’s not happening, maybe done a little folding. So it kind of depends on what’s presenting and what feels most pressing. I’m not going to fold laundry if I have parents who are in a feeding crisis between either their babies or themselves. Right. I’m going to point myself at. Basic human needs. First and foremost. Sleep. Food. Sleep. Food. Sleep. Food. Right. Those are primary. If we’re not hitting those notes, things go crummy quickly. Right? So and and all those other things get attended to in the time that I have almost always.
Sarah Trott: [00:25:34] So is a three hour visit pretty typical then?
Esther Gallagher: [00:25:37] For me it is. I would not say that that’s common for other doulas. I think it starts at three and goes up to eight. You know, some doulas are doing eight hour days or nights as we talked about during the span that they’re doing. And you know, some are are starting right in, they’re hitting the ground running and everyday visits until everybody’s on an even keel, which starts to feel true around two weeks for most families even keel being we’re ready for we’re ready for action.
Esther Gallagher: [00:26:19] We understand that, you know, this is a very dynamic thing we’re doing and, you know, bleeding and breastfeeding and, you know, body things are pretty even keeled. And if not, we’ve started addressing them with further therapeutic modes. I think the physiological window for healing and recovery is really six weeks commonly. And so it makes sense for a lot of people to just plan for that, especially if they have no other resources going in. And then we you know, the fourth trimester is we tend to think of it as a three month span. And for some people, they’re really going to need a wing person for that much. Maybe not every day. Right. Maybe it becomes every other day or twice a week as we go by. But yeah, that’s kind of the different ways to kind of imagine and think about what. What kind of care and how much care do I imagine I need? And these are all discussions to have with the person that you call up and interview about possibly being your doula.
Sarah Trott: [00:27:41] Okay, great. So maybe something we can do is add a list on our show notes here of good doula interview questions. So go to our site. We’ll put that there. And I wanted to see if there’s anything else you want to touch on.
Esther Gallagher: [00:27:57] Just circling back to how available it is in some ways in our culture to kind of relinquish a kind of power and agency around parenting, and hopefully your postpartum care provider is somebody who helps you sort out and reinforce your intuition, your power in an agency around parenting for this journey and isn’t coming in with a lot of shoulds, but helps you explore alternative ways of looking at the same thing. And and. You know, kind of supports you and feeling literally somatically in your body feeling for. What’s my impulse here? Right. And not shutting that down, because most of the time it’s a pretty good impulse, right? You know, and if you feel as though your impulses can’t be trusted, let’s talk about how do we get closer to the kinds of impulses that can be trusted. Yeah.
Sarah Trott: [00:29:20] So that’s a great note for us to end on and we’ll wrap up here. Thank you so much, Esther. It’s really great to be chatting with you again today.
The content provided in this article(s) is provided for informational purposes only and does not constitute medical or other professional advice. Neither Sarah Trott nor Buckeye Media LLC (DBA Fourth Trimester) are liable for claims arising from the use of or reliance on information contained in this article.