Mothers are Number 1 with the Doula

Mothers are No. 1 with the Doula
By Cara Tabachnick

Michal Glines was pregnant for the first time at 40. A planner by nature, she had a husband, a house in Tucson, Ariz., and a successful career as a landscape designer before deciding to start a family.
But when John was born, she and her 43-year-old husband, Michael Racy, a lobbyist, concluded that no amount of preparation could ready anyone for a child.
“I am a businesswoman with a career,” she said. “Your instinct is to handle the child the way you would handle a business, but it doesn’t work that way.”
Enter the postpartum doula, a combination nurse, mother and information source. Different than the more common birth doulas, who assist during labor and delivery, the postpartum doula arrives after the baby is home to counsel the mother on breast-feeding and swaddling and to dispell old wives' tales. And, most important, the doula keeps a sharp eye out for signs of postpartum depression.
The popularity of postpartum doulas is growing swiftly, said Tracy Wilson Peters, executive director of Childbirth and Postpartum Professional Association, a national organization of doulas and birth experts. While the group does not keep records on the number of working postpartum doulas in the United States, "since 2002, calls to our organization have increased by 31.5 percent,” she said.
Postpartum doulas fill gaps in the traditional family network as women move away from home and establish careers first and start families second.
This group of women in their 30s and 40s tend to be well-educated about childbirth and financially secure, since most doula services, which can cost from $20 to $40 an hour, are not covered by insurance.
“Sometimes new parents feel uncomfortable asking parents for advice or they live far away,” said Nancy Barber, 59, Glines' doula and owner of We Follow the Stork in Tucson.
For most postpartum doulas, the emphasis is on the mother, who they feel needs the most help.
“Mothers need to be mothered so they can have successful babies in society," said Jane Honikman, a founder of Postpartum Support International in Santa Barbara, Calif.
Mothers are often forgotten after the birth, she said, when most of the attention goes to the baby. Some mothers feel overwhelmed or cut off from family and friends after making the transition from career woman to stay-at-home mother.
“The weeks after birth are a real period of isolation in our society,” said Christine Kealy, 60, owner of In a Family Way, a postpartum doula company in New York that caters to urban professionals. “Women are used to doing things well. When a baby comes they are in uncharted water.”
One of her clients, Annika Pergament, a broadcast journalist in her 30s, said, “Little things all of a sudden become huge tasks that you are not sure you can accomplish.”
Allyson Orell, 33, lost her mother to cancer shortly before she decided to start her own family. In the weeks following the birth of her daughter, Julia, now 13 weeks old, she felt isolated and overwhelmed and struggled with depression, even though she had family support near her home in Lantana, Fla.
“I had other relatives around, but it was hard, they all have their own lives,” Orell said. Once she decided to use New Beginnings, a local doula service, Orell said she felt more confident every day.
“Now I wouldn’t have any other children without using a postpartum doula,” she said.
Doulas--the word means woman's servant in Greek--give advice gleaned from experience, training sessions or doctors about how to care for infants in areas like breast-feeding or swaddling.
“Breast-feeding is complicated,” Barber said. “People don’t realize babies have to be positioned right. Little things have to be tweaked.”
“It is a huge, huge life change,” Glines said. “To have someone come and answer all the strange questions I wanted to ask is invaluable.”
A report by DONA International, a nonprofit group with 5,700 members that trains and refers doulas, said new parents who have support and feel secure and cared for are more successful in adapting than those who don’t. And they have greater success in breast-feeding, have more self-confidence and endure less postpartum depression.
“Whenever there are support systems in place, it can be helpful in ameliorating postpartum depression,” said Dr. Paul Gluck, associate clinical professor of OB/GYN at the University of Miami and an expert on postpartum depression.
“It hasn’t been proven or studied yet to have an effect, unlike birth and labor doulas, but it makes sense that using postpartum doulas will help alleviate stress,” he said.
“After all,” added Honikman, the stress center founder, “birth is just a moment in time, but postpartum is forever.”
E-mail: cjt2113@columbia.edu