New York Times STYLE:
If Only Everyone Had a Postpartum Doula
When a baby comes, friends and families don’t always know how to help.
A version of this article appears in print on Oct. 3, 2018, on Page D2 of the New York edition with the headline: Everyone Should Have a Postpartum Doula
New parenthood — during which ordinary people find themselves abruptly responsible for a brand-new and sometimes famished, inconsolable being — is famously harrowing.
It’s good to have supportive family and friends during this time. But increasingly, parents are turning to postpartum doulas, as well.
Unlike birth doulas, who assist mothers during pregnancy and childbirth, postpartum doulas step in when the baby is already born, and throughout the first six weeks after birth. They teach the supposedly natural but actually quite difficult to master skills of soothing, bathing and breast-feeding infants, without any personal baggage.
There is no one agency that certifies all postpartum doulas, but between 2012 and 2017, DONA International, the oldest doula certification program in the country originally known as the Doulas of North America, accredited 37 percent more postpartum practitioners. The number of certified postpartum doulas at the Childbirth and Postpartum Professional Association (CAPPA), another well-established program, has doubled since 2008.
Meema Spadola was certified by DONA in 2006 and practicesin the New York City area. With cropped black hair and pink-framed glasses, Ms. Spadola, 48, is a modern Mary Poppins: a combination friend, teacher and spirit guide with a price tag of $50 to $70 an hour.
One sunlit afternoon, she mounted the red brick steps of a new client’s house in Brooklyn, armed with a stretch of black fabric for “babywearing” (like a sling for your infant) and a recipe for high-protein nursing snacks affectionately known as “boobie bites.” (recipe and nutritional facts following article) The client, Shannon Gillen Lipinski, a 37-year-old choreographer, had become a mother just 8 days earlier.
Upon entrance, it became clear that Ms. Gillen Lipinski’s home had been recently transformed. A tarp taped over the front window blocked the day’s bright light. Empty plastic pumping bottles were waiting to be filled; a giant gray birthing ball rolled aimlessly; and the closet was stuffed with tiny onesies covered in bunnies, strawberries and polka dots.
The eight-day-old at the heart of it all, Sasha, was mercifully sleeping, wrapped against Ms. Spadola’s chest, but everyone knew the peace was tenuous. And too soon it was time for Ms. Spadola to teach Ms. Gillen Lipinski swaddling, which meant she had to risk waking the baby and eliciting cries.
“This is so scary,” Ms. Gillen Lipinski said, her voice breaking.
“We’re being very daring,” Ms. Spadola said, laying out a pink blanket inside the crib.
Ms. Gillen Lipinski had committed to choreographing a show in Los Angeles that started in several weeks. With the rehearsal deadline looming — and Sasha prone to crying through the night — Ms. Gillen Lipinski was exhausted. She was trying to learn how to breast-feed and pump milk and calm her infant when she herself was in a panic, but nothing seemed to be going smoothly.
“We always thought we’d have two,” said Ms. Gillen Lipinski. But, she said, perhaps swayed by the three hours of sleep she got the night before, “we just completed our family.”
“It will not always be like this,” Ms. Spadola reassured her, expertly folding the pink blanket over itself to create a tight cocoon around Sasha, while simultaneously patting the baby’s chest and firmly whispering “Shh.” Sasha opened her eyes, yawned and squirmed.
New parents Shannon Gillen Lipinski and Tom Lipinski with their postpartum doula, Meema Spadola, left, and 8-day-old Sasha.CreditAndre D. Wagner for The New York Times
“Ack,” she gurgled, before falling back asleep.
Postpartum doulas like Ms. Spadola fill a void in the U.S. healthcare system. There’s no national healthcare program for new mothers here the way there is in many other countries, despite growing evidence of the postpartum period’s importance in the health of both babies and their mothers.
Medical providers and policymakers have already recognized that birth doulas improve such health outcomes. Two states, Minnesota and Oregon, now include birth doula services in their Medicaid coverage, and in the spring of this year, Gov. Andrew Cuomo announced a pilot program to expand Medicaid coverage for doulas in New York. The idea of hiring such doulas has gotten a lot more mainstream.
Still, even as postpartum doulas multiply, the care they provide remains largely unsubsidized and expensive. (The majority of Ms. Spadola’s clients are white, upper middle class and can pay out of pocket, though she does offer a sliding scale.) And though the care aims to be non-judgmental, it often comes along with white, middle-class assumptions about parenting, said Christine Morton, the author of the book “Birth Ambassadors,” which chronicles the rise of doulas in the United States.
Some birth activists and nonprofits are working to change that, and to make postpartum doula care more democratic and widespread. Ancient Song Doula Services in Brooklyn, a low-cost doula collective for women who couldn’t otherwise afford one, is one such place. The majority of the organization’s clients are women of color, and more than half of the doulas are low-income themselves, volunteering to help other women through labor and after birth. The collective is fighting abysmal maternal mortality rates among black and brown women, in addition to well-founded fears among women of color, said Chanel Porchia-Albert, its founder.
“A lot of times women of color won’t express what they’re going through, or seek out help, because they don’t want to be criminalized for the choices they make,” Ms. Porchia-Albert said, adding that a black woman might fear losing custody of her children if she admits to being overwhelmed or exhausted.
One client, Aisha Crawford, 33, wanted to be prepared for anything that might come up when she gave birth, so, six months pregnant, she arrived at Ancient Song to get matched with a postpartum doula free-of-charge. She took a seat in the intake room, a comfortable space outfitted with yoga pillows and a baby crib, and explained her situation to the intake coordinator. She and the father of the baby had a fine relationship, and she wanted him to be involved when the baby arrived. But she wasn’t sure she could depend on him.
“I don’t want to say I’m scared to have the baby by myself, but just in case, I need someone there with me,” Ms. Crawford said.
Like other workers who provide intimate care, postpartum doulas become experts at navigating the delicate and the unsaid: a pregnant woman’s hopes, family expectations, nerves and the relationship between a baby’s parents. They are advocates for their clients not just to doctors and nurses, but also to family members, who have their own ideas about how things should be done.
Ms. Crawford said her parents were initially wary of her pregnancy, because she was still legally married to a different man, who would not sign divorce papers. Berenice Kernizan, Ancient Song’s intake coordinator, nodded empathetically.
“I’m sure as soon as the baby comes, they’re going to forget all about that,” she said. “The way they nag you is the way they show you that they love you.”
Shifting on the couch, Ms. Crawford said she was a little nervous about much of what lay ahead: the months of pregnancy, the hours of labor, and, perhaps most daunting of all, the day the baby would come home with her, delicate and perfect and in need of so much.
“We’re just there to be like that sister-friend,” Ms. Kernizan reassured her. “Guiding you through the whole experience.”
Boobie Bites – Energy Lactation No Bake cookies
I double the recipe as its THAT good. I took this from Pinterest to calculate the calories. Hope everyone enjoys them as much as I do!
Minutes to Prepare: 10 Minutes to Prepare: 15 Number of Servings: 60
1 cup of old-fashioned oatmeal
1/2 cup peanut butter or other nut butter
1/2 cup ground flaxseed
1 cup shredded coconut
1/3 cup of honey
1/2 tablespoon Brewer’s Yeast
1 teaspoon vanilla
1/2 cup mini chocolate chips
- Combine the dry ingredients first: oatmeal, coconut, chocolate chips, Brewer’s Yeast, and flax seed.
2. Add the peanut butter, honey, and vanilla and turn your mixer on low (or stir together).
3. Refrigerate mixture for at least one hour.Serving Size: 1 inch ballNumber of Servings: 60
Recipe submitted by SparkPeople user JOLOVE22.
- Servings Per Recipe: 60
- Amount Per Serving
- Calories: 71.6
- Total Fat: 4.4 g
- Cholesterol: 0.0 mg
- Sodium: 32.3 mg
- Total Carbs: 7.4 g
- Dietary Fiber: 1.5 g
- Protein: 2.1 g