Re: postpartum service line.

[Guest guest]

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I have been all over your website for a long time now, answered

surveys and read your resource material more times than I can count.

Your service is wonderful-we could use you here.

Adrienne and anyone else who can add input.

The only doula's in my area are hospital based. I am familiar with

the national organizations and have sought resources there as well.

The problem that I am in South Carolina, and we are a little behind

in everything except the fun stuff like STD's and heart disease.

I am discovering that as my practice grows, I am hearing more

interest focused on postpartum support from a doula or similar role.

Primarily support and education, plus a little light housekeeping,

meal help etc. I am looking at using an expereinced person in this

role at an hourly rate as a outsource; adding my fee to the base

salary. Obviously I would carefully screen and do some training for

continuity, but I would seek out individuals who could really

function autonomously. My questions are:

What percentage of your patient population uses postpartum doulas?

What are their responsiblities? More important, what will they NOT do?

What are their fee's?

How many hours or how long are they usually needed?

Thanks!

Altman

All The Best

www.feedyourbaby.com

[Guest guest]

In Portland, OR, postpartum doulas Re: postpartum service line.-I have been all over your website for a long time now, answered surveys and read your resource material more times than I can count. Your service is wonderful-we could use you here.Adrienne and anyone else who can add input.The only doula's in my area are hospital based. I am familiar with the national organizations and have sought resources there as well. The

problem that I am in South Carolina, and we are a little behind in everything except the fun stuff like STD's and heart disease. I am discovering that as my practice grows, I am hearing more interest focused on postpartum support from a doula or similar role. Primarily support and education, plus a little light housekeeping, meal help etc. I am looking at using an expereinced person in this role at an hourly rate as a outsource; adding my fee to the base salary. Obviously I would carefully screen and do some training for continuity, but I would seek out individuals who could really function autonomously. My questions are:What percentage of your patient population uses postpartum doulas?What are their responsiblities? More important, what will they NOT do?What are their fee's?How many hours or how long are they usually needed?Thanks! AltmanAll The Bestwww.feedyourbaby.com

[Guest guest]

In Portland, Oregon, postpartum doulas tend to be private-practice based. They charge between $18 and $25 an hour for their services. Some specialized in overnights or multiples. Their services focus around "mothering the mother": providing emotional support, running the home so mom can rest, teaching infant care, demonstrating how to use different baby carriers, slings, etc., caring for older children, preparing meals, running errands, doing laundry, etc. They provide breastfeeding assistance like helping get baby positioned, giving moral support, keeping the mom's "nursing startion" well-supplied, helping set up and wash equipment, etc. We had a postpartum doula come with a mother to our

breastfeeding

support group today (mom was feeling nervous about coming alone). Like all doulas, postpartum doulas do not perform clinical tasks. They tend not to do heavier housework, either (like mopping floors or cleaning bathrooms), but that depends on the doula. Their goal, in a way, is to work themselves out of each particular job by helping the family through this major adjustment and then moving on when mutually desirable (which, for some families, is tricky since they want the doula to stay until the kids are in college!) I hope this helps a bit. Let me know how it goes for you or if you have any other questions. Yours warmly, Adrienne

[Guest guest]

It would be wonderful to have more postpartum helpers

available who focus on " mothering the mother " and

helping with meals, housework and errands. Because

what I tend to see is someone who comes in and takes

over the baby-care so mother can " rest " and thereby

keep her from getting comfortable in her new role.

I'm sure you're aware of how loosely and incorrectly

the term " doula " is being used out there.

I recently had a long visit with a mother with *zero*

confidence in her abilities to breastfeed or deal with

this baby at all, and a two-week-old who wasn't

gaining well. During the two hours, the baby was

being changed, carried in a sling, soothed, etc, by

the doula, except when I would specifically get mother

and baby together for breastfeeding, after which she'd

hand the baby off again. The doula was very nice,

obviously loved babies (who are infinitely more

appealing than housework, granted) and an expert

baby-soother -- but this baby didn't need to be

soothed, she needed to be with her mother more. I

really tried to stress the skin-to-skin, early cues,

etc. and brought the doula into the conversation about

how she could clear the decks and help the mother

focus on this -- but it's hard to say if anything

registered.

Of course it's different when someone hires a " baby

nurse " or worse yet, a " sleep trainer " specifically to

take over baby-care at night. Recently a mother of

twins mentioned that the " night doula " was giving

fortified breastmilk. Since the twins were born a bit

early, I assumed this was some hold-over from the

hospital's use of fortifier (which sometimes goes on

longer than necessary). But it turned out that this

" night doula " was adding powdered formula to the EBM

so the babies would sleep longer, and " learn " to sleep

through the night. Arrgghh! I then explained that

any fortification had to be done very carefully so as

not to overtax immature kidneys or upset the baby's

delicate fluid balance, and that she should

immediately discuss this with her pediatrician (who

I'm glad to say was quite strong in her response, and

the mother fired the " night doula " (who unfortunately

is still out there for the hiring.) I think this

mother was uncomfortable with this arrangement anyway,

or she wouldn't have asked.

Sorry this has turned into a long rant. Mothers need

someone to provide the space and time so they can get

breastfeeding off the ground and learn their new job.

(That great book, " Breastfeeding Made Simple " explains

how in traditional societies provide a designated time

of rest and seclusion for new mothers and babies --

that would be an excellent book to include in

doula-training). I think mothers also need to be

educated on what they ask from their employees (some

new mothers are very deferential to the " baby nurse " ),

and be ready to defend their own mothering turf.

I wonder if somehow you could tap into the labor pool

available among retirees, who might be trained as

doulas -- maybe advertising in one of those " better

than 55 " communities. A lot of vigorous women in

their late 60s or early 70s might appreciate this kind

of flexible, part-time work with cute babies, which

would come in short 1-3 week stints that would still

let them travel, etc. as needed. A calm, older woman

who's a good cook might be a great helper.

Margaret Wills

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