Someone who comes in to cook meals, provide emotional support, feed your baby while you sleep and even let you rant about your nosy relatives? Not too good to be true: This, among other things, is the role of a doula. Doulas provide support and guidance to new parents during and after birth; in honor of World Doula Week, which happens the last week of March, we’re talking to several for their advice.
Jane Spitzer owns Tender Mother Care Concierge in Norfolk, Mass., and she travels frequently to clients between Boston and Providence. She’s also Jewish, and she feels that her training is an integral part of her Judaism.
Some people might get midwives confused with doulas. What’s the difference?
Midwives often are nurses; they have more advanced medical training and usually go to nursing schools, which have midwife programs. They have the ability to prescribe and also to diagnose conditions. They often work alongside OB-GYNs as do doulas, too, but more in a medical capacity, and are able to handle more complex circumstances relating to birthing.
During labor, a doula will often help with positioning and with different exercises in different stages of labor. In my opinion, doulas often provide more emotional support and holistic and natural support. I’m a medically-based doula. I believe in science and evidence.
What should people look for in a doula?
You need to find someone you’re comfortable with—they will see you in pajamas or feeding. You want someone you feel a connection with and can be vulnerable with. Doulas should be insured, trained as a doula by CAPPA or DONA, have references from families and be CPR certified.
How much does it cost?
It can vary, and nights cost more, usually from $30 to $65 per hour. It’s a great new-mom gift. Sometimes, if lactation consulting is involved, it can be covered by insurance.
What’s your process?
How long do families usually have doulas?
Most doulas work up to three to four months; after that, you start to become a babysitter.
What kind of emotional support do you provide?
I suffered from postpartum anxiety and depression, and I had very subtle undiagnosed symptoms that were hard to read. People talk a lot about depression—crying and not being able to get out of bed. It’s more complex than that. I volunteer for groups, speaking at MGH and many hospitals. My mission is to make moms aware of the subtle differences and how to tease out whether you have normal blues or something more. It’s my mitzvah.
How can women get help, and what signs should they look for?
You need a perinatal mood specialist or clinician to diagnose you, but there are people more prone to having postpartum depression or anxiety: people who have gone through a traumatic birth; maybe the baby suffered when born, maybe mom went through a physical trauma from a botched C-section or her baby didn’t have enough oxygen. Those types of events can lead to a crash. I tell my clients that they always need to know their mental history and take ownership of it. I highly recommend seeing a psychiatrist or perinatal mood specialist to find medication or a plan for before going into birth; this is something you need to plan for if you have a family history.
Crying is normal for up to a month, but after two weeks you should feel like you’re getting better. It’s difficult, because [after birth] is when we’re in our most sleep-deprived state. Sleep is one of the biggest triggers for postpartum depression. If you feel like you’re still crying after two weeks, if you have restlessness—sleeping too much or too little—this is usually the first sign that something is going awry.
The other thing nobody talks about is postpartum anxiety. This can look like the desire to control everything. A lot of people get very controlling and begin nesting before giving birth, which is normal, but if it starts consuming the majority of your day and becoming a frantic race to get everything done and be perfect, it’s a tip-off too. There are also intrusive thoughts: Women can start worrying, and they may have visuals in their head of actually hurting their baby. Or it can be more subtle, what I call “caring gone awry.” For me, I cared so much, I worried: What if I bathed my baby and my daughter flipped over by accident and drowned and someone thought I killed her?
What resources do you recommend?
Is there a connection between your work and your Jewish faith?
When you come in and take care of someone, being caring and empathetic, as a Jew, that’s the kind of person I want to be. I do tend to have a lot of Jewish clients, and I think there is a connection with the food, love and care—not that other cultures don’t share that—but there’s a common bond with a Jewish doula if they have a Jewish client. I have a hamsa on my business card because it’s good energy. Food, love, healing and looking out for the best interests of someone is a mitzvah and a good deed, and it makes me fulfilled to help people feel trust and safety in the world.
What’s your biggest piece of advice for new parents?
Never be afraid to ask for help when you need it as a new mom or a second-time mom, and never be ashamed to ask for help. And never take unsolicited advice personally.