Monday, September 23, 2013

Is DAD the Ideal Postpartum Doula?



Is DAD the Ideal Postpartum Doula? 
 Is DAD the Ideal Doula? as published on The Birthing Site
by Allie Chee, with comments from Darren Mattock, Darla Burns, Elly Taylor, and Dr. Ning X. Fu, O.M.D., Ph.D

Postpartum care around the world has well elaborated traditions that support healing, bonding, and growth for the new family. They are respected and received by families in all financial strata. These traditions are considered essential not only to the mother’s immediate recovery, they’re believed to benefit her subsequent pregnancies, menopause, and golden years.

The postpartum time for women in the US historically involved at least periods of bed-rest, during which an experienced woman—usually one or several family members—supported the new family.

However, the concept of postpartum care for the family is currently the subject of debate in the United States where
the words “indulgent,” “expensive,” and even “classist” appear in discussions.
Most recently a reviewer of my book New Mother suggested that my position on the father’s role postpartum was one-sided and underestimated fathers’ abilities.  I was happy the reviewer raised that valid and important question, because it caused me to consider why I’d written (in New Mother and many other places) that women experienced in caring for new mothers and newborns are the ideal postpartum care providers.  It caused me to reconsider…

What About the Dads?
My premise about postpartum care is based on practices I’ve seen around the world and my study of Western and Eastern medicines’ postpartum traditions. But the intention of this article is not to discuss the strengths of the traditional caretakers around the world and their methods/skills.  It’s to address the questions: What about the dads? Aren’t they the ideal postpartum doulas (or caretakers)?
I’ve known many fathers who were wonderful in their understanding and care for their family postpartum.  My husband is one of them, but of course we had our share of challenges.  He attempted to take three weeks off postpartum, but since he’d only been in a new job for two months, we actually felt fortunate that he could be home for seven days.  (And recall, the US is one of only a few countries that mandates zero paid days of maternity or paternity leave—so that every day a father and/or mother stays home, they’re likely losing income.) Despite working full days and a having a commute approaching four hours round trip, my husband would come home and spend time with our baby and help me.  Our baby’s skin never touched the sheets—she slept on either my chest or her Daddy’s for every nap and nighttime for the first month of her life.  (However, that didn’t mean we didn’t want to allocate the budget for professional postpartum care.) 
I felt fortunate that my husband was so involved. But many women don’t have partners who are capable of giving them the kind of care they need, even when they have the desire and ability. They simply don’t have time. If working, they’re away from home 8-12 hours a day. New moms and babies are awake throughout the night, and questions and needs arise around the clock.  If dad works all day and helps all night—when does he recuperate? And then, of course, there are moms who don’t live with or have any participation from the fathers.
However, even if they have a few days or weeks off from work, even if they’ve had other children and thus some experience, and even when they want nothing more than to help—expecting the father to be the primary or only caretaker is shifting our culture’s “you-can-be-and-do-it-all” expectation from the mother to the father.
What I wrote in New Mother is that it’s everyone’s postpartum time—dad’s, too.  He is elated over the birth, experiencing new emotions about his responsibilities, is losing sleep, is trying to maintain his focus at work, and he may be new to parenthood. 
Traditionally it was women (usually family members and sometimes paid help) with experience caring for newborns and postpartum women who offered the primary support. This allowed everyone to settle into the new experience joyfully and with significantly reduced stress.
• How many fathers in the US (or anywhere in the world other than countries mandating paid paternity leave) can take off a few months or even a few weeks from work?
• How does a new mom or dad know if the blood clot mom just passed is a “normal” size, or if she’s hemorrhaging? 
• How does a dad know how to prepare a sitz bath and check sutures to see if everything is alright “down there?”
• How does either know what to do if mom has a blocked duct or simply isn’t getting a good latch breastfeeding?
• How does dad know if mom is experiencing the normal hormonal shift and emotions that occur when mom’s milk comes in or if something more severe is happening? 
• How would dad know what foods and beverages are most healing and supportive for lactation?
• How would dad answer if mom asked, “Do you think I’m making enough milk for our baby?” or “Is this rash normal?” or “Is our baby’s skin too yellow?” or “Why does our baby’s lips have blisters on them?” or “Is the ____________ (head, umbilical cord, poop, you name it) supposed to look like that?”
• With 30-50% of new moms in the US delivering their babies by surgery, and ever increasing numbers of mothers having conceived through medical intervention, even more issues can develop postpartum that neither mom nor dad would have a way to anticipate, understand, or know how to respond to.

It’s true that it’s not necessary. We don’t have to know these things. We don’t have to have someone prepare a few meals for us, to answer our dozens of questions immediately, or offer us a little opportunity for rest and quiet time together as a family. Mom and/or dad can do it all.  
That applies to any time of healing or rite of passage. Let’s look at a few examples. Marriage: a man and woman don’t need the love and support of others and all that expense and fuss to get married. Jeez, just give the justice of the peace $50 and get back to work.  After major surgery of any kind, we don’t need support. We’ll probably heal sooner or later whether or not we eat well, rest, and feel loved and cared for by someone with post-op care experience.  (Just to be sure…I’m being facetious!)
The question is why? Why go through any life altering experience—with so much potential for joy and bonding—alone, exhausted, and depleted? Why expect mom or dad to do it all?
How comforting and peaceful to have a knowledgeable, experienced woman at our side—even if only a few hours a day for a few or several days—who can allow mom and dad a little more sleep?  Who, with her experience, can quickly help and dismiss concerns—leaving mom and dad to revel in the new spirit who’s joined their lives! 
Opinions aside: Take a glance at the statistics of new mothers in the US suffering from PPD, PPP, failing to breastfeed when they wanted to, requiring pharmaceuticals to function, returning to work as soon as possible and leaving the care of their newborns to strangers—especially in light of the statistics for these same issues in third-world countries. It’s clear that our approach to the postpartum time is flawed.
As Valerie Lynn, author of The Mommy Plan, said for an article I wrote for the Spring 2013 issue of Midwifery Today, “In Western countries the notion of a ‘resting period’ after childbirth is deemed an extravagant and self-indulgent act by a mother. I find this generalized opinion to be uninformed, outdated and baseless when there is an overabundance of statistics indicating some of the highest rates of postpartum-related illnesses belong to high income or developed countries, such as the United States.”
Postpartum support for the family is not considered a luxury in cultures all around the world—it’s considered a part of childbirth, and expected for families rich and poor. Try and tell a new grandmother in India that she won’t be allowed to serve as the primary help for her daughter and son-in-law postpartum! Tell a new grandma in China that her son-in-law will be the only person providing for her daughter postpartum! 
Back in the United States (and Canada, Australia, and a growing list of other countries), by the time we’re pregnant and new parents, most of us haven’t spent much if any time with a postpartum mother or newborn in decades—if ever!  Ditto for our relatives. We’re utterly inexperienced for the most important time and role of our lives.
I reached out to a wider community to see what other thoughts could be contributed to the conversation.  I spoke with a dad, a doula, a counselor, and a doctor—and this is what they had to share.

DARREN MATTOCK, a leading voice and visionary in the modern fatherhood movement, birth activist, creator: Becoming Dad
“I am a huge advocate for doulas. An experienced doula knows that dads are a key to mother-and-baby wellbeing, and will take a whole-of-family approach in providing care and support. This includes engaging dad to develop a productive working relationship that empowers him to be involved and connected as a caregiver, but also allows him space to just be in the experience of becoming dad. A postpartum doula can be an incredible source of practical, emotional and psychological guidance and support in a time and space where dads presently receive virtually none. Yes - this is dad's postpartum time, too. A postpartum doula can play a significant role in making this time healthier, happier and more harmonious for everyone - including dads.”

DARLA BURNS, Executive Director of Postpartum Doula Programs for CAPPA
“When we think about the postpartum period, we often think of the postpartum dyad (mother and baby), but I remind the families I work with that this is truly a triad (mother, father, baby). All parts of this triad need to be supported and nurtured, as each has its own set of unique emotions, level of comfort, and ability to cope with the vast changes occurring. When we support, educate, and nurture new dads, I find that they are more participatory in caring for their newborn and have more confidence in their ability to parent, which leads to a more harmonious and joyful family experience.”

ELLY TAYLOR, relationship counselor, author: Becoming Us
“The emotional bond between partners is the cornerstone in the foundation of their family. The most important thing from my perspective is that, in the immediate postpartum period, the couple has the time, focus and energy to be able to get to know each other and connect as a new family. It is challenging to carve out this space and protect it from the avalanche of tasks and distractions of modern-life. But it’s absolutely essential: the bond between a couple reduces stress, reduces the risk for postnatal anxiety and depression, supports the mental and emotional wellbeing of each of them – and of their baby.
One of the biggest things I’ve seen to negatively impact a couple’s relationship, even many, many years afterwards is when one or both of them experience the birth as traumatic. It may be that the woman was traumatized, and her partner directly affected by how the trauma has impacted her, or he was directly traumatized by aspects of the birth himself. A traumatized mother has a 75% higher risk of developing PPD. We know that caring, capable support during labor can reduce the risk for birth trauma and that the same following a traumatic birth both facilitates postpartum adjustment and reduces the risk for symptoms of Post-Traumatic Stress Disorder.
These to me big are arguments for the value of a Postpartum Doula – not only do they provide practical support, but can give all-important emotional support as well.”

DR. NING X. FU, O.M.D., Ph.D, senior professor: Five Elements University of Traditional Chinese Medicine
“In China, it is expected that the mother will be not just be cared for, but will be protected, at this vital time. Traditionally, the people supporting the mother in the postpartum time were family members who’d learned from experience what skills, foods, and tasks best served the new mother, protected her health, promoted her rejuvenation, and enabled her to produce abundant milk for her baby. Fathers do not receive paternity leave, but it is common for them to save funds and vacation time while trying to conceive and during the pregnancy so they can stay home with the mother during the first few to several weeks.
In the past, people only hired help outside the family if their relatives’ age or health prevented them from being able to help.  This is changing now, and it is more common for families to hire trained and experienced professionals—but fathers remain deeply involved.
Fathers spending as much time as possible postpartum with the mother and baby—along with hiring professional support—is an invaluable investment in the mother’s and baby’s health, and in family bonding.  I believe it’s very important to introduce this approach to American culture.”

So how do we answer the question: Is DAD the ideal postpartum doula? How about:
Dad is the husband* and new father, and when empowered with support—even if minimal—from a postpartum doula, that’s the recipe for a happy, healthy new family!


*husband, beloved partner, friend, as applies or preferred
Illustration-  I love you, Daddy! owner: Allie Chee; artist: Gioia Albano



ALLIE CHEE After earning a BA in literature and a 2nd degree black belt in Korean martial arts, 20 years traveling in 50 countries, working in numerous entrepreneurial ventures, and serving as co-publisher of a leading financial industry magazine, Allie Chee lives in Silicon Valley with her husband and daughter and is a student at Stanford.

Her articles have appeared in: 
•  The Well Being Journal
•  The Holistic Networker
•  The Birthing Site
•  Natural Mother Magazine 
•  MidwiferyToday


Her published titles are: New Mother, Free Love, and Go, Jane!

Website: www.alliechee.com  Facebook: www.facebook.com/AllieChee 
NEW MOTHER on Amazon

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