The Trend Toward Night Doulas: Exploring the Original Vision of Postpartum Doula Care

By Vicky York, IBCLC, CPD
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There is a growing trend toward hiring a postpartum doula to spend the night with a family after the birth of their newborn. Although it is wise to support a newly delivered mother's need for rest after birth, the financial cost to families for this service is great; therefore other key needs for this time period are being set aside.

When a family chooses night help, which usually costs $175-$250 per night, they often feel they can't additionally afford to pay a doula during the day. The family then misses out on guidance with breastfeeding, newborn care dilemmas, and postpartum depression support. Professional, effective help with these concerns by an experienced and knowledgeable doula can often eliminate the need for someone to be hired to just come get up with the baby all night for as many weeks as the money holds out. That set-up is a throwback to the days when parents hired baby nurses who came and lived with the family for 6 weeks, undertaking all the newborn care, then leaving the mother still feeling insecure about how to care for her child herself. Our original goal as postpartum doulas was to enable the mothers to become independent of us, by giving them confidence in their ability to mother their babies. We can teach them to understand and care for their new baby by sharing our wisdom, training, experience and modeling behavior.

It has been said, "Give a man a fish and he will eat for a day, teach a man to fish and he will eat for a lifetime." It can be more effective to give mothers education and skilled professional "mother nurture" from trained, certified postpartum doulas during the day. This will boost mom's confidence in her mothering abilities while receiving practical household help during the day and letting her nap, enabling her to endure the night challenges.

A new mother needs to be mothered herself, preferably by her family members. In our current societal structure that is very often not possible and these women suffer in isolation. This is a time to learn the art of mothering from other women, a time to be protected, fed, and cared for in special ways by women who know. New mothers need to begin the process of communicating with this child who they will be raising for the next 18 years. Dependence on a night doula does not afford a new mother the intimacy of communication that begins between mother and baby, as they then miss that nighttime connection.

The typical service of a night doula consists of getting up when the baby does and bringing the baby to the mom to nurse, then changing the baby, burping him and getting him back to sleep. Once a family has decided to hire a doula to help at night, it is natural to wish to maximize on this support, leading many tired parents to ask the doula to feed the baby a bottle of pumped breast milk and mom then gets up and pumps only when her breasts are so full and painful they awaken her. Breastfeeding is a supply and demand process. When the baby skips a nursing session and gets a bottle and the mom doesn't pump at that time, her breasts get the message that less milk is needed and after a period of engorgement they will lessen their supply. In addition, there is the risk of nipple confusion with the very new baby, as the rubber nipple demands a different sucking technique than the mother's breast.

It is a shame for parents to spend so much money on night help that they then can't afford baby carriers, CranioSacral therapy and other bodywork or even a housekeeper. For less than half the price a postpartum doula can come during the day and educate, cook, help the mom through a breastfeeding session while folding the laundry and teach her a swaddling technique that calms the baby. She can demonstrate infant massage and watch the baby while the mom naps or runs an errand. Not to mention the mom's need to talk to someone about her feelings at this time.
New mothers can more easily and naturally manage the postpartum time when they are cared for in the ways common to many older cultures around the world – gently, thoroughly, and wisely in support of the deeply transforming process of bringing forth a new life. Certified postpartum doulas extend basic postnatal care in the form of household management, baby care, sibling care, lactation support, newborn care tips, and providing resources within the birth community. They charge, on average, $20-$35 per hour across the nation.

During the time of childbirth, it's as if a woman's heart is opened up; she is so sensitive to her baby and her surroundings. She would give her life for this new little being and will give infinitely. Her relationship with her husband is being tested and strengthened. Her instincts are finely tuned and she is undergoing the acute phase of lifelong bonding with her infant. This bonding is partially influenced by hormones such as Prolactin. Prolactin levels are associated with the frequency of suckling: the more frequent the feedings, the higher the level of serum Prolactin. (Breastfeeding and Human Lactation by Riordan and Auerbach) There is likely a natural reason why babies awaken and want to nurse frequently at night.