In traditional cultures around the world, new mothers observe a lying in period for weeks after they give birth. During this time they rest and recover from birth, nurse their babies, and eat nutritious foods. The community comes together to cook and clean for them, care for their other children, take over whatever daily tasks they normally do. Mothers who enjoy this postpartum rest experience lower rates of postpartum depression and greater breastfeeding success.

I know you probably don’t have a village coming to help you when your baby comes, so consider cooking and freezing before baby is born. For ideas, do an internet recipe search for meals that freeze well. Tell friends and family who offer to help that you’ve registered at Meal Train, or ask them to bring a meal that freezes well to your shower. And take some time before the baby comes to hire a postpartum doula.

When most people hear the word doula, they think of professional labor support. But doulas also provide in home support after the baby comes. They can help with household tasks, provide reassurance and emotional support, and teach the skills that you need when living with a newborn: how to feed, hold, swaddle, diaper, and bathe your little one. ”Our doula was a calm, supportive, kind, loving presence who knew tons of wonderful tricks to soothe our little girl,” remembers Kelilyn McKeever, who shared with me how her doula helped after the birth of her first child. “After her first visit I felt so comfortable I scheduled another visit, and the next time she came I was able to sleep! It was wonderful. I learned so much from her, and it was fantastic to be able to talk things over with her since I only have one baby as my frame of reference and she has so many!! I would highly recommend a doula to other new moms. As it turns out, hiring a postpartum doula was amazing for us. It transformed our lives – my life especially.”

No one prepared me for how lonely you can feel as a new mum even though you’re never alone,” Lesley Walsh, a new mother told me. “I didn’t really know myself as I was adjusting to this new role. My doula gave me the confidence I needed that despite my inexperience, my parenting choices were right. She helped me feel like all of this was totally normal. I would TOTALLY recommend a doula to new parents without doubt. I’ve said to so many people that the greatest gift you can give a new family is a few hours of a doulas time. My doula is the best. I am incredibly grateful for the time she and I spent together.

Kimberly Bepler who runs ABC Doula Service in Portland, Oregon described a postpartum doula to me as “someone to teach you all about your newborn, help you recover after birth, fill all the gaps you are neglecting in your home and kitchen, and help you and your partner learn to navigate new parenthood with confidence. Doulas make life better for families with newborns, with skills, education and experience.“ If a family needs additional support, for example a lactation consultant or help with postpartum depression, their doula can make referrals to community providers.

“Postpartum Doulas are trained professionals that care for postpartum families physically, emotionally and spiritually,” Jodi Krentzman a doula at Hip to Heart in Massachusetts, explained to me. “I try stay ahead of the game by anticipating the wants and needs of the family before they have to ask.  I also troubleshoot any issues that arise with the baby (non-medical) and give them the tools to do the same when I am not there.”

Postpartum mothers are recovering from pregnancy and labor, and they are not sleeping through the night. Acclimating to life with a newborn is sometimes overwhelming. There are blissful and beautiful moments, but it is not all unicorns and rainbows. I spoke with Ann Tohill of Mountain Mama Doula. She sees her role as something that is “based on the family’s changing needs and varies day to day. I show up ready to take on whatever the family needs at that moment, whether it be a beautiful home cooked meal, fresh sheets on the bed, or someone to hold their baby while they shower or nap.”

Word of mouth is a great way to find a supportive, reliable doula. Ask your friends with kids who they recommend. Ask your childbirth educator, local La Leche League leader, prenatal yoga instructor, midwife, or pediatrician for suggestions. You want your doula to be certified with a reputable organization such as CAPPA or DONA, so checking their sites for help in your area is also a good strategy. Kimberly suggests, “call the doulas you are interested in and talk with them on the phone. Trust your gut. You will need to feel safe and nurtured and if your doula isn’t that way on the phone, she might not be a good fit for you.” Another doula I spoke with, Jill Reiter, who is known as The After Baby Lady, recommends “asking during an interview, ‘If we encounter an issue you don’t have experience with how can you support us?’ The answer should be something like I don’t have all the answers, but because of my training and/or certification I do have a network of resources I can tap into to help support you during different situations.”

“In addition to being wonderful with our daughter, the doula was looking out for me,” remembers Kelilyn, who describes her doula as incredible. “Home alone with a difficult baby my basic needs – like eating! – could get lost in the shuffle. Whenever our daughter napped, the doula would help with prep for the family dinner, laundry, unloading the dishwasher; it was another weight off my shoulders so I could relax and grab some desperately needed rest. As a new mom at home alone it’s easy to feel isolated and a doula really helps on that front as well. I wish we’d known so we could have had a postpartum doula come help us sooner.”

Julie Brill, IBCLC, CHLC, CCCE, CLD, CAPPA Faculty teaches independent childbirth and breastfeeding classes in the Boston area and via Skype, provides lactation consultations, and trains doulas and childbirth educators in New England for CAPPA. Her doula anthology, Round the Circle: Doulas Share Their Experiences, is available at Round the Circle and at Amazon. Julie is a La Leche League Leader and the mother of two teenage girls who were breastfed into toddlerhood.

1.  Make sure you have your labor bag with you in the car (not the trunk) so you have access to your pillows, snacks, drinks, music, focal point, etc. Have a hot water bottle or ice pack handy. Since moving around and changing positions in labor makes labor easier, sitting seat belted into your seat during the car ride can be challenging.
2. Eat something cold and sweet just prior to being admitted. This will help ensure that your baby is awake and active for the initial fetal monitoring, which can help you get off the monitor sooner. Continual monitoring increases the risk of interventions without improving outcome.
3. Your labor support person can help you get back to doing what was working for you at home. Do you want to get back in the shower? Walk the halls? Rock on the birth ball? Slow dance? Finding your way back to these types of activities will enable you to relax, lower your adrenalin levels, and let your oxytocin levels get back to rising. It is common for labor to slow down when you come into the hospital, as finding your way, answering questions, and getting settled can pull you into your left brain. Adrenalin blocks oxytocin, the hormone that drives labor, so the sooner you can return to the labor rituals that were working at home, the sooner your contractions can pick back up again.
4. Make your labor room home-like in the ways that are important to you. Playing music can help you find a rhythm, provide positive associations, and give you privacy. A special picture of your wedding, vacation, family, or pet can make an effective focal point. Smell is highly associated with memory. If you associate the smell of lavender essential oil with relaxation or the smell of a coconut scented sun tan lotion with a day at the beach, place a little on a cotton ball (not your skin). Some women find the scent of peppermint essential oil helps with nausea. Citrus smells such as lemon, orange, and grapefruit can be invigorating during pushing.
5. Dim the lights in your labor room. Some families bring battery operated tea lights for this purpose. Melatonin, which we make in the dark, aids in raising oxytocin levels.

Julie Brill, CCCE, CLD, CAPPA Faculty teaches childbirth classes in the Boston area and trains doulas and childbirth educators in New England for CAPPA. Her doula anthology, Round the Circle: Doulas Share Their Experiences, is available at www.RoundtheCircle.com and at Amazon.

1. In labor, continuous monitoring increases the risks of many interventions, including pitocin, epidurals, and cesarean birth, without improving birth outcomes for mother or baby. Asking a woman in labor to be still (and often in bed) so the monitor can do its job is not a benign request since it can result in a longer labor and more painful contractions. The American College of Obstetricians and Gynecologists (ACOG) doesn’t recommend routine continuous monitoring in labor.
2. It is sometimes possible to be monitored near the bed (sitting on a birth ball, standing and swaying, leaning on the bed, etc.) rather than in bed, to increase comfort and encourage the labor to continue to progress. When mothers or babies need to be continually monitored, it is sometimes possible to get a telemetry monitor, which can be worn and allows the mom to walk the halls during labor.
3. Babies are expected to have periods of sleep and wakefulness during labor. They will usually have a flat (steady) heartbeat during sleep and a baseline variablity during the times they are awake. Only the variable heartbeat is considered reassuring, so more monitoring is often done when a baby is initially asleep.
4. Cold and sweet foods make babies move. Eating something cold and sweet prior to monitoring will help ensure a variable heartbeat and a shorter period of monitoring.
5. Normal fetal heart rate is 110 to 160 beats per minute. A heart rate that is below 110, above 160, or flat for long periods of time is considered non-reassuring. The old term is fetal distress, but the wording was changed to acknowledge that no one can say for sure that a baby is in distress based on heart tones alone.
6. Monitors can distract support people’s attention away from the laboring mom, and some families choose to turn the audio off and cover the monitor. Electronic fetal monitoring will show the length and frequency of contractions, but not their relative strength.
7. Women birthing in hospitals can expect a period of monitoring of about twenty minutes when they are admitted in labor. Those birthing in free standing birth centers and at home will not have to meet this requirement.
8. Interventions such as pitocin (used to induce or augment labor) or epidurals, and conditions such a premature labor, require continuous monitoring because of the increased risk.
9. There are alternatives to electronic fetal monitoring. Fetoscopes can pick up the babies heart rate without exposing mother and baby to ultrasound. Since dopplers are handheld they are usually not used for more than a few minutes at a time, and thus are usually more comfortable than electronic fetal monitors which are held on with belts. If you are on the electronic fetal monitor, consider asking the nurse how long you’ll be on, and buzzing her after that amount of time if she’s not with you in order to be taken off the monitor.
10. Internal monitors are both more accurate and more invasive than electronic fetal monitors. They are often accompanied by a fetal scalp blood sample, which gives additional information about the state of the baby. They require the bag of waters to be ruptured if it hasn’t released on its own, and once placed are usually used for the remainder of the labor. They are used when there is a concern about the baby’s heart rate, or when it is difficult to get the heart rate. Because they are less likely to produce a false positive reading, they can help to avoid an unnecessary intervention.