It wasn't clear to me if the 8 hours of post-partum doula care constitutes
the 8 hours immediately after birth, or just any 8 hour period in the
days/weeks after birth. Either way, doulas should know:
(1) Babies need to be in constant contact with their mother's bodies,
bare-skin-to-bare-skin.
(2) Babies just learning to be babies (instead of fetuses) need lots of
"unstructured time just hanging out at the breast." This advice comes from
Cathy Liles, and is has helped many a mother and baby be successful at
breastfeeding. You don't just wait til the kid is obviously dying to nurse
and then put him in proximity to the breast and expect him to immediately
latch on, nurse efficiently for 5 minutes, and then be done and go back to
sleep for 4 hours. You let the baby hang out, nursing, nuzzling, licking,
touching, resting, and sleeping on the breast. You don't expect the baby to
nurse effectively every time from his first attempt. You give him time to
just hang out at the breast, without expecting anything, including time
sleeping on the mother's chest.
(3) Mothers need confirmation that they are capable. They may need help,
support, and advice, but don't do direct baby care for them.
(4) Run interference between the mother and others around her, protecting
her right to private time alone with her baby. Show by your actions HOW
others can help the mother -- by not insisting that she show off the baby
and entertain visitors, by doing housework, by bringing her water (or
whatever she wants), by answering the phone for her and taking messages,
etc. Model how post-partum support needs to look once you are gone.
Reiterate that mother and baby need to be together. Show the doulas (and
the parents) the video by Johnson & Johnson, "Amazing Talents of the
Newborn", which describes different states of infant arousal, and shows how
parents and newborns can interact socially even in the first few days of
life if the parent knows how to recognize the baby's quiet alert state. You
might need to point out that the babies in this video are all from undrugged
births, so a particular baby may not be as responsive as the ones in the
video, if the mother received drugs during labor.
Kathy Dettwyler
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