I have mentioned before that my husband and I decided to hire a doula when I was pregnant with our twins. We decided on hiring a doula team so that we could have 24 hour help. At first, we thought we would just have them postpartum, but ultimately chose to include them in the birth as well. Hiring our doulas was a decision I hesitated about at first, but ultimately have never regretted.
Carol and I are still good friends; she has been an enormous support as I start this venture and has graciously agreed to let me interview her as I think there are so many expectant parents of multiples that have never heard of hiring a doula and may not know how much it can help!
The Twin Coach: The first question many people have is “what is a doula?” Can you give me a little background information?
Carol Braun: I think the best description of what a doula is comes from the DONA (Doulas of North America) website:
“The word ‘doula’ comes from the ancient Greek meaning ‘a woman who serves’ and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.”
There are birth doulas and postpartum doulas. A birth doula primarily works with a woman and her partner before the birth of the child, offering research-based information, reviewing comfort measures and developing a birth plan. The birth doula also provides physical and emotional support to the woman and her partner during the labor at home and/or at the birth center or hospital.
Postpartum doulas essentially “Mother the Mother”. They help ease families as they transition while caring for their newborn. Doulas offer support with breastfeeding, newborn care and infant soothing techniques. In an effort to help keep the family household in balance, the doula may also “tidy up” or do some light cooking or laundry if appropriate. I like to explain our services as “preventative education” as well. Hiring a doula can help prevent postpartum depression or problems with breastfeeding. Ultimately, the objective of the doula is to give the parents enough knowledge and confidence and in their parenting skills that the doula is no longer needed!
TTC: I hear many people talking about hiring a “baby nurse” or a “night nurse”; what is the difference between that type of postpartum care and what a doula offers?
CB: The difference is quite large! It is my experience that a baby nurse, or newborn care specialist (as many states do not allow such a title unless the person is actually a certified nurse) only encompasses the need of the baby. A postpartum doula works hard at understanding the dynamic of the family within their household and weaves her services according to the needs of the mother, baby and other family members.
A newborn specialist is similar to a doula in that she provides newborn care and instruction, but generally will not “tidy up” or do “light cooking”. She may also be capable to help with breastfeeding, but her knowledge tends to come from her own experience nursing her children- which can be helpful, but every baby is different when it comes to nursing and there is so much to know about breast feeding! Newborn specialists also tend to have more experience with “sleep training” or putting a baby on a feeding or sleeping schedule.
Typically a newborn care specialist will work with a family until the baby is sleeping through the night, but will also work with families for the first four weeks or so, to help the parents adjust to the “sleepless” nights. Doulas also are known to work at night, but again, focus on supporting the mother as she tends to her baby in the middle of the night…breastfeeding doesn’t only happen during the daytime hours!
TTC: Yes! I totally agree. Because we had 24 hour help when you worked with us, you partnered with another doula, Julie Skehan, who helped us at night. My lower extremities were terribly swollen after the birth, and since Julie was formerly a licensed massage therapist, she would massage my legs and feet as I nursed, in order to get the blood flowing again. Talk about support!
TTC: So, now that we know what a doula is, can you tell me about your own background and why you became a doula?
CB: Well, I’m married to Steven and mom to Beckett. I have a Bachelor’s Degree in Social Work, which gives me a strong foundation for doula work. I’ve always been fascinated with pregnancy and birth since I was a little girl. I grew up in a large, Italian family,so it seemed like a baby cousin was born left and right. I have fond memories of wanting to touch my Aunt’s pregnant, round belly all the time (they lived next door and she had 5 children). The idea of feeling a baby move inside her was thrilling to me!
That same aunt was the person responsible for introducing me to what a doula was. I had just moved to California (2002) and I wasn’t “feeling it” when working for the State Health Department. After alot of self reflection, I found myself eager to unearth my passion for birth. I thought about going back to school to become a Labor and Delivery Nurse, or a Midwife, but I didn’t fancy the idea of going back to school. Once I found out that you could have a career in doula work, I couldn’t sign up for the certification course fast enough! I got certified (by DONA International) as a birth doula in 2004 and haven’t looked back. I’ve served over 60 birth families and probably about 30 or more postpartum families.
TTC: Do you have any have special training?
CB: As doulas, either birth or postpartum, it is essential to stay up with all of the research based information out there. Much of my income goes toward paying for workshops or lectures just to keep me informed. There are specific methods of birthing which I have studied,(ie: Hypnobirthing, Lamaze, Birthing From Within) and I’ve found it quite helpful to remain versed on breastfeeding and the challenges women are faced with while learning to nurse within the first few weeks after delivery.
I’ve also attended workshops and lectures on more sensitive issues which can present themselves during a woman’s most vulnerable time, in labor or just postpartum (ie: past sexual abuse/trauma, postpartum depression/anxiety, fetal demise). In addition, I’ve served on the Board of Directors for the Doulas Association of Southern California (DASC). DASC is responsible for many of the educational opportunities that have been offered to me as a doula. We learn from each other, do quite a bit of outreach, and bring in many fascinating and highly educated researchers to update us in an effort to keep our clients informed and empowered.
In general, although one is neither required to be certified, nor attend any specific training, it is highly recommended that one attend a certification training workshop to become familiar with childbirth education and the role of a doula. There are several well known organizations who offer such training. These organizations also practice a strict code of ethics and scope of practice as well.
Again, it is strongly encouraged that if one were to provide doula services, whether for birth or postpartum care, that one remain updated and active within the doula community. I’m a firm believer in attending at least 1-2 major trainings per year, just to keep me fresh. I would encourage clients who are interviewing doulas to inquire as to how many or what types of trainings they have attended. This will tell them a lot about the quality of services they will be paying for.
TTC: You have a lot of experience both as a labor doula and postpartum doula for parents of multiples; for expectant twin parents reading this, what would be the most important reasons why they should consider hiring a doula?
CB: Particularly for a family welcoming multiples, it would be to help the transition into parenthood go more smoothly and be less shocking. In addition, to help nurture the mother, who’s in an extremely vulnerable state for the first few months after birthing twins.
Since twin moms are more susceptible to postpartum depression (PPD) it’s critical to help maintain her wellbeing through this time. A postpartum doula can help ward off circumstances which can lead to PPD. She should have the experience to recognize the signs of PPD and guide the family to get help when appropriate.
Another important reason to hire a doula for postpartum care of twins is to help identify a routine which will work for their family dynamic/household so things are not so overwhelming. Lastly, to help with breastfeeding if that’s how the parents decide to nourish their children. On average, by breastfeeding twins for the first year of life, a family can save close to $3500.00. However, it’s also a huge commitment and a mother will need to allow herself the time and patience to learn how to nurse her twins as efficiently as possible. This is where an experienced doula can be invaluable.
TTC: Having worked with so many multiples what are the most common areas that new parents are surprised they need help with?
CB: The 3 B’s, and they all tie into one another:
- Budgeting: There are so many things people can do to limit their spending on things they won’t really need before the babies are born. In my opinion,and from what I’ve experienced with all of my multiples clients, budgeting for postpartum help for the first 3-6wks after leaving the hospital is by FAR the most important thing for the family to do. Getting a strong foundation from the beginning is key.
- Breastfeeding: There is so much to learn from an experienced lactation support person. The goal will be to as efficient while nursing as possible, so mom can get back to catching up on rest. Tandem nursing (feeding both babies at a breast at the same time) will be one of the most important things to learn.
- Banking on as much time to catch up with sleep and nutrition.
TTC: Often people who already have children think they won’t need help with their newborn twins since they have been through it all before. What has been your experience in those cases? Has having twins been as easy as they expect, or did it turn out to be much different and how were you able to help in either case?
CB: The one thing I’ve noticed is that when parents expecting twins already have other children, both parents tend to have a very strong sense of their parenting roles and routines. I think their consistancy is what gets them through the young years. Perhaps this time around they have learned to accept that their lives will revolve around the care of their young children, at least until things fall into a new routine that works for them.
I often help clients to remember that acceptance of this new way of life is really half the battle. It won’t ALWAYS be about the babies…eventually they will access the elements which shaped their identity. But, as with everything, change takes time to feel “normal”, so I ask many of my clients to just allow themselves the time and to always remain fluid.