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1. What do postpartum doulas do?
What a postpartum doula does changes from day to day, as the needs of the family change. Postpartum doulas do whatever a mother needs to best enjoy and care for her new baby. A large part of their role is education. They share information about baby care with parents, as well as teach siblings and partners to “mother the mother.” They assist with breastfeeding education. Postpartum doulas also make sure the mother is fed, well hydrated and comfortable.

2. How long does a postpartum doula spend with a family?
Doula support can last anywhere from one or two visits to more than three months.

3. What hours can I expect a doula to work with my family?
Some doulas work fulltime, with 9 to 5 shifts. Others work three to five hour shifts during the day, or after school shifts until Dad gets home. Some doulas work evenings from around 6 pm until bedtime, 9 or 10 pm., and some work overnight. Some doulas work every day, some work one or more shifts per week.

4. What is the difference between a postpartum doula and a baby nurse?
The role of a postpartum doula is to help a woman through her postpartum period and to nurture the family. Unlike a baby nurse, a doula’s focus is not solely on the baby, but on fostering independence for the entire family. The doula is as available to the father and older children as to the mother and the baby. Treating the family as a unit that is connected and always changing enables doulas to do their job: nurture the family.

5. What is a postpartum doula’s goal?
The goal of a doula is to nurture the parents into their new roles. As they experience success and their knowledge and self-confidence grow, their needs for professional support should diminish.

6. How can I find a postpartum doula in my area?
Use DONA International’s online doula locator.

7. How does a doula nurture the parents into their roles?
Self-confidence has a tremendous impact on a person’s ability to approach any task, and parenting is no different. DONA International doulas are taught to always consider parents’ feelings and always build confidence whenever possible. Doulas accomplish this through praise, acceptance and a non-judgmental approach. In addition, the doula will teach parents strategies and skills that will improve their ability to bond with their babies. A calm baby who is growing well will help parents to feel more confident in their skills.

8. Do doulas help mothers to deal with postpartum depression?
Unlike therapists or psychiatrists, doulas do not treat postpartum depression. However, they will help by creating a safe place for the mother emotionally. The doula will provide a cushioning effect by accepting the mother within each stage that she passes through. They relieve some of the pressure on the new mother by helping her move into her new responsibilities gradually. By mothering the mother, doulas maks sure that the mother feels nurtured and cared for, as well as making sure she is eating well and getting enough sleep. In addition, DONA International certified postpartum doulas are trained to help clients prepare themselves for parenthood, maximizing support and rest. These doulas will help their clients to screen themselves for PPMDs and will make referrals to appropriate clinicians or support groups as needed.

9. Do doulas teach a particular parenting approach?
No. DONA International doulas are educated to support a mothers’ parenting approach. Doulas are good listeners and encourage mothers to develop their own philosophies.

10. How do postpartum doulas work with a mother’s partner?
A doula respects the partner’s role and input, and teaches concrete skills that will help the partner nurture the baby and mother. The doula will share evidence-based information with the partner that shows how his or her role in the early weeks will have a dramatic positive effect on the family.

Download our Dads and Postpartum Doulas brochure in PDF format.

Adapted from: Nurturing the Family: The Guide for Postpartum Doulas
by Jacqueline Kelleher (Xlibris Corporation, 2002)


Questions for prospective doulas:

•  What training or experience have you had?

•  What is your fee and what services does it cover? (Be sure to find out exactly what she will and won't do. For example, if you're expecting her to cook or help with an older child, make sure that's included.)

•  What happens if I give birth earlier (or later) than expected? Is your schedule flexible, and if not, can you refer me to another doula if need be?

•  Can you provide references from other families you've worked for? (And be sure to check those references!)

Keep in mind your personal response to a prospective doula during the interview:

•  Does she seem kind, warm, and energetic?

•  Does she seem knowledgeable?

•  Does she communicate well?

•  Is she a good listener?

•  Would you feel comfortable having her in your home?


Preparing For Postpartum:


Postpartum Food Preparation: Menu Planning:


Making placenta capsules:


Making a Homeopathic Remedy From Your Placenta:



The Postpartum Blues:

After the baby is born, many new mothers have the “postpartum blues” or the "baby blues." The word “blues” is not really correct since women with this condition are happy most of the time. But compared to how she usually feels, the new mother:
  • Is more irritable
  • Cries more easily
  • Feels sad
  • Feels confused

The postpartum blues peak three to five days after delivery. They usually end by the tenth day after the baby's birth. Although the postpartum blues are not pleasant, the woman can function normally. The feeling of the "blues" usually lessens and goes away over time.

Medical experts believe that changes in the woman's hormones after delivery cause the postpartum blues.

The American College of Obstetricians and Gynecologists recommends that women do these things to help relieve the "postpartum blues":
  • Talk to your partner or a good friend about how you feel
  • Get plenty of rest
  • Ask your partner, friends and family for help
  • Take time for yourself
  • Get out of the house every day, even if it's just for a short while
  • Join a new mother's group and share your feelings with the women you meet there

If the symptoms last for longer than two weeks or worsen, you may have postpartum depression. This is a serious medical condition.  For more information, read the article on postpartum depression.



You are not alone. You are not to blame. We are here to help. PSI is built on the foundation of providing support to families. If you or someone you know might be experiencing symptoms of prenatal or postpartum mood or anxiety disorder, know that it is treatable and you’ve taken a very important first step. We have PSI Coordinators throughout the world who provide information and support. There is someone in your area who can help you if you are experiencing any of the following: depressed, irritable, exhausted, unlike yourself, sadness, anger, guilt, worry, feelings of inadequacy.




Natural/attachment parenting:


Cloth Diapering & EC:

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Jul. 31, 2008 at 9:27 AM

great post....we had a doula during delivery and were soooo happy. Because my mom was around for the first week we decided to not get the PP doula, but did hire the pp doula for lactation svs after about 2 weeks. that help has allowed me to still be nursing dd who will be 18 months on Sunday!!!

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Jul. 31, 2008 at 9:34 AM

Great Journal!!

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Jul. 31, 2008 at 9:13 PM

Are you a postpartum doula? I would like to do that. Might be more feasible than being a midwife or birth doula with young kids and a full time job!

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Jul. 31, 2008 at 11:12 PM

Placenta delivery techniques were taught to me when I was studying basic midwifery in London many years ago. I recall the demonstration with a smile every time my hand goes to a uterus after the birth of a babe and before the placenta comes out. The Sister asked one of my classmates to stand up and put her arms out; she threw a sheet over her and said, "This is the uterus, tubes and ovaries." She then jabbed the student moderately firmly in the sides, making her jump and quickly bring down her arms. Sister then said, "When you are getting impatient waiting for the placenta to let loose, the first rule is to never fiddle with the fundus! It makes the uterus jumpy, and it clamps down, keeping the placenta trapped for longer than it needs to be. It can lead to hidden hemorrhage between the placenta and uterine wall."
-Roberta Gehrke, CNM

Reprinted from Midwifery Today E-News (Vol 2 Issue 2, Jan 14, 2000)
To subscribe to the E-News write:
For all other matters contact Midwifery Today:
PO Box 2672-940, Eugene OR 97402
541-344-7438,, Midwifery Today

Message Friend Invite (Original Poster)

Jul. 31, 2008 at 11:18 PM


Here are two links worth reading:



"Although external to his body, Jacob's placenta was his most essential organ, performing all the functions that his immature gut, lungs, immune system, kidneys, liver, and skin were not capable of in my womb."

Placenta Rituals and Folklore from around the World


"In some places, the placenta is known as the child’s sibling or twin. In Nepal, for example, the placenta is known as bucha-co-satthi (the baby’s friend); in Malaysia, when a baby smiles unexpectedly, he or she is said to be playing with the older sibling—the placenta. The Ibo people of Nigeria and Ghana are said to treat the placenta as the baby’s dead twin, and to give it full burial rites."


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Jul. 31, 2008 at 11:21 PM

The Magical, Magnificent Placenta

Message Friend Invite (Original Poster)

Aug. 1, 2008 at 1:26 AM

Delayed Separation of Placenta

In hospital birth, the placenta usually is expected to separate and make its appearance within 20 to 30 minutes.  Even midwives at a home birth can get a little uncomfortable with waiting, mostly because they don't want to be responsible for an infection setting in.  However, in an unassisted birth where the woman is responsible for her own well-being, the baby is already birthed and so she can afford to have a wait-and-see attitude because it is not going to affect the baby's health in any way.

Relax about the placenta.....Your body knows what it is doing.  In many cases, the placenta sheers off from the rest of the uterus within the first few contractions following delivery. Sometimes, if labor has been particularly long and exhausting, you uterus may be resting up before contracting enough to expel the placenta.  It will help after the birth, while you are holding and getting to know the baby, if you will sit upright.  Just as gravity helped your baby be born, it also helps the placenta to peel off and sink to the lowest point.....your cervix.  Often, while you are sitting there nursing the baby (which helps the uterus contract and the placenta to detach) the placenta will ooze out of the cervix into the vagina, where it sits until you get up a plop! it just falls out.  Sometimes, you may try to give a little push to get it out, only to find that it's in the vagina and pushing with the uterus doesn't help.  In that case, a TINY tug on the cord will let you know whether it's detached or not.  It should just plop right out.  If it doesn't, give it a little more time.

Sometimes, however, it does not detach immediately.  Don't be alarmed, sometimes it just takes longer.  If you have remained upright and it still feels attached, nursing the baby vigorously may help.  Lie down with baby, totally relax your mind and body and feel the satisfaction of what your body has been able to do.  Feel good about yourself for sticking with it and doing a good job, despite obstacles.  Give yourself permission to let go of that placenta.  Feel the release that comes, and visualize the placenta letting go.

Sometimes it is necessary for the placenta to let go in order for the uterus to clamp down and stop bleeding.  Evaluate your flow and make a decision about whether you feel it is excessive or not.  If you don't have any fever or chills, or if there is not a bad smell that would indicate infection, decide whether you feel comfortable waiting longer.

I have known women whose placentas did not come for several hours, and in one case a couple of days.  I have also known women who had significant blood flow, and whose placentas came out in pieces over a period of several hours.  You must do what you are comfortable with.

One suggestion would be to try some Cayenne Tincture.  Wait 30 minutes.  If the placenta has not been expelled, then give some Lobelia Tincture.  After 30 minutes, try Cayenne again.  Often this will do the trick.  It's best to use your own fresh homemade tincture.  Store bought Lobelia tincture is usually weak and worthless.  Don't be afraid to take quite a dose.  The reason herbs do not work for most people is that they don't take enough of them.  The most that is going to happen with these herbs if you take too much is that you will vomit.  No other bad side effects are going to happen.

Very rarely there is a condition called placenta accreta in which the placenta is actually imbedded in the uterine muscle.  In that case, a surgical procedure is usually required to remove it.

More often, however, it is simply maternal inertia which stalls the delivery.  Get up and walk around a little, if you aren't losing too much blood and don't feel lightheaded.  Have someone walk with you in case you start to feel dizzy or unsteady.  In that case, sit back down.  Try drinking some fluids, and perhaps eating a tablespoon of raw, unheated honey.  Give your body some fuel to re-energize the process.

During this time of waiting, you might try sitting on the toilet and just relaxing your mind and body.  Sometimes your body will let go of things on the toilet that resisted expulsion in other locations.  Often it's the mother's subconscious revulsion at expelling bodily fluids anyplace else except the bathroom.

No one can tell when it is the right time to go to the hospital.  You must check your intuition, and ask your body for wisdom.  If you feel at an impass, you might first try contacting a midwife who might come over and give you a shot of pitocin.  After that, your next stop is the hospital and a probable manual extraction.

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Aug. 6, 2008 at 7:47 PM

1) Leaving the cord to pulse does "no harm" and therefore should be encouraged. If you can think about what Nature intended, our ancestors way back before scissors and clamps were invented must have had to wait to deal with the cord/placenta until the placenta was birthed. They probably chewed it, ground it with rocks, or burned it through with hot sticks from the fire. The little teeth on the clamps indicate that traumatizing of the vessels is necessary to quell bleeding. Some midwives say that if you delay cutting the cord until an hour or so after the birth, there will be no bleeding at all from the stump.

2) Scientists are now discovering that umbilical cord blood is full of valuable T-cells which have cancer fighting properties. A whole industry has sprung up to have this precious blood extracted from the placenta, put in a cooler with dry ice, and taken to a special storage facility to be ready in case the child gets cancer at some time in the future. This is human insanity of the first order. That blood is designed by Nature to go into that child's body at birth, not 30 yrs later! We need to acknowledge that there are things about the newborn circulation and blood composition that we just don't know and we need to bet that Mother Nature had things figured out pretty well for us to survive this long. Maybe the supposed need for Vitamin K in the newborn comes out of early cord clamping?

3) Leaving the cord slows down the "fire drill" energy that many birth attendants get into after the baby is born. Leaving off the busyness of midwifery for a half hour allows the mother and baby undisturbed bonding time without a "project " going on i.e. the cord cutting instructions, explanations, jokes, etc. The father, too , is undisturbed and able to enjoy this "high" time without focusing on a job at hand.

4) Educator Joseph Chilton Pearce in his book "Magical Child" makes reference to studies that were done on primates who gave birth in captivity and had early cord clamping. Autopsies of the primates showed that early cord clamping produced unusual lesions in the brains of the animals. These same lesions were also found in the brains of human infants when autopsied.

5) For women with an Rh Negative blood type, there is a growing belief that the clamping of a pulsing cord that causes the blood of the baby to transfuse into the blood stream of the mother causing sensitization problems. Robert S Mendelsohn, M.D., in his book "How to Have a Healthy Child. . . In Spite of Your Doctor" blames the whole Rh neg problem on too quick clamping of the cord. Especially in Rh neg mothers I urge midwives to wait until the placenta is out before thinking about cord clamping.

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Oct. 25, 2008 at 4:54 AM

From a friend's doula website:




Other resources:

  • ATLC Warmline - The ATLC WarmLine provides mentors who offer real-time, in-person phone mentoring to support parents and caregivers in effective, conscious parenting.


Books for Children:

And here are just a few more links: this well-organized and informative site provides a treasure trove of information on breastfeeding, sleep, and other parenting topics.

Newman Breastfeeding Clinic and Institute

Dr. Sarah J. Buckley, MD Gentle Mothering

The latest Attachment Parenting research:

Everything about babywearing

Diaper Free! The gentle wisdom of natural infant hygiene.

The Center for Nonviolent Communication

The Postpartum Rainbow

Gentle Parenting options and insights

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Oct. 27, 2008 at 9:04 PM


Routine Newborn Baby Care Procedures

Choices for newborn baby care procedures begin immediately at birth.  The best preparation is to have considered them and decided beforehand what procedures you desire (or don't want) for your newborn.  For a hospital birth, there are numerous routine procedures which can be administered, delayed or even refused.  Unfortunately, first time parents are often unaware that many of these routine procedures are not grounded in evidence-based practice, but are rather the product of ease and access for staff.

Many parents don't realize the impact that these procedures can have on their newborn child.  Once you have decided what procedures you prefer and whether you want them performed immediately or on a delayed schedule, the best way to communicate them to staff/caregivers is to include a Newborn Baby Care section in your birth plan.  This will ensure that your preferences are on paper before the birth and remove any doubt as to your wishes for your new child after birth.

Another critical point to remember is that you can and absolutely have the right to receive information about each and every procedure that will be performed, as well as the right to either request the procedure be performed in your room or that a parent/guardian accompany the newborn for each one.  This includes weighing, measuring and the pediatrician's evaluation of the baby - all can be performed right there in the mother's room.  Remember, your first responsibility is to the welfare of your child, not to the comfort of the hospital staff nor arbitrary hospital policies.

The most commonly performed routine newborn baby care procedures to consider are:



For most hospital births, it is routine procedure to suction the baby's mouth and nose as soon as the head emerges on the perineum.  Either a deep suction hose or a bulb syringe is often used to extract any mucus or meconium that may be present. 


There are several reasons why routine suctioning in this manner is unnecessary and often ill-advised.  Babies born vaginally gain the benefit of traversing the birth path, which aids in squeezing any mucus and amniotic fluid from their nose, mouth and lungs, reducing the amount of mucus present and lowering the risk of aspiration and respiratory distress at birth.  This effect is increased when the mother's perineum is free of tears or episiotomy.  In addition, the gag reflex is present in healthy babies and will, in the vast majority of cases, let babies clear their own mucus.  The research supports that at most, 10% of all births will require some form of active resuscitation, including suctioning.  


Furthermore, suctioning the baby while still on the perineum is typically not necessary as the baby is still receiving oxygen via the placenta so long as the cord is left intact.  This gives the infant time to clear its own mucus after birth without using suctioning as a first resort.  The need for suctioning can be determined after the baby is fully birthed and signs of distress have been noted.  In addition, the benefit of gravity is available at this point and can be utilized by supporting the baby in a prone position (belly parallel to the floor), reducing the need and amount of suctioning required.   

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Cord Clamping

The next and perhaps most critical newborn baby care decision to be made for your baby's welfare is cord clamping - immediate or delayed. The benefits of delayed cord clamping, which is defined as waiting until the cord has stopped pulsating until clamping or cutting it, are well-documented.  Once the baby is born, its entire circulatory system undergoes an amazing transformation to allow the baby to receive oxygen via its lungs rather than through the umbilical cord - a valve in the heart closes, the lungs perfuse with blood and eventually a first breath is taken.  When this delicate balance is interrupted by prematurely severing the child's lifeline, its umbilical cord, numerous undesirable side effects can occur.  

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Newborn Vitamin K Injection

All newborns are born with a low level of Vitamin K which is responsible for preventing hemorrhage by enhancing the blood's clotting ability.  In a small percentage of newborns, cerebral hemorrhage can occur which spurred the universal practice of newborn vitamin K injections in the United States.  There are, however, some points to ponder when considering this intervention, especially the alternative of an oral dose.

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PKU Screening

Certain metabolic disorders, including a  PKU test, are routinely part of a newborn baby care screening at birth through a heel stick blood sample.  These disorders have devastating effects that are best handled with early detection and treatment to ensure the best possible outcomes.  This is the least controversial newborn baby care procedure since the benefits do outweigh the risks.

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Hep B Vaccine

The Hep B Vaccine, a disease that is transmitted via infected blood and sexual intercourse, is given at birth in the hope of catching as many people as possible.  It is not required for administration at birth and may be given at any time in childhood or adulthood.  In low-risk families, it may be advisable to delay the administration to the weeks after birth, rather than injecting a minutes-old baby, causing pain as one of its first experiences outside the womb.

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Silver Nitrate or Antibiotic Eye Ointment

To prevent the chance of blindness due to gonorrhea from an infected mother, hospital-born babies may be given silver nitrate or other antibiotic drops in their eyes, even if the mother previously screened negative for this or other STDs in her pregnancy.  Silver nitrate causes pain, burning, swelling and blurred vision for the first days of life and in the vast majority of cases, is not needed when the mother is known to be free from infection.

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To Bathe or Not to Bathe

If there is one newborn baby care procedure that many families never consider, it's bathing  a newborn.  However, this may indeed be something a new family decides to decline.  The vernix which coats the baby's extremely sensitive skin is the best natural moisturizer available and will protect it from infection when massaged into the skin.  Additionally, a bath can cause a baby's body temperature to drop, thus necessitating further interventions to regulate it.


Male circumcision, and female circumcision, for that matter, are very controversial subjects.  Some religions require circumcision.  However, there are no proven medical benefits to the procedure and significant drawbacks.   It is now considered a cosmetic procedure and its routine performance is being phased out in many areas.  The American Academy of Pediatrics no longer supports it.  In Australia, public hospitals are no longer performing routine circumcisions.   


Please give due diligence to your decision in this matter.  There is no research to support its use.  If you are uncertain whether or not to circumcise your son, consider viewing a circumcision video.  If you can't handle watching it, why would you consider doing it to your son?

Carefully consider your newborn baby care options, especially if you are birthing in a hospital.  Over 1 million healthy infants each year spent up to 3 days in the NICU for "observation" in the United States, with many unneeded interventions simply because the technology exists.  If at any time you have questions about a newborn baby care procedure, don't hesitate to ask questions.  You are your child's first and foremost advocate - be the voice they lack as you choose what interventions are in their best interest.

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