| PROFESSIONAL PRE- AND POST-BIRTH ASSISTANTS OF CHARLOTTE, NC & SURROUNDING AREAS |
| CHARLOTTE, NC * HUNTERSVILLE, NC * CONCORD, NC * GASTONIA, NC * SHELBY, NC * HICKORY, NC * STATESVILLE, NC * ROCK HILL, SC * FT. MILL, SC |
| Charlotte Doulas |
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| The Childbirth Professional’s Role in Combating Postpartum Depression by Laura Nance |
“What? You are going on vacation with six children? Are you crazy? That doesn’t sound like
much of a vacation to me!” Such were the comments I heard when I recently went on a week-
long trip with two of my friends and our six children, ages one to eight. It turned out to be the
most relaxed trip I have taken since I had children, a true vacation. We took turns cooking and
cleaning up. We all pitched in and did laundry. I kept the three youngest children so the other
two mothers and three older children could go snow tubing. This experience provided me a feel
for how other cultures live, surrounded by family and friends, everyone sharing the load. No
wonder postpartum depression is almost unheard of in developing lands. Americans could learn
a lot about preventing postpartum depression by imitating the way these extended family cultures
live.
With several families living in the same house, responsibilities are shared, reducing the load of
each individual person. This is especially seen in the birth period. Grandmothers, aunts and
cousins rally around the mother. In the comfort of her own home, she follows the natural course
of labor that her body was made for. It is a quiet, peaceful experience without the hustle and
bustle of noise and bright light of a hospital. She is encouraged and supported through her
labor by women who have traveled this same path, women who view birth as a normal but sacred
event. The women stay with her afterward and care for household chores such as cooking,
cleaning, and caring for other children. This allows her the opportunity to focus all her energy on
resting and breastfeeding and getting to know her new baby. She has security in the knowledge
that she is surrounded by her loved ones who will continue to support and help her.
By contrast, the American high tech birth is filled with inductions, monitors, epidurals and
cesarean sections. When these interventions are used routinely, they take the birth away from
the mother so that it is no longer her experience. She does not participate fully in the amazing
miracle of birthing her baby. She is then sent home where her husband will be away at work all
day, as will most of her friends and neighbors. The average American family is spread all over
the country, leaving new mothers without the help and experience of her mother and sisters.
She is expected by American culture to be up immediately; cooking, cleaning and doing laundry,
in addition to caring for her newborn and any other children she may have. In many cases she
will return to work herself in as few as six weeks. Take the feelings of loneliness and
inadequacies as a new mother, combine with plunging hormone levels, add to the nagging
emptiness acquired from her birth procedure and you have the perfect concoction for
postpartum depression.
According to Robin Lim in After the Baby’s Birth, approximately 3-20% of women experience PPD
and 4% of these experience symptoms for as long as one year. The truly sad part of the
statistics however, is that while over 90% of post-natally depressed women sense a problem,
only 20% report their symptoms to a medical professional. While most women with PPD do not
outwardly harm themselves or their baby, the effects can still be debilitating and long lasting.
During this special time of bonding if a mother with a newborn baby has feelings of despair,
inadequacy, helplessness and hopelessness, along with panic attacks, impaired concentration
and hostile behavior, the ability to mother and the relationship between the two is impaired.
Since birth and the early months together as a family are some of the most joyous times a
woman will experience and some of the most important developmentally for the baby, the cloud of
postpartum depression should not overshadow this period.
Can we change the way America lives? Can we encourage extended families to live together
and push for more home births? Probably not. However, as childbirth professionals, we are in a
unique position as change agents in the prevention and treatment of postpartum depression.
How can we use this position to the fullest extent possible to positively affect families?
Our part in the battle against postpartum depression begins in the prenatal education period by
teaching families the value of positive birth consumerism and informed consent. Most women do
not even realize they have a voice when it comes to their birth. The concept that “the doctor
knows best” and “the doctor is in charge” rums rampant. Women need to have the confidence
that in most instances their bodies function correctly to produce a baby, and usually function
even better without medical intervention. They need to know they have the right to say what they
do and don’t want when it comes to their body and the birth of their child. If this right is taken
away from women it can be a contributing factor in the development of PPD.
As an advocate for the laboring mother, a doula helps to ensure that the mother’s voice is heard.
This leads to a reduced instance of unwanted medical procedures, such as pitocin
augmentation, epidural and cesarean section, which could contribute to developing PPD. A
labor doula also helps keep the energy positive during the birth and later helps the mother
remember her birth as a joyous experience.
Any new mother can feel overwhelmed by the task of caring for a new baby while functioning on
less than optimal sleep. When women are without the support of their own mother or other
female family members or friends this feeling can go from overwhelming to despair. A
postpartum doula can alleviate the pressure by helping out around the house or with other
children and encouraging rest and breastfeeding. She also helps by helping the mother to gain
confidence in her own ability as a mother.
The final way we can make a huge difference is by educating the families we work with (along
with ourselves) in the recognition of the symptoms of PPD along with the knowledge that
developing a depressive condition is not a defect on their part and that treatment options do
exist. Short-term antidepressant use is many times used in the treatment of PPD. Many
antidepressants are compatible with breastfeeding therefore there is no reason to quit
breastfeeding because of medication. In fact, continued breastfeeding should be encouraged,
as it can be an important tool in the treatment of PPD due in part to the release of the hormones
oxytocin and prolactin. If a woman had a less than optimal birth experience she can gain great
confidence in the fact that she can still give her infant the perfect food and the special
relationship that the nursing mother/baby dyad experiences. This education should take place
during the prenatal period before it could be an issue. As professionals we need to be aware of
situations that may make a family more at risk for postpartum depression. We also need to be
observant in all situations for possible signs of PPD.
Many times we have a more intimate relationship than other professionals have with the families
we serve. This puts us in a special position to arm women in prevention, recognition and
treatment of postpartum depression, because it is a potentially preventable and very treatable
condition.
Laura Nance is a Bradley Method Childbirth Educator, a CAPPA Certified Labor Doula and a
CAPPA trained Lactation Educator. She is also a Labor Doula Trainer for CAPPA. She has an
interest in the cultural differences of birth in other countries, especially traditional societies.
much of a vacation to me!” Such were the comments I heard when I recently went on a week-
long trip with two of my friends and our six children, ages one to eight. It turned out to be the
most relaxed trip I have taken since I had children, a true vacation. We took turns cooking and
cleaning up. We all pitched in and did laundry. I kept the three youngest children so the other
two mothers and three older children could go snow tubing. This experience provided me a feel
for how other cultures live, surrounded by family and friends, everyone sharing the load. No
wonder postpartum depression is almost unheard of in developing lands. Americans could learn
a lot about preventing postpartum depression by imitating the way these extended family cultures
live.
With several families living in the same house, responsibilities are shared, reducing the load of
each individual person. This is especially seen in the birth period. Grandmothers, aunts and
cousins rally around the mother. In the comfort of her own home, she follows the natural course
of labor that her body was made for. It is a quiet, peaceful experience without the hustle and
bustle of noise and bright light of a hospital. She is encouraged and supported through her
labor by women who have traveled this same path, women who view birth as a normal but sacred
event. The women stay with her afterward and care for household chores such as cooking,
cleaning, and caring for other children. This allows her the opportunity to focus all her energy on
resting and breastfeeding and getting to know her new baby. She has security in the knowledge
that she is surrounded by her loved ones who will continue to support and help her.
By contrast, the American high tech birth is filled with inductions, monitors, epidurals and
cesarean sections. When these interventions are used routinely, they take the birth away from
the mother so that it is no longer her experience. She does not participate fully in the amazing
miracle of birthing her baby. She is then sent home where her husband will be away at work all
day, as will most of her friends and neighbors. The average American family is spread all over
the country, leaving new mothers without the help and experience of her mother and sisters.
She is expected by American culture to be up immediately; cooking, cleaning and doing laundry,
in addition to caring for her newborn and any other children she may have. In many cases she
will return to work herself in as few as six weeks. Take the feelings of loneliness and
inadequacies as a new mother, combine with plunging hormone levels, add to the nagging
emptiness acquired from her birth procedure and you have the perfect concoction for
postpartum depression.
According to Robin Lim in After the Baby’s Birth, approximately 3-20% of women experience PPD
and 4% of these experience symptoms for as long as one year. The truly sad part of the
statistics however, is that while over 90% of post-natally depressed women sense a problem,
only 20% report their symptoms to a medical professional. While most women with PPD do not
outwardly harm themselves or their baby, the effects can still be debilitating and long lasting.
During this special time of bonding if a mother with a newborn baby has feelings of despair,
inadequacy, helplessness and hopelessness, along with panic attacks, impaired concentration
and hostile behavior, the ability to mother and the relationship between the two is impaired.
Since birth and the early months together as a family are some of the most joyous times a
woman will experience and some of the most important developmentally for the baby, the cloud of
postpartum depression should not overshadow this period.
Can we change the way America lives? Can we encourage extended families to live together
and push for more home births? Probably not. However, as childbirth professionals, we are in a
unique position as change agents in the prevention and treatment of postpartum depression.
How can we use this position to the fullest extent possible to positively affect families?
Our part in the battle against postpartum depression begins in the prenatal education period by
teaching families the value of positive birth consumerism and informed consent. Most women do
not even realize they have a voice when it comes to their birth. The concept that “the doctor
knows best” and “the doctor is in charge” rums rampant. Women need to have the confidence
that in most instances their bodies function correctly to produce a baby, and usually function
even better without medical intervention. They need to know they have the right to say what they
do and don’t want when it comes to their body and the birth of their child. If this right is taken
away from women it can be a contributing factor in the development of PPD.
As an advocate for the laboring mother, a doula helps to ensure that the mother’s voice is heard.
This leads to a reduced instance of unwanted medical procedures, such as pitocin
augmentation, epidural and cesarean section, which could contribute to developing PPD. A
labor doula also helps keep the energy positive during the birth and later helps the mother
remember her birth as a joyous experience.
Any new mother can feel overwhelmed by the task of caring for a new baby while functioning on
less than optimal sleep. When women are without the support of their own mother or other
female family members or friends this feeling can go from overwhelming to despair. A
postpartum doula can alleviate the pressure by helping out around the house or with other
children and encouraging rest and breastfeeding. She also helps by helping the mother to gain
confidence in her own ability as a mother.
The final way we can make a huge difference is by educating the families we work with (along
with ourselves) in the recognition of the symptoms of PPD along with the knowledge that
developing a depressive condition is not a defect on their part and that treatment options do
exist. Short-term antidepressant use is many times used in the treatment of PPD. Many
antidepressants are compatible with breastfeeding therefore there is no reason to quit
breastfeeding because of medication. In fact, continued breastfeeding should be encouraged,
as it can be an important tool in the treatment of PPD due in part to the release of the hormones
oxytocin and prolactin. If a woman had a less than optimal birth experience she can gain great
confidence in the fact that she can still give her infant the perfect food and the special
relationship that the nursing mother/baby dyad experiences. This education should take place
during the prenatal period before it could be an issue. As professionals we need to be aware of
situations that may make a family more at risk for postpartum depression. We also need to be
observant in all situations for possible signs of PPD.
Many times we have a more intimate relationship than other professionals have with the families
we serve. This puts us in a special position to arm women in prevention, recognition and
treatment of postpartum depression, because it is a potentially preventable and very treatable
condition.
Laura Nance is a Bradley Method Childbirth Educator, a CAPPA Certified Labor Doula and a
CAPPA trained Lactation Educator. She is also a Labor Doula Trainer for CAPPA. She has an
interest in the cultural differences of birth in other countries, especially traditional societies.
