Why Doulas Should Discuss Prenatal Expectations and Postpartum Reality with their Clients

As a  postpartum doula it is important to talk seriously about how prenatal expectations can differ from their  actual lived reality after baby is born.

Although the woman might be mostly focussed on the upcoming birth, these are important discussions to have especially when we know that the difference between what they expected and what is going on can cause a lot of pain.

We cannot predict what the postpartum will bring for them and what they might be experiencing;

they could be:

  • Wonderfully delighted by how easy things are 
  • Completely calm in meeting the needs of their baby
  • Entirely overwhelmed with the number of decisions they have to make every hour
  • Shocked by the demands of their baby
  • Surprised by how much pain and confusion she is experiencing
  • Worried that her milk supply is not meeting the baby’s demands
  • Exhausted by their lack of sleep
  • Starving
  • Perplexed by how she is going to get one sitz bath done, let alone three
  • Unsure of what a sitz bath is
  • Desperate for 6 minutes to shower and shampoo her hair
  • Confused by the comments people make
  • Unsure of who to trust for getting answers and solutions
  • Tired by the number of visitors
  • Angry at how many people expect to hold the baby
  • Outraged by the mess that visitors leave behind

Notice all the emotions on this list?

Women can have a huge range of feelings during the moments, hours and days after the birth. I think it is better to expect this than to be side-swiped by it and I have found that this great feelings inventory is so helpful at giving us permission to have all kinds of feelings when our needs are met, and all kinds of feelings when they are not.

As a doula it is easy to spend some time talking prenatally about how they think things might go and what their needs to be; sometimes I offer to fill out an actual postpartum plan worksheet with them so it becomes obvious where her needs might be met and where she might need to ask for more help or seek out other resources.  Preparing prenatally is so important as she will not have the full capacity to do this after the baby is born.

I agree with Elizabeth Davis who calls the first few days postpartum a “taking in” time where the woman should be the passive receiver of sleep, food, support.

Wonderfully, in some communities, this care happens automatically, with food and household helpers arriving daily to assist.

We know of some clients who practiced the 40-day lying-in confinement where they rested, fed their baby, rested again and were fed by friends as they stayed within the cocoon of their home.

This is no longer the norm and some might doubt that this would be the desired choice of the woman; but I have seen the smiles and dripping milk and well-rested mamas and I can now attest to this as a possible option.

Most of the time women they find themselves alone, hungry, confused and struggling to recover from their birth physically (and on every level of their being) while being responsible for caring for a new human being.

I love Robin Lim’s discussion of how the first task of the new mother is to be deeply cared and that unless this need is met she does not have the resources to care for anyone else.

Since I read about this (After the Baby’s Birth)  I have noticed, with dismay, how many questions and forms and decisions are thrown at the woman within hours of the birth - at a time when what she needs is to be warm, clean, secure that her baby is latched on and well-fed, and resting.

So, women have a cascade of unmet needs and often are not able to ask for help, relate their confusion or fatigue to people who might take action and they rarely have space to do the precious work of processing their birth.

What needs might they have?   Here is another great list!

Postpartum doulas are invaluable in supporting the woman after the birth but I always believe that information is power and prenatal discussions are vital in educating new parents and preventing many of the challenges of new parenthood.

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