Growing Yourself as a Doula
February 2010
  Summer Birth Doula Training Workshop & Mentoring Program
beady belly
Feeling like it's time to take the next step towards becoming a doula or midwife? This intensive four day training will immerse you in woman-centered birth culture and give you lots of opportunities for hands- on practice! Two consecutive weekends in Rockland, Maine; July/August.

Bonus- Register with deposit by March 20th- receive the early registration discount AND a $20 Amazon gift card - perfect to grow your birth book collection! $500 tuition. Discounts may apply.

Click for more info.
 
Male Infant Circumcision Bill Up for Debate next week

Will Massachusetts become the first state in the US to ban circumcision of male infants? In 1996, Congress banned female genital mutilation. The MGM bill seeks to extend that ban to infant boys.

Info on the Brit Shalom- a non-cutting Jewish baby-naming ceremony.

Map of regional variations in circumcision rates.

Videos about male infant circumcision.
 
mother rising
Warm Welcome's Online Bookstore

Enjoy all the usual Amazon discounts, and support a crucial midwifery clinic in Haiti when you purchase books at Warm Welcome's Amazon bookstore through Mar. 31st.

Check out the new breastfeeding book by Ina May Gaskin (Spiritual Midwifery), and newly added book on Blessingways- Mother Rising, pictured above.

100% of proceeds of this site now through 3/31 will go to the work of Bumi Sehat in Haiti.
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Traditional Postpartum Doula Training
with Warm Welcome Birth Services

mama and baby
Traditional Postpartum Doula Care is a collection of skills and techniques to nourish the new family. Take your doula practice beyond birth with this intensive  workshop with Michelle L'Esperance, Certified Professional Midwife. Appropriate for aspiring postpartum doulas, or as a refresher & deepening for those already supporting new families.

Sunday, March 28th, 2010.
9:00-5:00PM; Cradle in Northampton, MA.
$108. Enrollment limited to 20.

Click here for more information about this workshop.

What does a postpartum doula do?

Online registration and payment through PayPal are available. Please request and review a current workshop information & registration packet first.

As an fyi, my future Traditional Postpartum Doula workshops will be two days long; this will allow us to explore more topics in more depth. I expect that some will prefer the longer 2 -day training (first one this summer/fall), but some of you may prefer the slightly simpler one-day training. Tuition is yet to be determined for the two-day training, but will likely be between $200-$250.
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 Question of the Month
I'm a new doula, and am wondering what role/responsibility I have for a client of mine who seems to be showing signs of postpartum depression. I don't have any training in mental health & do not want to overstep my training, but I want to be a real help to this mother & family. What should I do?

I'm so glad that you're aware of this issue, and aware that you do not have the training to be the sole support for a mother who may be experiencing postpartum depression (PPD) or anxiety. Birth & postpartum doulas do have a very important role to play in helping to identify mothers who are at risk of or actually suffering from PPD,  and in connecting these families to the appropriate resources. Often doulas are among the first outside the household to notice possible signs of PPD and stress. Usually, a new mother feels comfortable and trusting of her doula, and may reach out to her for assistance with what can feel like an unexpected, even embarrassing set of symptoms.

Risk factors for PPD include (but are not limited to):
-A history of depression.
-An unexpected or difficult birth experience.
-Mother or baby having health problems during or after birth.
-Not enough support from partner/family/friends.
-Financial stress.
-Marital stress.
-Breastfeeding difficulties.
-Social isolation.

Signs of PPD/anxiety:
-often feeling sad or depressed
-often feeling anxious or panicky
-feeling persistently overwhelmed
-ongoing difficulty bonding with the baby
-can't relax enough to sleep, even when baby sleeps
-can't eat as she normally would
-thoughts of deliberately hurting the baby or herself
-having other persistent upsetting thoughts

As a doula, you may observe some of these signs. For instance, simply by spending some time with the family and asking a few simple questions, you may see that she is not eating or sleeping normally. When I have a client who I know has one or more of the common risk factors, I find a private time to gently ask her if she's noticing any signs of PPD/anxiety.



It's important to reassure mothers & families that 10%- 20% of new mothers suffer from some symptoms of PPD, and that it is very treatable. There is no reason to go on suffering in silence, and in doing so, miss the sweet side of mothering a newborn.

"Baby Blues"

Friends and relatives are often frightened at the prospect of PPD, and may be quick to label any negative feelings as "just the baby blues".  It is true that many mothers experience some moodiness or tearfulness in the weeks following birth, and that this is not necessarily an indicator of PPD or anxiety. It is common for a mother to have a good cry on day 2, 3, or 4, typically followed within a few hours by her milk coming in. This is a normal hormonal surge which should be treated with tenderness, but it is not in itself cause for concern. Two keynotes of simple 'baby blues' are first- the episode of tearfulness or feeling overwhelmed is transient (it passes within a few hours); and second- the mother will usually feel better afterwards-more relieved or relaxed than before she had a cry. The doula may be able to help the family distinguish between baby blues and something more persistent and serious. Whenever in doubt, connect the family with expert resources (see below).

Resources for Postpartum Depression, Anxiety, or Stress

In Western Massachusetts, we are quite fortunate to have a strong organization supporting women & families who are experiencing PPD, anxiety, or stress. MotherWoman is an excellent resource, offering free postpartum support groups in Amherst, Holyoke, Greenfield, and Northampton, as well as referrals to allied professionals.  Online, there are extensive educational resources for professionals and families at Postpartum Support International. Clients can also find a free active online discussion group on this topic at Mothering Magazine.

Families who are juggling the normal (so-called!!) demands of parenting a newborn, along with the additional stresses of PPD or anxiety, will often need support connecting with these resources. It may not be enough to just tell her about these resources; with her permission, you may make some phone calls, find out when the next MotherWoman meeting is & arrange for her to get there, print out a helpful article for  her partner or family to read, etc.

Finally, if the mother is expressing an urge to actually hurt herself or her baby; if she seems to be out of touch with reality, paranoid, hyperactive, or hallucinating, she is likely to be suffering from postpartum psychosis. While very rare, this is a serious, life-threatening condition.  A mother with these symptoms should never be left alone, and it is imperative that she be connected with medical treatment/support quickly.

Thankfully, most women who suffer from postpartum stress, depression, or anxiety will improve greatly from increased social support, good nutrition, sleep support, and possibly short-term therapy. Doulas can serve a key role in quickly connecting families with this vital support, and in directly providing some of it in the form of postpartum doula care.

Thank you for all that you do- it makes a real difference!   -Michelle
Warm Welcome Birth Services
Michelle L'Esperance, Certified Professional Midwife
(413) 203-4479
Email