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Having A Healthy 4th Trimester: Q&A with Amber Star Merkens, Postpartum Doula

Before I met Amber Star Merkens, I had no idea postpartum doulas existed. I immediately had a ton of questions for her because I became so excited about the idea that there are professionals available to help new moms out- this is seriously something everyone needs to know about! If you think doulas are only helping during labor, think again, and read on!


What is a doula?

The term doula literally means a woman’s helper. A doula usually provides support during and after childbirth. Whether it’s teaching pain management techniques, offering breastfeeding assistance, lending a sympathetic ear, or providing reassurance and encouragement, both birth and postpartum doulas do whatever is needed to make labor, healing, and bonding bonding between family members as safe and as easy as possible.

Traditionally, friends and family members provided the necessary support to new mothers because they had a lot of firsthand experience with birth, breastfeeding, and infants. Today, even when friends and family want to help, they often don’t know what is most useful, especially when it comes to labor and the initiation of breastfeeding – which they may have never seen up close. The professional doula movement began in response to our culture’s lack of traditional birth and postpartum care available to women.

As a postpartum doula, I focus on the mother’s needs during the “4th trimester”, or the first 3 months after birth.  I provide a mother with whatever she needs to feel nourished, relaxed, appreciated, and confident. I am aware that a mother’s wellbeing  and her ability to recover from the hard work of childbirth  are absolutely essential in order for her family to thrive.  After all, how can a mother who is depleted, exhausted, or possibly depressed properly care for her baby?

Hundreds of societies worldwide still have cultural structures in place which facilitate taking care of birthing women and new mothers. They see the direct correlation between the health of the mother and the health of the community. But here, women are often left to fend for themselves, particularly during the postpartum period. All the attention goes to the baby, and the mother becomes an afterthought. She is simply expected to get on with life as usual and immediately “bounce back”. We ask her to take care of everyone and everything at once. It’s not right, and yet we wonder why so many women suffer from postpartum mood disorders and fail to meet their breastfeeding goals. My hope as a postpartum doula is to help change these practices and move toward more peaceful and joyful beginnings.


What kind of support does a postpartum doula provide?

She will listen to your worries and concerns without judgement, help you to process your birth experience, she’ll give you a framework for what is normal for you and your newborn when it comes to sleep, feeding, and emotional and physical recovery, she’ll make sure you’re hydrated, fed, and well rested by preparing healthy snacks and teas and by snuggling your baby or watching an older sibling while you nap, she’ll give baby wearing and newborn care tips, answer your questions with evidence based information rather than opinion, and she’ll model “mothering the mother” for your partner and other loved ones.  In addition to helping mom adjust, a postpartum doula will help a partner adjust to his or her role too. A postpartum doula will also screen for postpartum mood disorders, and she will give you personalized referrals and local parenting resources when needed. Most postpartum doulas do not stay with a family beyond 3 months, although some do. I find that my clients benefit the most from support during the first 6 weeks of their baby’s life.


My mother/sister is planning on coming to stay with me and help once the baby’s born. Do I still need a postpartum doula?

A lot of people say a postpartum doula is like your best friend or sister, but without the emotional baggage!

A good way to figure out whether you would benefit from the extra care of a postpartum doula is to ask yourself a few questions about your situation and your relationships. Does your mother or sister fall into the category of helper or visitor? Be honest with yourself. Helpers do things like laundry, cooking, cleaning, and whatever else needs to be taken care of without being asked. They are not offended if you need time to yourself. Visitors are well meaning, but they want to chat and hold the baby more than do chores, and often need to be entertained. Many of my clients have wonderful mothers or sisters with the best of intentions, but they either act more like visitors than helpers, or they end up zeroing in on the baby while mom’s needs get pushed to the background.

If you are planning to breastfeed, do you feel comfortable doing so in front of your sister? Does your mother have breastfeeding experience, and if so, does she feel good about it? Will your mother or sister encourage you as you find your own parenting style or will she offer a lot of unwanted advice? Will you worry about her needs? Remember, you’ll have a whole lot of other things to worry about during the first few weeks, so don’t give yourself more! Your answers to these questions will give you a good idea of whether you’ll need extra professional support.

I have actually had some really great experiences working alongside clients’ family members. Loved ones often like having a professional there who they can ask questions to, or gain concrete instruction from. Sometimes I act as a go between when my client feels uncomfortable expressing her needs. I am also happy to take on daily tasks that allow mothers, daughters, sisters, and partners to spend more time simply being together as a family.
What is the difference between a postpartum doula and a baby nurse?

I am actually both, I recently certified as a Newborn Care Specialist (which is actually the correct term for “baby nurse” unless you are hiring a registered nurse) with the intent of bringing my clients even more information, while still working within the postpartum doula model of care. Generally speaking, a postpartum doula focuses on the mother, as I mentioned before, but also supports the whole family as a unit. A newborn care specialist specializes in newborns exclusively and takes over care of the baby. Her role is more similar to that of a nanny, but with specific newborn education and experience. A postpartum doula may take over care of the baby for short periods of time to allow space for rest and healing, but her ultimate aim is to give parents a chance to get to know their own babies, and to offer whatever support is necessary until they gain enough confidence to go it alone.


What are the most important factors to consider when picking a postpartum doula?

I think the most important thing is to have a personal connection with your doula. Always meet a doula before booking her services. She should be someone who you feel completely comfortable with, who you can imagine being at your most raw and vulnerable around, and who makes you feel positive, calm and at ease. Beyond that, your personal preference and priorities will guide you.

Most doulas have special interests and areas that they have sought out extended training in, so ask them about what those might be. For instance, some postpartum doulas are also trained in massage, some are yoga instructors, placenta encapsulators, or lactation counselors. You might want to find someone who especially enjoys cooking, or someone who has experience working with multiples. Think about your family, and what is important to you, and then try to find a doula who reflects your hopes and dreams. The right fit can make your first few months of parenthood the best of your life!


Is there anything moms can do to prevent postpartum depression

Setting yourself up with a support system goes a long way toward preventing isolation and exhaustion, which can lead to postpartum mood disorders. A conversation about your 4th trimester resources is a great place to start, and is a really important part of your birth plan. Your birth is just the beginning! I lead free workshops for expecting parents, helping them understand exactly how to get this conversation started. We also discuss the reasons why traditional practices of postpartum care make physiological sense. If you’d like to find out more, and receive a registration link to my next workshop, you can enter your contact information on my website: .