Tully and Postpartum Care- A Doula's Perspective

The postpartum doula world was a buzz when previews were released for Diablo Cody’s newest film, Tully. Having loved Juno, also written by Cody, for its realistic slice-of-life depiction of a supported teen pregnancy, we had high expectations that Tully would show how postpartum doulas aide the transition into parenthood. 

The movie opens with actress Charlize Theron, playing a very pregnant Marlo, lumbering down the hall to wake her son. You can feel the exhaustion of the third trimester as Marlo sets into motion the cascading responsibilities of the day. Quickly you are introduced to the struggles that she has been through, from caring for a ‘quirky’ son to struggling with a previous perinatal mood disorder. In an attempt to stave off a resurgence of Marlo’s ‘hard time,’ her brother Craig, played by Mark Duplass, offers to pay for a night nanny. Taken aback with mild offense and slight trepidation, Marlo reluctantly takes down a number to call “in case [she changes] her mind”.

After the baby is born, the movie goes on to portray the early postpartum period in a way that may feel all too real to recent parents: a repetitive whirring of never-ending, circular tasks done on little sleep, minimal energy, and dwindling patience. Director Jason Reitman catches shots that make us as parents laugh, gasp, and nod empathetically. After weeks of feeling alone, empty, and exhausted, Marlo decides to take Craig up on his offer. Enter Tully, a twenty-something night nanny played by actress Mackenzie Davis. Early on in their working relationship, Tully reiterates to Marlo that she is ‘[there] to take care of [Marlo]’. Feeling both apprehensive and relieved, Marlo welcomes Tully into her home, accepting the kind of helpful support that a postpartum doula might typically provide - support with breastfeeding, emotional processing, baby care, and household tasks.

Marlo’s journey with Tully takes some unconventional turns as Tully steps out of the role of a postpartum doula (imagine a wine-fueled hot tub conversation and sexual fantasy, adolescent makeup parties, and a night of bar-hopping together in the big city). Much to our dismay, the film’s end reveals Tully to be a delusion-- a symptom of postpartum psychosis. A psychosis that went unnoticed by Marlo’s husband and family.

Yikes! And let's pause for a reality check. While this movie demonstrates a real issue that affects a very small portion of the population (statistics tell us that .001% of childbearing women will develop postpartum psychosis), there is a larger - and quite serious - story to tell. Postpartum psychosis, though rare, is an extremely concerning ailment that requires immediate medical support: among the women who develop postpartum psychosis, approximately 5% will commit suicide; there is a 4% infanticide rate associated with the illness. And while postpartum psychosis is uncommon, other perinatal mood disorders are more prevalent:

  • 80% of postpartum parents experience the baby blues-- feelings of sadness, stress, and/or difficulty bonding with baby;

  • 14% of women suffer from postpartum depression;

  • 4-10% of new mothers experience postpartum anxiety/panic disorder; and

  • 3-5% of childbearing women are affected by postpartum obsessive compulsive disorder.

Any of these perinatal mood disorders (which can affect partners, as well, though at different rates of prevalence) can make the postpartum period more challenging - and less magical - than families often expect it to be. A perinatal mood disorder can interrupt bonding between parent and child, which can have impacts over the longer term. The statistics - and the story of "Tully" - demonstrate the importance of awareness surrounding perinatal mood disorders, their symptoms, and where families can go for help.

Perhaps the most important message of "Tully" is that every family deserves support in the postpartum period, a period that encompasses all pregnancy outcomes including miscarriage, abortion, and fetal/infant loss. If you are struggling with your perinatal experience, or even if you are simply preparing yourself and your family for a new addition, you don’t have to go it alone - I encourage you to explore (and use) the resource list that follows.

Camilla Rae is a Bridgetown Baby Postpartum Doula and INNATE Postpartum Care- Certified Provider. With loving compassion, Camilla enjoys caring for the expanding family, sharing baby rearing wisdom, and holding space for the transition into parenthood. When she isn’t caring for her clients, she can be found snuggling her 4 month-old, Maverick, volunteering at the Moreland Farmers Market, traveling the world, and homesteading.

*Statistics are provided by the CDC and Baby Blues Connection.
 

Postpartum Resources

Crisis Lines

Emergency: 911

Multnomah County Crisis Line: 503.988.4888

National Suicide Prevention Lifeline: 1.800.273.8255

National Hopeline Network, Suicide & Crisis Hotline: 1.800.442.4673.

Community Information and Referral Services: 211

Portland Area Mental Health Crisis Line: 800.716.9769

 

Perinatal Mood Disorder Support

Doula Support

ABC Doula :: 503.752.1691 :: abcdoula.com

Birthingway College of Midwifery :: 503.760.3131 :: birthingway.edu

Birthing Stone :: 503.718.7574 :: birthingstone.com

Bridgetown Baby :: 503.970.9554 :: bridgetownbaby.com

Doula Love :: 503.766.3495 :: portlanddoulalove.com

Doula Match :: A website to help you find birth and/or postpartum doulas in your area. :: doulamatch.net

Doula My Soul. :: 360.545.3356 :: doulamysoul.com

It’s a Belly :: 503.493.7390 :: itsabelly.com

Kindred Mother Care :: Sejal Fichadia :: kindredmothercare.com

Groups

Baby Blues Connection :: Baby Blues Connection is a parent-to-parent support service based in Portland. :: 800.557.8375

Brief Encounters :: A safe place for parents whose babies have died before, during, or after birth. Brief Encounters provides nonsectarian group meetings for bereaved families. :: 503. 699.8006 :: http://briefencounters.org

Postpartum Support International :: Postpartum Support International is dedicated to helping women suffering from perinatal mood and anxiety disorders, including postpartum depression, the most common complication of childbirth. :: 1.800.944.4773 :: http://www.postpartum.net

Providers

The Postpartum Stress Center :: The Postpartum Stress Center, LLC, is a premier treatment and professional training center for prenatal and postpartum depression and anxiety.

WellPDX :: WellPDX is a collective of Portland metro area acupuncturists, chiropractors, massage therapists and naturopathic doctors.

Camilla Rae is a Postpartum Doula and INNATE Postpartum Care-Certified Provider at Bridgetown Baby. This article first ran in NW Kids Magazine July 2018. http://www.nwkidsmagazine.com/2018/06/july-2018/

Ben's Story: Surviving Birth Trauma - A Dad's Perspective

by Brita Johnson

Photo courtesy of Ben B.

Photo courtesy of Ben B.

For Ben and his wife Lauren, the path from their son’s birth in January, 2017 to Father’s Day, 2017 was a rocky road marked by medical trauma, parenting challenges, emotional struggles, and, finally, healing. Ben recalls that first Father’s Day as the time when things started to normalize and they began to enjoy the kind of family moments he’d expected from the start.

Things had felt easy in the beginning. With nothing more serious than the slight nausea and fatigue that you’d expect, Lauren’s had been a textbook pregnancy. When they went into the hospital for an induction a few days past Lauren’s due date, they anticipated a similarly easy labor and delivery. Instead, Ben says, “we walked out forever changed.”

It was while on the operating table for a routine c-section that everything went sideways. Once the baby was delivered, Lauren started bleeding profusely. Ben was rushed out of the operating room while the surgeons scrambled to stanch the bleeding. He spent 15-30 minutes in an adjacent room, not knowing if Lauren would live or die. “It was the most profound loneliness I’ve ever experienced,” Ben says of those moments.

Once the hemorrhage was under control, Ben spent the next three days at Lauren’s side in the intensive care unit, focused wholly on her survival. No part of the story of their first three days as parents is about meeting their son, looking into his eyes, counting fingers and toes, and marveling at his tiny perfection. The baby, who would be named Sully, entered the picture only on day four, when their doctor had to push for an exception to the rules to allow Sully into the ICU to meet his mother.

Ben, Lauren, and Sully headed home from the hospital not long after, to settle into their new life as a family of three. But, “the course of what I thought parenthood was going to be was completely altered,” says Ben. Medical struggles, ongoing physical impacts from Lauren’s hemorrhage, severe colic, and the emotional fallout from their trauma consumed them for the next four months. Lauren experienced a bout of postpartum depression; Ben focused on supporting her through that. As she began to resurface, he took a dive into depression, anxiety, and PTSD.

During those months, Ben lived in a swirl of fear (“Would things ever be normal again? What if this was a mistake and we never reclaim our identity? What if we never get to surf or travel or do the things we love?”) and anger (“why us?”).

“It honestly took 8 months to…I won’t say ‘recover’… but to get back to neutral,” Ben says. What helped? A flood of family and friend support; research into paternal postpartum experience, PTSD, and trauma recovery; an awareness, shared with Lauren, about the need to heal; a subsequent therapy journey. And, support from Bridgetown Baby.

Friends recommended Bridgetown Baby, and soon postpartum doula support became an integral part of Ben’s, Lauren’s, and Sully’s early weeks as a family. “Merriah came into our home when everything was at its worst,” says Ben. Doula support was powerful for Ben and Lauren in ways both simple and profound. “Just to have the energy of someone who’d seen what we’d gone through, and could support us in learning to be parents… In the moments where the four of us could sit down together and talk, Merriah really listened and always gave thoughtful advice.”

Then there was the magical frittata (“I still remember how good it tasted”), and the gift of sleep: “For me, it was having Merriah walk through the door and look at me and say, ‘just go to bed.’ All the riches in the world weren’t as valuable as getting to lie down in the guest room and sleep uninterrupted.”

For Ben, postpartum doula support was something he didn’t know they needed until they needed it. Ben says, “it's unimaginable that we could have gotten through what we did without doula care.”

Looking back, Ben can (almost) chuckle at some of the fears he experienced in those early months. Sully is now a happy, verbal toddler—Ben’s face glows with joy as he describes Sully’s newest abilities and capers. As they approach Father’s Day 2018, Ben marvels at the difference a year makes. “Last year, we were still navigating the crisis, we were in survival mode. Right now, life is chaotic…but life is full, in a good way. We’re able to focus on each other in a different way, and enjoy ourselves as a family.”

With the perspective he’s gained, Ben now feels a drive to share the struggle he went through: if his experience can make it just one or two clicks easier for someone else to find the resources they need, he feels it’s worth telling his story.

For all dads, Ben would like to recognize the tumultuous feelings they might have: “[having a new baby is] a really intense experience, and it’s not easy. And it’s not easy for everybody, not just the mom. The dad’s emotions and reactions are not an outlier—they’re part of the equation. I didn’t think that way walking into it.”

For dads who’ve “gone through something with childbirth, or raising a kid, whether it’s [a crisis of some kind or whether it’s] as simple as you’ve had a completely normal experience but it’s just hard to raise a kid…I hope it can help to know that there’s someone else who’s gone through it and is willing to talk it through.”

His biggest take-home is that it’s okay to feel the feelings you have. ”You owe it to yourself first,” Ben says, “and your family second, to get in there with those feelings, to recognize them, and work through them.”

Find more information on the Bridgetown Baby blog about dads' varying experiences, including tips and resources to make your job as a dad easier and more fun!

Until That Moment In The Kitchen: More on Mother's Day

Mothering is a collection of stories. In honor of Mother’s Day, we celebrate our collective journey— and acknowledge that within that collective journey, our individual experiences of mothering can differ widely. Some stories of mothering are threaded through with sadness, making Mother’s Day a complex sort of celebration. Bridgetown Baby client Saranna’s full story will be featured later this year in our Client Stories, but, in this snippet, she shares a moment of healing in the aftermath of loss, part of the arc of her growing family’s story.

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After we lost our son Spencer at 20 weeks gestation, I felt I was stuck for a long time at a certain point in my grief—grief support groups didn’t feel welcoming; the things people said, however well-meaning, made me feel more alone, as if there weren’t room for the grief I was experiencing. And when our daughter Neha was born a year and half later, the way people spoke of her (“now you have your baby,” as if that could fill the hole left by Spencer’s death) made me feel fiercely protective of her; I didn’t want her to bear the burden of feeling like a replacement for the older brother none of us ever got to know. So I took that burden on, too—and felt even more alone.

But perspective and healing came in an unexpected moment in the kitchen one afternoon. Neha ran up to me, bursting with news.

“Guess what, Mommy? Mocha (our dog who had passed about three months earlier) and big brother Spencer are driving around in a big red car in heaven together.”

“Oh, wow, Neha—that’s neat. Can you tell me more?”

“No, it was just in my dream.”

“Oh, I see. Do you miss them?”

“Yeah.”

I asked her if she had more she wanted to share with me; she said no, and went running out of the kitchen as fast as she’d come in. 

And I thought, ‘wow, just…wow. Here I am just cutting vegetables for dinner and, in a conversation that must have seemed so simple to her, she allowed me to experience my grief in a different way.’

In that moment, I suddenly felt that I didn’t have to hold all of the weight and responsibility of remembering this person, and honoring this person, and missing this person…Neha has integrated it seamlessly and lovingly into her story; the weight can be shared. It was as if my heart said, “I don’t have to bear this burden alone. And everyone’s going to be okay.”

~as told to Bridgetown Baby doula Brita Johnson

Camilla's Story: A Doula Has Her First Baby

by Camilla Malkin

Photo credit: Brita Johnson

Photo credit: Brita Johnson

Becoming a mother after two decades of caring for infants, small children, and families has been an interesting process. While I was pregnant the speculation around how easy the transition would be groomed me to smile politely as anxiety bubbled within me.

‘[I was] an expert with so much experience.’

‘[I would] know what to do under every circumstance.’ 

‘[I had] a Mary Poppins bag of tricks, wisdom, and knowledge.’ 

Yet even with 20 years of practice under my belt I felt like a complete amateur when they handed me Maverick for the first time. As I fumbled with hospital sheets and a starchy swaddled newborn I realized instantly that no amount of prior exposure could have prepared me for the feeling of holding my son. That bundle of life was one of my greatest accomplishments. I had grown him from two cells and carried him within me for 40 plus weeks. As my husband, Andy, and I examined his every inch we caught each other settling into the awareness that Maverick was going to be an adventure of a lifetime and we were only at the beginning. 

When we were released from the hospital I took an eternity buckling the baby into the car seat. I was having trouble securing the straps. My muscle memory was being overridden by my new title of “mother”.

Buckle the 5 point harness. Pull the strap. Slide up the chest clasp. Check for two fingers of give. Nope. I did that wrong. Was I supposed to tighten then adjust? Or adjust then tighten? Was the chest fastener too high? What is a sternum again? Check. Double check. Redo. Check again.

Looking back on our process of choosing a doula, I am so thankful for my husband’s astute articulation of what we (read: I) needed. We were in search of someone who would doula me so I wouldn’t doula myself. 

As we victoriously reach one month of parenthood I am able to reflect on how grateful I am for the loving support of the Bridgetown Baby team. Our son is getting to know us as our best selves. We get to spend time revelling in the nuances of this child. We are becoming experts on all things Maverick. Welcoming in our postpartum doulas has meant we get to focus on the important emotional bonding without having to compromise our everyday routines (showering, eating, hydrating, sleeping) while ensuring that all three of us are getting care and support as we learn, as a family, what works best for meeting our needs and goals.

It’s been an amazing transition. And I’m happy to say that now my muscle memory kicks in even when my mommy-brain can’t fully comprehend why there is so much fabric in the Moby wrap! 

C.V.’s Story: Double Twins Dad!

by Kari Hastings

Photo credit: Nicole Wasko Photography

Photo credit: Nicole Wasko Photography

Stay-at-home dad C.V. already had 4-year-old twins (the bigs) when his second set of twins, boys Carlyle and Sebastian (the littles), were born in fall of 2015. He had forgotten what it was like to have two babies at once, but reality hit full force those first few months. And this time, the infants’ round-the-clock needs were compounded by having two other young children.

“Having twins, again, for me as a Dad … was overwhelming,” says C.V., who quit his job as a pastor to stay home after his first twins, a boy and girl, were born. “In my fuzzy memory, it was as though I was reliving a bad dream.”

Overnight, life turned into an endless rotation of diapering, swaddling, feeding, sleeping and bottle-washing. Competing with these demands were C.V.’s older children, who needed to be fed, entertained, bathed and parented. The sleep deprivation was brutal. The mental exhaustion was punishing. C.V. knew he and his wife, Stacy, needed help.

Stacy’s friend referred them to Bridgetown Baby, and a Go Fund Me account helped them purchase 36 overnights over a six-month period. The help, in the form of postpartum doulas Merriah Fairchild and Emily Darley Hill, brought a measure of sanity back to the household.

The North Portland father says although well-meaning family and friends tried to help, the complex feeding system and efforts to sync the twins’ feeding and napping schedules was difficult to navigate. But when he explained everything to Bridgetown Baby’s doulas, they not only got it, they helped him achieve his goals with professional guidance and seamless care.

“We continue to be in over our heads,” C.V. says, laughing. “But I look back on those overnights with such a sense of gratitude. They made me feel like I could keep going. I really don’t know what we would have done without them.”

What would he tell other parents about to welcome twins into their families?

“Know that you will get to the end of yourself,” C.V. says. “You need to prepare yourself to ask and to receive help. With Bridgetown Baby, you can trust your babies will be well taken care of. It’s a very significant release to be able to hand them over with peace of mind. Just know that when you are at your end, Bridgetown Baby is hope and support … and sleep.”

Carmen and Anand’s Story: Managing Multiples & Reflux

by Kari Hastings

Photo credit: Clicks by Suzanne

Photo credit: Clicks by Suzanne

When Carmen and Anand’s twin daughters made their debut in October 2016, the couple got initiated into baby land – times two. “Neither of us had any experience with babies, like zero,” Carmen says. “The first time Anand held a baby was when he held our girls.”

Going from zero to 60 overnight was intense, and both Carmen and Anand say they couldn’t have done it without Bridgetown Baby’s Welcome Home and overnight packages. Carmen had a cesarean birth at 34 weeks. Her babies, Anais and Amara, spent 20 days in the Neonative Intensive Care Unit, which she describes as “baby boot camp.” “We learned a ton from the NICU nurses,” she says. “But it’s different when you’re home with them, and you have to figure out what to do.”

Anais, born at just 3 pounds 12 ounces, had significant reflux issues and screamed in pain after every feeding. Bridgetown Baby postpartum doulas Merriah Fairchild, Rose Otter and Catherine Akerson Bailey all worked with the twins, demonstrating how to get them to breastfeed and bottle-feed at the same time, and how to massage their tiny bellies to relieve pressure, burp them and wear them around the house in a wrap. The doulas also assisted with practical things, like setting up an organized bottle-feeding system and figuring out which bottles and nipples worked best.

Anand says having their input was calming

“I’m a research-oriented person,” he says. “I do a ton of reading and look up everything online. I was able to just let go, save up my questions and ask the professionals when they showed up every week. It really helped our relationship with the babies and our relationship with each other.”

Carmen says the “overnights” were the best.

“Those overnights were a godsend,” she says. “We just bought it like it was another resource. It’s really not a luxury item. It’s a need to have, not a want. Merriah would leave the next morning, and the babies and I would be happy and rested, the kitchen would look great, lactation cookies would be baked and breakfast would be on the table.

“The biggest gifts they gave us were confidence and peace of mind. Our postpartum doulas really were a bridge to our new life.”

Julia's Story: Navigating Anxiety and Postpartum Depression

by Kari Hastings

Photo credit: Leah Biado-Luis Photography

Photo credit: Leah Biado-Luis Photography

Julia T., mom of Emma – born in February 2016, remembers her most vulnerable moment with Bridgetown Baby’s Emily Darley Hill. It was morning, and Emily was dropping in for one of their scheduled visits. Anxiety and postpartum depression had taken hold of Julia in the middle of the night, overwhelming her with feelings of negativity and a pleading question, “How will I ever feel better again?” When Emily arrived, Julia crumpled onto her couch and cried, “I just want to be a good mom.”

Although Julia had a good support system – a mother and sister living within blocks, plus many nearby friends – she says Emily’s support as a postpartum doula pulled her through that dark time and helped her find her footing as a new mom. “Emily normalized what I was going through,” Julia says. “She assured me I was going to be OK, and for me, that was huge.”

Emily connected her with a therapist who specializes in postpartum issues, and a neighborhood moms support group. Julia, who had a planned C-section, bought three Bridgetown Baby packages – a breastfeeding package and two home-visit packages.

Julia says knowing she would have a weekly doula visit was a lifesaver. “Emily would take the baby, wear her around the house in a wrap, clean, do laundry, cook, do food prep for the week, and my husband and I would just relax or sleep,” she says. “She would rub my feet, listen, give me advice, just anything I needed.”

Setting up Bridgetown Baby services in advance of her birth was one of the smartest things she did, Julia says. “I’ve struggled with anxiety in recent years, so I wanted to line up that support ahead of time,” Julia says. “I’m so glad I did. Emily was the sweetest, most calming presence. You can have the best family and friends in the world. The difference with a doula is that it’s their job to help you. There’s no guilt associated with it. They’re professionals.”

 

New Family Stories (aka The Lovely, Messy Truth)

For expecting parents, the days after your baby is born stretch ahead like a blank expanse. You probably have some idea or hopes for what it will be like, and perhaps some war stories shared by friends who have kids. But overall, it's a bit of a mystery. And then, suddenly, you're on the other side with a new human and it's nothing like you expected. The good parts are unimaginably blissful, and the hard times are beyond what you ever thought you could endure. Nothing can really prepare you for the intensity of the postpartum period, and that can feel scary and lonesome.

But know this: you are not alone.

Isolation is one of the toughest parts of parenting in America. When you're alone with questions, and a new baby whose life has been entrusted to you, it's daunting. Our mission as postpartum doulas is to build a bridge of support for new families, to help you find your own strength and capacity, but even doulas have to go home sometime. We want you to know that you are never truly alone in this parenting endeavor. You are surrounded by love and community, even in the dark, wee hours. To that end, we have launched a new project for this year, with a focus on sharing stories from the postpartum zone: good things, hard things, mundane moments. And, because we are passionate about our work, our stories talk about how postpartum doulas can support families in many different ways. Every family deserves postpartum support.

We are so excited to share the first installment in our New Family Stories this February. They are compiled and written by the talented and brilliant Kari Hastings. Please let us know what you think, what you want to hear about, if you'd like to share your own story. We would be so honored.