Overnight Postpartum Doula Care

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Whether it’s your first child or your fourth, we all know that bringing home a new baby means a big transition! Many of our clients realize the need for additional support during this transition and call on an Overnight Postpartum Doula to help.

Our postpartum doulas are Newborn Care Specialists and professionally-trained experts.

When choosing a doula to care for your family, there are options for not just who it is but also for what they do! Daytime Postpartum Doulas can provide professional support including soothing techniques, feeding guidance, and addressing questions about postpartum physical and mental health. Overnight Postpartum Doulas provide much-needed support making sure that the whole family (including visiting grandparents) get the sleep they need, offer feeding support, and encourage safe and developmentally appropriate sleeping habits. 

If you’ve ever been confused about the types of care you could have for your newborn you’re not alone! Sometimes our Newborn Care Specialists are referred to as “night nannies” or “night nurses”. Doulas and Newborn Care Specialists, however, are neither nannies nor nurses. Rather, they have specialized training regarding caring for a newborn and their family. 

During every overnight shift, your doula will provide you with a log and notes detailing your baby’s night. Let’s look at a sample of exactly what a shift log from your doula/NCS may look like.

Overnight Postpartum Doula Shift Notes

Monday, May 5th

8:45pm: Arrived for my 9pm shift. Removed shoes, changed into a fresh DOB shirt and washed hands. Greeted Dad and was escorted upstairs where Mom was nursing the baby. I said hello to Mom and Baby as she got up to change his diaper then chatted with her while she tried to nurse him some more. 

9:15pm: Baby was a bit fussy, so I offered to carry Baby while the parents showed me around the house and chatted about plans for the night. Mom plans to nurse him for his next feeding and then I’ll give a bottle for the one after that. I encouraged both parents to get ready for bed and worked on getting Baby settled down. He was swaddled with a paci then we walked and jiggled and patted until he finally stayed asleep at 10:35. I tried laying him down several times before that but he would start to cry and jostle around. 

10:35 pm: Baby asleep in bassinet.

11:25 pm: He had hiccups and was awake, replaced paci and rocked with hand on his chest.

11:40 pm: Back to sleep.

Tuesday, May 6th

12:30 am: Fussy. Changed wet diaper and took him to Mom to nurse. 

1:00 am: Burped, changed poopy/wet diaper. Swaddled with Paci and rocked to settle. 

1:15 am: Soundly asleep in bassinet.

3:35 am: Fussing and grunting. Went downstairs to prep a bottle with monitor. Baby finished 2 oz of the 2.5 oz bottle of EBM. 2 huge burps half way through. Texted Mom so she could wake up and pump. 

3:50 am: Back asleep in bassinet.

4:30 am: Brief wake up. Wouldn’t settle with paci, hand on chest or rocking. Finished maybe 1/2 oz of bottle. Burped and right back to sleep. 

6:15 am: Fussy and wouldn’t stay asleep in bassinet. Wanted to be held and would go back to sleep and then wake up as soon as I laid him down, so we rocked in the nursery chair. 

6:35 am: Changed wet/poo diaper. 

6:45 am: Mom came down and nursed him while we talked about the night, including creating sleep associations, tips on keeping baby awake during the day for developmentally appropriate stretches and nursing on demand not to exceed 2.5 hours during the daytime hours. 

7:05 am: Said goodbye to a well rested family!  

 

The goals of an overnight shift might change from night-to-night or family-to-family. This is why our Overnight Newborn Care package includes five continuous weeks of three 10-hour overnight shifts per week. This allows your whole family needed rest and sets a foundation of healthy sleep habits for your baby. You can also duplicate these packages to extend your Overnight Postpartum Doula care!

 

Needing some sleep? Contact us to find out more about our overnight newborn care.

The Changes Your Body Experiences After Birth

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We spend nine months getting ready for baby to arrive–both physically and emotionally. But the actual birth experience portion of your journey is relatively short. After birth, your body continues to change for many months. Here are some of the changes you can expect in the moments, weeks, and months after birth. 

What will I experience immediately after birth?

Immediately after birth, a care provider may place baby directly on your chest. This skin-to-skin contact helps regulate baby’s body temperature and calms baby. But it can also help your uterus contract to reduce bleeding. Bleeding may still be taking place from where the placenta was attached to the uterus or from any tears. A care provider might provide medication to slow or stop that bleeding, perform a uterine massage, or stitch the perineum. You might also shake, have contractions, feel weak, or be sore (you did just work very hard). 

How long does it take to recover from childbirth?

How long it takes to physically recover from childbirth depends on what happened during birth as well as the birthing person’s activity level. If you had tearing, an episiotomy, excessive blood loss, or a cesarean birth, it may take you longer to recover. In the days and weeks following birth, your body will feel different. You may be exhausted, bloated, and sore. The change in hormones can cause mood swings, sweating or hair loss. Pregnancy and childbirth also stretches ligaments and muscles, so your abdominal and pelvic floor muscles take time to tighten back up. If you had a c-section, remember that it is major surgery. You shouldn’t lift or over-exert yourself. Take the time you need to recover, listen to your body and be gentle with yourself

What are the emotional changes I’ll experience after birth?

Our brains are a part of our bodies, and the physical changes to our brains can alter our emotions. The change in hormones that happens in the postpartum period can make you feel happy, excited, positive, overwhelmed, sad, possessive, or disappointed. These are all normal. Making a plan for how family and friends (link to last blow) can help reduce stress. Prolonged and severe depression can also happen after childbirth, and if you (or your support network) are worried about a Postpartum Mood Disorder (PMDD) or Post-traumatic Stress Disorder (PTSD), talk to your care provider. 

What physical changes are not normal?

If you have any physical or emotional changes that concern you, talk to your care provider. They can help you determine what is normal and what isn’t. You should also talk to your care provider if you have vomiting, flu-like symptoms, fever, heavy bleeding, difficulty urinating, leg pain, vaginal itching, dizziness, shortness of breath, or racing heart. 

Can I recover more quickly after childbirth? 

The most important thing to do after giving birth is listen to your care provider. They can help you understand what you went through and how long it will take to recover. Make sure you prioritize your needs for rest, nutrition, and mental health. Many women feel physically recovered from childbirth around 6 weeks, but for most, it may take longer. 

A postpartum doula can provide education and support, and assist with newborn care, breastfeeding support, or anything else that can help ease the transition when a new baby arrives. 

Returning to Work After Baby: 4 Tips for a Smoother Transition

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When it comes to returning to work after baby, we’ll start with the unfortunate truth: the US does not guarantee paid parental leave on a national level, and not all workers qualify for the six weeks of unpaid leave federal law mandates. According to the Washington Post, “Most Americans do not have access to paid family leave through their employer.” 

All of this means that there is no standard for when you return to work after parental leave: it could be six weeks or six months. But regardless, returning to work–for either the birthing person or partner, can be a significant transition. You may be thinking about everything from your energy levels, your schedule, pumping and/or feeding, your partner’s schedule, and how your baby will do without you. Here are 4 things to consider and plan for before you return to work. 

A woman speaks to her boss about maternity leave and how she will take it after her baby arrives.

Know what your leave looks like and be open with your employer. 

Long before delivery you may be thinking about your parental leave options–both what your employer offers and what your ideal scenario might be. Be open with your employer and consider asking for something that might make the transition back to work easier. That might include returning part-time at first or working from home. Your employer might also be willing to be flexible in ways that they haven’t shared with you. Ask other employees or your employer directly about how others have returned to work after leave. 

A caregiver sits with babies while their parents return to work.

Think about childcare after parental leave, and then come up with a back-up plan. 

You may have come up with the perfect childcare solution: you are returning part-time to work and a friend or family member is baby-sitting on the other days. In 2022, that might be problematic because of changes in school openings due to COVID. Or, the caregiver might have to quarantine after a COVID exposure. Problems could arise simply because they are not as reliable as you would like them to be. Whatever your childcare plan involves after you return to work, come up with a backup plan. If you have a family member caring for baby, what happens if they are sick? 

If you are working from home, remember that you are still working and taking care of baby is also full-time work. Although working from home can make it easier to care of baby, you should still try to have a secondary caregiver available. Some of our clients have utilized our postpartum doulas while working from home to ease that transition. 

A couple cooks together as they discuss returning to work after their baby is born in Baltimore.

Figure out priorities and roles for when returning to work after baby. 

You partner may have taken little or no time off after baby arrived. But, your transition back to work is still a transition for them as well. Take time to figure out each of your priorities and roles. If you are not a morning person, consider having your partner take care of baby’s or the family’s morning routine. This way, you can get ready for work in the way that you need to. Discuss who will pickup baby or kids from caregivers, daycare, or school. You may have figured out a postpartum plan of who was cooking and cleaning, but you may need to revisit those plans if both partners are back at work. 

A tired parent yawns as their baby watches while they work from home.

Don’t be afraid to acknowledge your emotions and ask for help. 

The postpartum period can be difficult: you are adapting to a new family member. If you gave birth, you may be experiencing physical changes in your body as well (link to blog). You are going to have a lot of emotions–from being excited about being back at work to sad that your baby is someone else’s care. Don’t be afraid to acknowledge that whole range of emotions and understand that they are all OK. If you being feeling overwhelmed when you return to work after parental leave, ask for help, whether from your partner, family, friends, or other loved ones.

Snoo Bassinet: Should You Buy One?

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With promises of extra sleep, little need to sleep train, and an extra set of hands, the Snoo Bassinet by Happiest Baby is a product we often get questions about. As professional overnight newborn care providers, we have absolutely used this product when families request! Newborn sleep is a hot topic on most new parents’ minds so it makes sense that this is an often requested topic of discussion.

Let’s break down the purported benefits of the Snoo, the standard and optional features, the pros and cons, and what we think overall. Should you buy the Snoo?

Snoo Bassinet promises vs reality

On the sales page for the Snoo you’ll find quite a few benefits outlined. Let’s walk through these and share our experiences with each. 

Please note, for this section, these are simply our experiences and not meant to dispute the legitimacy of these claims.

Added Sleep

This really depends on the temperament of your baby. It’s true for some families and less true for others. Some babies really love the movement of swings or bassinets and others hate them. There’s really no way for you to know this without testing it for yourself first.

“…in my experience not every baby takes to the Snoo. Some infants, especially those with different sleep needs or temperaments, have not found the motion and noise soothing, like at all” – Rae Braxton, DOB Doula

Rae Braxton, a doulas of baltimore doula who attends postpartum newborn clients

Sleep Trains Baby

Kind of. The bassinet does help soothe some babies back to sleep from the wakeful part of their sleep cycle. Adult sleep cycles last between 90-120 minutes while a baby’s is more like 40. They also wake during the night because their stomachs are smaller. During their more active part of their sleep cycle, it’s normal for them to make noise and move around sometimes resulting in them waking up. The Snoo detects this movement and soothes them back to sleep. Transitioning out of the Snoo can be simple or could be difficult, again depending on your baby’s unique needs.

 

Your 24/7 Helper

While it is true that your baby can go into the bassinet while you shower, as the website claims, they could also simply be put down to nap and you take a shower. So long as your baby is in a safe space, they can be put down anywhere. As Postpartum Doulas, we also know that extra hands to help with snack prep, light cleaning, and laundry are also invaluable. You don’t always want to put your baby down, sometimes you just need hands to do the tasks you can’t get to while you’re holding the baby.

 

Responsive

We can confidently say that the Snoo Bassinet is definitely responsive. When it senses that baby is fussing, it activates shushing and/or movement to soothe them back to sleep.

“While working overnights, I really appreciate having a Snoo because the Snoo helps to soothe the baby. Although I am awake when the baby is fussing, the Snoo is usually able to soothe the baby so that I don’t have to get up from a restful position.” – Amanda Dymond, DOB Doula

Amanda Dymond shares her thoughts on the Snoo Bassinet

Mobile App

Yes, we can confirm there is a Snoo App and it has lots of interesting information. The main thing it does is compile information and in our experience is limited in functionality.

“…I think the app integration works well for more tech savvy parents and caregivers. (The app is not very intuitive but if they like compiling data, it would work well for their needs)” – Rae Braxton, DOB Doula

 

Added Safety

The claim is that because the swaddle is secure it prevents the baby from rolling into an unsafe position. This one is a tricky one to assess because most swaddles keep your baby in the position they’re in and once your baby is attempting rolling they shouldn’t be in a swaddle anyway. We can definitely confirm the Snoo will keep your baby in their spot while in the bassinet. 

 

Calms Fussing

Much like the added sleep claim, this one is very subjective. If your baby finds the Snoo to be relaxing and soothing, yes! It will definitely calm the fussing. If, however, your baby finds it to be stimulating, it’s unlikely to calm the fussing.

“… it really depends on the temperament of the baby. Some find the automated motion calming, while it can stimulate other babies. “ – Lani Cohen, DOB Doula

 

Key Snoo Bassinet Features

This bassinet offers a host of features that parents may love to offer their new babies.

Directly from the Happiest Baby website:

“Breathable mesh walls for healthy air flow

5 levels of specially designed sound + motion to soothe babies and boost sleep

Premium motor for quiet and reliability

Advanced algorithm can tell baby cries from room noise

For babies 0-6 months old who cannot roll over consistently

(meaning they have rolled from stomach to back—multiple times—during sleep)”

Sleep Sack Sizing and Snoo Sheets

According to the website, the sizing for the swaddles looks like this:

 

Small: 5-12 lb

Medium: 12-18 lb

Large: 18-26 lb

X-Large: 26-33 lb

 

We can attest that these swaddles do run a little small as they’re intended to be snug. There are only 3 included with your purchase: one small, one medium, and one large. This means if your baby happens to have a blowout or spit up on their swaddle you’ll need to wash it quickly before their next nap or purchase additional swaddles in their size. One swaddle will run you $44.95 or you can purchase a set of three for $73.40. 

This also goes for the Organic Cotton Snoo Sheets as your bassinet purchase only comes with one. The sheets can be purchased individually for $19.95 or a set of three for $38.50.

 

Snoo Weight Limit

The Snoo’s weight limit is 25 lbs. Beyond weight, parents should also be aware that babies should not be using the Snoo if they are rolling consistently and definitely not if they can get up on hands and knees.

A newborn is swaddled and set into a Snoo bassinet

Pros and Cons of the Snoo Bassinet

Pro: This smart bassinet may help your baby sleep better, getting parents additional sleep that may help aid in warding off things like Postpartum Depression, for which sleep disturbances are a risk factor, and delayed healing.

Con: There’s no way for you to know if your baby will actually like this device besides investing the money to try it.

 

Pro: This bassinet is great for babies who enjoy being swaddled up for sleep.

Con: That means you may end up retiring this bassinet as soon as 2 months when your baby begins to try rolling over. That’s a potentially very short period of time.

 

Pro: You get 9 months of premium access to the Snoo Subscription app that accompanies the bassinet when you purchase or subscribe to a Snoo Bassinet Rental through an authorized dealer or Happiest Baby themselves.

Con: If you use that app primarily as your tracker for baby you will have to pay after that 9 month period of time or spend time transferring data out of the app.

 

Pro: You can rent it at a lower rate than purchasing it.

Con: If you end up keeping it past a couple months it might end up being more expensive anyway with the added fees and taxes, plus you can’t keep it to use with any future babies if that is your plan.

a new parent sets their baby into a bassinet

So, should you purchase a Snoo Bassinet? 

As with so many other parenting choices you’ll make that depends on your baby. A quick search of the message boards on a website like Reddit will yield many varied results and some insights that might help make the decision based on real-life reviews of the product.

Overall, we think this product can be very useful in some situations. Being that there is the possibility that you don’t use it past 2 months of age, the up front investment is very high, and it’s a case-by-case product, we highly recommend renting or borrowing one to see what you think before diving into purchasing it.

“My advice is to always try renting before making the full commitment! It really can be a fantastic tool and help parents get the sleep they need—but it’s definitely not one size fits all. “ – Rae Braxton, DOB Doula

Should you choose to move forward with the Snoo, we highly recommend purchasing additional swaddles and sheets to ensure you have at least one backup in case your little one soils them.

A useful tool for some, an expensive waste of money for others, the Snoo Bassinet is a purchase you won’t find a definitive answer on!

Hypertension in Pregnancy | Preeclampsia and HELLP

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Hypertension in pregnancy and its related complications, such as Preeclampsia, can have significant implications in the health and safety of birthing individuals and their babies. Prior to 2007, these conditions were more rare in otherwise healthy pregnancies. Studies have shown, though, that Chronic Hypertension in Pregnancy doubled between 2007-2021 (source). 

Understanding what these conditions are, how they are diagnosed, and what symptoms to watch for is key to early detection and effective treatment. With early intervention and treatment, pregnancy outcomes have a high probability to be positive even after diagnosis. In this post, we will explore hypertension in pregnancy and preeclampsia including symptoms, how these conditions are diagnosed, and variations or other related diagnoses.

A doctor takes the blood pressure of a pregnant patient in their office.

Hypertension in Pregnancy

What is Chronic Hypertension in Pregnancy?

Chronic hypertension in pregnancy is defined as high blood pressure that either exists prior to pregnancy, is diagnosed within the first 20 weeks of pregnancy, or does not resolve by the 12-week postpartum checkup. According to this article, Chronic Hypertension affects at estimated 5% of pregnancies.

What is Gestational Hypertension in Pregnancy?

The main difference between Chronic Hypertension and Gestational Hypertension in pregnancy is that Gestational Hypertension (formerly known as Pregnancy-Induced Hypertension or PIH) is new Hypertension that is diagnosed after 20 weeks of pregnancy. This condition is unique in that it is diagnosed after birth if you don’t develop preeclampsia and your blood pressure returns to normal after 12 weeks postpartum.

While this makes it sound less severe than Preeclampsia, it’s of note that if this condition progresses from mild to severe Gestational Hypertension the treatment is very similar to severe Preeclampsia. Both conditions are important to monitor and intervene if necessary.

Unlike Preeclampsia, Chronic and Gestational Hypertension may not always present with symptoms. However, regular monitoring of blood pressure is essential to ensure early detection. 

What Symptoms Should You Watch for?

Pregnant individuals who experience high blood pressure readings (140/90 mmHg or higher), headaches, visual disturbances, or swelling of the face, hands, or feet should discuss with their healthcare provider if further testing is needed.

How are Chronic and Gestational Hypertension Diagnosed?

Both Chronic and Gestational Hypertension are diagnosed via blood pressure measurement, urine analysis, and blood tests. Blood pressure tests are always the first line of defense as they’re taken at each routine visit. Urine analysis is also routine however they’ll do a more intensive analysis to rule out Preeclampsia. Blood tests may also be taken to check on organ function.

How Common is Hypertension in Pregnancy?

Hypertension occurs in about 10% of pregnancies in the United States. Chronic Hypertension affects about 1-5% of pregnancies, while Gestational Hypertension affects approximately 6-8%.

Pregnant individual takes their own blood pressure at home to monitor for hypertension, preeclampsia, and hellp in pregnancy

Preeclampsia

What is Preeclampsia?

Preeclampsia is a serious condition that typically develops after the 20th week of pregnancy. It is characterized by high blood pressure and damage to organs, most commonly the liver and kidneys. This condition can progress rapidly and pose significant risks to both the pregnant person and the baby. It can potentially lead to complications like preterm birth or placental abruption and can even be fatal if left untreated.

What Symptoms Should You Watch for?

The symptoms of Preeclampsia can range from mild to severe. It’s important that individuals share their symptoms with their healthcare provider no matter the level of intensity. It is possible, however, to have Preeclampsia without these symptoms which is why routine prenatal appointments are important! Just like with Hypertension in Pregnancy, persistent high blood pressure (140/90 mmHg or higher), headaches, visual disturbances, and swelling of face, feet, or hands are common. 

Other things to watch for include:

  • Excess protein in the urine (proteinuria)
  • Upper abdominal pain, particularly under the ribs on the right side
  • Nausea or vomiting
  • Sudden weight gain
  • Shortness of breath

How is Preeclampsia Diagnosed?

If Preeclampsia is suspected, the first step will typically be to get a reading on blood pressure followed by a urine analysis. When readings are consistently at 140/90 mmHg or higher and there is protein present in the urine, healthcare providers will typically move forward with a blood test to check on liver and kidney function and platelet counts as well as an ultrasound and non-stress test (NST) to monitor the baby’s growth as restricted fetal development can be common in Preeclampsia.

How Common is Preeclampsia?

Preeclampsia affects about 5-8% of pregnancies in the U.S. It is most common in first-time pregnancies, but risk factors include being pregnant with multiples (twins or more) and a history of hypertension or kidney disease.

How Common is Postpartum Preeclampsia?

Postpartum Preeclampsia is rare, occurring in about 0.3-0.7% of pregnancies. It can occur in individuals who had Preeclampsia during pregnancy, but it may also develop in individuals with no prior related history. The symptoms remain the same during pregnancy and after delivery. Postpartum Preeclampsia can develop after a baby has been delivered. The highest risk is 48 hours after delivery but it’s important to pay attention to symptoms that develop once you’ve arrived home and seek care immediately if something appears to be off.

Are There Other Conditions I Need to be Aware of?

The other main hypertension-related condition to be aware of is HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome. HELLP previously was thought to be its own classification. It is now thought to fall under the hypertension umbrella as a variation of Preeclampsia. This condition can be more difficult to diagnose because the early symptoms present just like Preeclampsia symptoms. This is why it’s important to know the symptoms, attend your routine prenatal appointments, and intervene early. Preeclampsia.org estimates that of the 5-8% of pregnancies that develop Preeclampsia, 15% of these people develop HELLP (source).

Hypertension and its related conditions are significant health concerns for pregnant and postpartum individuals. These conditions, while statistically more rare, are still important to pay attention to and know the symptoms of.

During pregnancy it is important to attend routine appointments for a whole host of reasons! Early detection of conditions like Hypertension is just one. Remember, even if a pregnant individual develops one of the conditions we’ve noted here, treatment is possible! Outcomes are greatly impacted by early intervention.

Struggling with one or more of the symptoms above? We want to encourage you to reach out to your doula and healthcare provider immediately. Chances are you’re okay (statistically speaking!) but the peace of mind from double checking is invaluable.