Dear Labor and Delivery Nurse,
My clients want to breastfeed–thanks for helping to make that happen! Whether they are planning a water birth or a scheduled Cesarean birth, we’ve talked in our prenatal visits about how their choices in birth will impact breastfeeding. They have carefully considered some preferences for the birth that were made with immediate and exclusive breastfeeding in mind. Thank you for respecting their birth preferences and working with us to navigate changes if labor and birth brings something unexpected.
For a vaginal birth, thank you for realizing that immediate skin-to-skin means that the baby needs to be placed directly on the mother’s skin (not on a blanket, not on her hospital gown) immediately after birth. Help us remind the doctor that my clients would really like the baby to land on the mother’s chest, not on the bed or sterile drapes, or be held by the doctor while drying and suctioning and cutting of the umbilical cord takes place. For a cesarean birth, thank you for honoring my client’s desires for as much of a physiologic and empowering experience as possible. Ideally, a gentle cesarean enables immediate skin-to-skin, with the baby being slid under the sterile drape right after birth and the potential for breastfeeding initiation in the operating room. If that isn’t possible, skin-to-skin after a few minutes, with the baby remaining in the operating room for the entire surgery if everyone is healthy, is also great! Studies have shown that when babies are brought to the warmer and dried and suctioned, breastfeeding initiation and exclusivity rates are not as high. Plus, for my client and her partner, the emotional experience of the event and bonding with the baby is a crucial part of this process, so separation from the baby may be difficult and traumatic.Thank you for being an advocate that supports breastfeeding and sees the impact that birth and early postpartum experiences can have on breastfeeding and parenting.
We know that the baby is working hard to breathe for the first few minutes, so we expect that baby isn’t going to breastfeed right away. But my clients would still like to hold and snuggle their baby during this transition time, knowing that breastfeeding will happen soon, and touching, smelling, and admiring their baby in the mean time. Thanks for avoiding the urge to get all the weighing and measuring done so that mom can breastfeed after that. We know you’re busy, and we know the baby needs to be weighed in order to be admitted to the motherbaby unit, and for that, we appreciate your patience wholeheartedly. Thank you for giving us the time to allow the entire process of breastfeeding, from those very first breaths to those last sleepy sucks, to unfold.
You may be wondering why I am not helping with breastfeeding. I trust moms and babies, and I know that babies are equipped with all the instincts to make it happen. My clients can’t wait to watch their baby do the breast crawl. I know baby has latched on five times to the wrong spot, and is bobbing around frantically, but it’s all part of the process. I have also talked with my clients about how skin-to-skin and breastfeeding colonizes a baby’s gut, and I want the mother and her partner to be the ones that do that, so I do very little handling of their baby during this delicate time. Thank you for giving us the space for these new parents to believe in their baby.
I believe in empowerment. I believe that nature has designed a system that works. Thank you for giving us space and time and trust–this hour is brief but it lasts a lifetime.
Best, Maura Winkler Birth Doula
This article only focuses on how a birth doula prepares clients prenatally and supports them in the very early postpartum, but birth doulas continue to provide support during the early weeks of breastfeeding, and postpartum doulas also are a resource for breastfeeding support in the early weeks and months. To find a doula that is perfect for you, check out www.doulamatch.net.
Maura Winkler is a birth doula, placenta encapsulator, and Breastfeeding USA counselor. She is currently pursuing the nursing portion of a nurse midwifery program at UIC. She has a passion for women’s rights, especially those related to birth and breastfeeding, and enjoys helping women and families advocate for their healthcare wishes. She is mama to a 2.5 year old girl, still breastfeeding!