Choosing a Postpartum Doula

First Trimester

Feb 13

Written By Sophie Smith

[If you are actually looking for info on Birth Doulas, click here.]

What do these different job titles mean?

“Postpartum Doulas” provide newborn care and parental education/support, during the day or night - but I focus here on night doulas as they are a more popular choice. They stay awake throughout the night to attend to the baby, and provide breastfeeding guidance, nutritious food and emotional support to mom during her postpartum recovery period.
- The rest of this page focuses on Postpartum Night Doulas as that’s the most popular choice in the Bay Area and where I have the most personal experience, but many of the concepts apply to the below jobs as well
“Night Nannies” or “Night Nurses” provide similar services, but don’t typically have as much training as doulas and are focused on just the baby, rather than providing more holistic support for the whole family.
“Baby Nurses” or “Newborn Care Specialists” (or the Chinese nanny version, called a “confinement nanny”) are live-in caretakers who provide “24/7” care, typically take 4-6 hours off every 24 hours. They tend to the baby at night, but sleep while the baby sleeps, in the same room. They are less expensive on a cost/hour basis than postpartum doulas, but you do provide room and board.
- There is high variability here: some people absolutely swear by their baby nurse experience, while others cite safety concerns (it’s a pretty exhausting job and there are many stories of nurses sleeping with the baby on their chest). Given they are so present in your home, you really want to make sure you’re comfortable with them.
- The best way to find a baby nurse is personal referral from someone you know, but Adventure Nannies is an excellent national agency that does Newborn Care Specialist placements.
- Baby nurses are a popular option in NYC, especially among families where parents work demanding jobs

Benefits of a night doula

MORE SLEEP! The value of this cannot be overstated. If you are breastfeeding, you’ll still have to be up every 2-3 hours in the beginning to nurse or pump. But the doula will do everything else - diaper change, burp the baby, soothe baby back to sleep - so you can crawl back into bed sooner. And you won’t need to be vigilant, monitoring for the baby’s cries, which will allow you to sleep much more soundly between feeds. Better sleep for you = better mental health & parenting
Learn from an experienced baby whisperer: The doula will teach you lots of tricks for how to calm, swaddle, and care for your baby. She will help you understand what is normal and what you should ask your pediatrician about. Depending on the contract timing, she may help with challenging transitions (out of swaddle, from bassinet to crib, etc)
Breastfeeding/bottle-feeding support: Not all doulas are certified lactation consultants, but most still know enough to provide helpful advice when it comes to challenges like latch issues, undersupply/oversupply, slow/fast letdown, engorgement, etc. If bottle-feeding, they can figure out the best bottle for baby, show you ways to reduce gas, etc.
Additional household help: Most doulas will do chores while the baby sleeps, such as dishes, laundry, tidying. Waking up to a cleaner house may seem like a small thing, but it’ll make a huge difference in feeling slightly less overwhelmed those first weeks!

Still unsure? Most people are like “sign me up!” But if you’re like me, you might still have a few concerns:

Cost: night doulas aren’t cheap, since the hours make it more demanding than your average childcare job. Consider adding it to your registry so your loved ones can pitch in to give you the gift of better sleep. Your employer may offer fertility benefits that could be used towards this cost (this is the case with Carrot). Even just a few days of support a week can help you catch up on sleep.
Privacy: is it weird to have a stranger in your home, coming into your bedroom, during this intimate new phase of your life? Yes, for a few nights - then you get used to it and the sleep support completely outweighs any concern!
Guilt: are you worried that you won’t have the full new parent experience, that this will make it too “easy”? Believe me, it will still be hard and you will still be exhausted! Yes, it is a privilege to be able to afford a night doula, but if you can, you will be glad you did!

Hiring a night doula

It’s never too late to hire a night doula (some are hired in desperation after the first couple weeks postpartum!), but the best ones book up early, so start search in late first trimester or early second trimester
Typical cost is $40-$55 an hour, based on experience/certifications, booked for 8 hours/night, between 3-5 nights/week. Consider adding cost to your registry so friends/family can contribute!
Usually booked for 6-8 weeks (doulas may have a minimum), some parents choose to spend a few nights at home alone first, while others have the doula start right away
Discuss with your doula if you want the option to extend the contract by a certain date or book for longer but tapering the number of nights
Baby sleep is very non-linear: will start to sleep longer stretches, but then experience a “regression”, with the worst happening around 4 months. Consider booking some time at the beginning, but then saving some money to use later on for support during the regression.

Questions to ask a prospective doula

Are you fully vaccinated (COVID, TDAP, Flu)?
Is there flexibility on which nights you come? Can I change nights part-way through (e.g. when partner returns to work)?
Do you have a backup doula who could fill in if you are sick or otherwise unable to make it?
What is your policy around working if the baby is sick?
What were some difficult situations with past clients that you helped with (e.g. acid reflux)?
What are some of your best baby soothing tricks?
Do you have any training in lactation support?
Would you help us introduce a bottle (pumped milk or formula), and at what point do you recommend? (*look for a doula who is supportive and non-judgmental about this - some may be overly pushy about breastfeeding only)
How would you help us establish healthy sleep habits - a foundation to support independent sleep later on? (See the Baby Sleep Basics doc for a primer on this)
- Note: I’d be wary of anyone who claims they will definitely have your baby sleeping through the night by 3 months; while this is possible for some babies, I don’t feel it’s developmental appropriate to force this when they’re not ready
Do you keep a log during the night? What information do you include? (basics include poops, pees, and feedings; additional info might include crying/fussiness and what seemed to help)
What kind of chores do you do? Will only do baby’s laundry and dishes, or adults too?
Do you cook and if so what are some of your go-to dishes?
(if relevant) Would you be open to travel if we wanted you to come on vacation with us?