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Placentas : To Eat or Be Eaten by The Internet

I don’t mean to be contrarian. It’s not really my nature to try and push back on things or choose the opposite argument for the sake of arguing. Maybe it’s because I’m a Libra, maybe it’s because I’m an INTJ personality type, but I am a strong questioner. Question everything, feel everything, remain open…that’s me. 

So it was interesting to have a common situation amongst my prenatal client meetings this past winter — apparent giddy anticipation for what I was going to say about placental ingestion. 

Three different sets of clients informed me that they had discussed amongst themselves whether or not to keep and consume their placentas and had mused between them that I likely had a whirlwind opinion on the matter with an outcome they couldn’t guess. I found this amusing. I kinda like that my personality is strong enough and my relationship with my clients deep enough that they’re talking about me like this. Being a bit of a nutty professor type doula is something I’m comfortable with as a brand I guess. 

And they were correct. I do have a somewhat tumultuous view of the question of what to do with a placenta that’s best delivered in an uninterrupted tirade, usually delivered at the outset of the third prenatal appointment. They ask the question and off I go! At the end of the maybe five minute schpeel, there are no answers, only more questions. That’s just the nature of many things to do with the human body, especially in postpartum, so I’m comfortable with giving a ramble instead of a supposed answer to what to do with this incredible organ at the end of birth. 

What is the placental jaunt, you didn’t ask? Join me…

There is no compelling evidence to suggest that ingesting a human placenta — however processed — is to the benefit to the person who has birthed it or the fetus who created it. 

However, there isn’t compelling evidence for many things that are of benefit to us, in part because of the political nature of funding high-level research. Placentophagy, as it’s formally called, is still seen as “gross” and pushed off into the realm of hippie-dippie, homebirthy, crunchy and thus unrigorous and unfounded territory Western (and primarily American) research bodies typically feel isn’t worth researching thoroughly. 

Coupled with the fact that organ meat of any kind is no longer cusine de rigueur, the gross out factor alone has largely kept this occurrence — something common within the mammal class and still practiced within many contemporary cultures — in a mental filing cabinet for the likes of Andrew Zimmerman and snow foxes, not sane, rational, middle-class, non-hippie parents. The loudness of the “NO!”s heard in labor rooms all over when asked “Will you be keeping your placenta?” can be deafening for this reason alone. 

Whale Placenta , via Thailan When. Artist unknown.

Whale Placenta, via Thailan When. Artist unknown.

So let’s talk about the mammal part a little. Truth : All mammals apart from humans routinely eat their placentas after birth. For many, that is compelling enough evidence that we should consume our’s. It was for me for a while, too, till I did more digging. Yes, all mammals eat their placentas after birth, however, the further up the food chain you go, the less likely it is that a mammal will consume their entire placenta. A friend of mine posted one of the most stunning photographs I’ve ever seen of a whale placenta floating along, still partly in an enormous amniotic sac, pierced by morning rays of sunshine and undulating exquisitely in the waves. Someone responded to this post asking why the full placenta wasn’t consumed. I chimed in (I can’t help myself) that because whales are high on the food chain and don’t need to hide the evidence of their recent births, it’s likely that this mama whale ate what she needed to in order to replenish herself after birth and just went about swimming along with her calf to tend to it in other ways. If this whale were not a whale but a guinea pig trying not to be eaten by a coyote or a coyote trying not to be eaten by a cougar, she would have likely have eaten her full placenta and set about removing herself and her new young one from the scene as disguise. 

Humans, like whales, are apex predators. We don’t need to hide our afterbirths for fear that the scent will attract anything other than predatory formula salesmen consuming our thoughts of a broken maternal body. So, naturally (if we want to co-opt the argument that placentophagy is “natural”) we don’t need to consume our entire placentas for safety.

We also have adapted to a system of grocery stores, which starts to break down the need for placental ingestion at all. One argument for the benefits of consuming a placenta (and these are argumentative points based off the very reasonable and likely assumption that the placenta has high levels of macronutrients like iron and magnesium similar to other organ meats) is that like other mammals we need to have an immediate resupply of blood-enriching nutrients we lost during birth. We do. That’s real life true facts. Do we need it necessarily from a placenta, OUR placenta? Likely not. Floradix will do the trick. Black strap molasses in some apple juice works wonders, too. Dates with ghee, almond butter, cacao, and goji berries — also a sexy, nourishing thing to shove in the face of a recently transformed birthing person. The next time you see a New Jersey black bear walk into an Acme for a date smoothie to replenish their postpartum bod, you let me know, otherwise, I think they’ll stick to a placenta snack in their hibernation spots (don’t think Uber Eats is up on cave delivery yet, anyhow. It’s barely in the suburbs.). Humans, however, have a choice in what they stick in their gullets, though, and choosing NOT to suck down their 8lb, bloody baby buddy meat, if that’s how they see it, is a-okay. 

How about the claims that it replenishes much needed hormones after birth? We legitimately have no idea if that’s true. Sorry. We don’t. This is where the super ultra high level primary tier research would be nice and Buddha willing, it will exist someday, but it’s not here now. We quite frankly, don’t know shit about hormones. Some research is pumping along on that front and there’s certainly the beautiful and rich history of midwives and healers sensitive as a tuning fork to the primal changes in hormones within pregnant, birthing, and postpartum folks, and where anecdote and oral history is a critical element in this profession, it’s not a mere semantical distinction to say that we don’t have quality research on the hormonal profile of placentas. We especially have no idea if processing human placentas into milkshakes or lasagnas or dried up bits to shove into pills preserves any of that supposed hormone profile. I’m not giving a valued statement here, this is just a fact of our unknowing that needs to be talked about frankly with parents curious about this topic. 

In regards to what birth workers world over and since time immemorial have noticed, there is also controversy. This, like so much of what’s broken within our health care system and the often knee-jerk counter “wellness” community is due to a lack of nuance more than a lack of correctness. 

Take for example the question of whether or not placental ingestion hinders or increases breastmilk supply. There is a schism in the birth community on whether the uptick in placenta eating has done more to benefit or harm breastfeeding success, with lactation counselors and midwives and doulas on both sides of the debate. Well, yeah, duh. Considering that this practice doesn’t have a standard of dosage, processing, monitoring, or individual screening for some bajillion different inherent factors, it is reasonable to assume there would be a variety of reported experiences and biases. It doesn’t help that the aforementioned political dynamics of research on this topic are seemingly much more compelled to shut down the potential of placentophagy doing any good has brought about more articles against it than for it from outside the realm of birth work. For some, that triggers an even less nuanced lens of this debate out of protectionism, as I see in my own birth community fairly often on this issue. For some, the idea that eating a placenta would ever do any harm is off limits to even bring up! It doesn’t matter that like any supplement and any biological system, what may work for someone may have completely opposite results in another. Without seeing the potential for adjustment or unsuitability of a practice, it is likely that an issue will be pushed aside as unworthy of exploration one way or another by a wider set of interlocutors. Beware, the circular firing squad. 

Another important part of this puzzle is the reported incidents of mothers/birth parents feeling “high” after consuming their placentas. This is also an area where the degree and mechanism of consumption need to be considered, but usually aren’t. The reported feelings of euphoria in some women/persons is a welcome counter to the “baby blues” experienced universally in the early postpartum period as hormones oscillate through to a once again non-pregnant state. This has been enough to create a frenzy of birth workers and parents taught that the placenta is a miracle worker, and for those it helps, it most certainly is. Dope. In other women/new parents, the feeling that comes from consuming their placentas leaves them feeling a lack of control — something really not beneficial to having to heal, process, and take care of an entirely dependent new little person. We don’t want parents drinking to the point of buzzed or drunk and then handling their infants, why would we advocate for them to consume something that would make them feel similarly, even if it is “natural?” 

In these two examples, again, I’m not saying that anyone is “right” or “wrong.” I’m not attempting to dismantle the notion that there are benefits to eating one’s placenta, but rather to express my disappointment in that this topic sometimes leads to yet another area to box the postpartum period into a time when outside influence reigns supreme, leading to feelings of guilt around not being good enough/natural enough/connected enough/intuitive enough/and so on. In some sort of perfect obstetrical dynamic where there is strong continuity of care, community support, 24/7 monitoring, history and nuance and stillness, yeah, maybe placental consumption would benefit everyone. But that’s still a maybe, and it’s also not the reality of the postpartum experience through most of contemporary society. Certainly not here in our’s. For this reason, I want to urge birth care providers to check themselves around how this topic is presented and managed amongst their clients and colleagues. Support the clients who are seeing positive results from ingestion, but allow space for those who aren’t to question if it’s right for them, that’s all. 

At the end of the day, I feel that this topic offers an organic and gorgeous place to talk about informed care and personal decision making with our clients. I have a schpeel, yes, but it offers intentional gaps that I want them to fill in for themselves. It’s exciting to watch my clients start to connect their gut instincts with what anecdotal and research-driven information is floating around. It’s something they’re going to be forced to do each and every day as parents. Opening this space for humor, analysis, discovery — THAT’S OUR DIVINE CALLING AND PRIVILEGE. This is the essence of being a guide for parents in pregnancy, birth, and postpartum. This is the core of our work. This is the “it.” It literally doesn’t make a difference at all if they eat their placentas on your watch or not since it’s not your job to save them from what would happen if they didn’t. You don’t get a gold star for helping someone be more animalistic. You haven’t won anything by saying there’s no evidence and galloping onward on your high horse. I would cordially invite you to get off your high horse starting with this discussion if you’re tempted to prance all over it. This topic sometimes encourages off the rails in fighting that’s super unhelpful to our profession. 

Instead, let’s let this heated debate offer a Miriana Trench to explore together — one more of process and intuition than what “side” you’re on. This dark, wet, unknown is scarier than public health data or National Geographic interest pieces, sure, but that’s the work. To fully know more about what this magical organ can and cannot do for their creators and keepers, we need to sit with all the questions individually and repeatedly and allow for our biases to be proven wrong or right uniquely with each person tasked with making their own decisions. I urge you to keep an open heart and level head when responding to the questions around the topic on social media and in learning spaces, too. 

And, you know…Bon appetite. 

Why Do Postpartum Doulas Cost so Much?

Money is always a tricky subject, especially when working within a profession in the "healing arts." For many birth workers, this profession is seen as a "calling" as much as it is a job. Add to that the fact of these caretaker roles being traditionally held by women, being seen as "fringe" or outdated, and still sometimes viewed as a luxury item despite mounting evidence otherwise, and with no set national standardization for the profession a leaving a host of intricate and competing economic influences driving the fees for these services in every direction.  

postpartum doula bed sharing santa cruz infant sleep

When I first started out as a doula, I was living in a community where bartering was the norm. In many ways, I really enjoyed that concept. There was always communal food, carpooling, couchsurfing, skill sharing, etc., and I learned a lot in my nine months there. On the other hand, I was making about $500 a month for a job I was way over qualified for and could barely pay my bills.

I was twenty-two, fairly fresh out of college staring at a five-figure student loan debt and trying, desperately, to grow my doula business. I spent hours upon hours learning how the internet worked (funny, as I almost failed my web building class in college), calling every doula and “alternative” practitioner in town, forming study groups, forming community groups, volunteering at childbirth ed classes, and scrounging for clients, all with zero pay.

I was burnt out and exhausted before I even had my first client. I moved out of that community after less than a year because I could not hack it on little to nothing. I traveled (by bike) south to San Francisco with the woman who was becoming my doula business partner, Jasmiene. We figured that if we could split the cost of owning a small business (and doulas are small business owners), and the time trying to acquire new clients, that we’d have a better chance of turning a profit and not getting burnt out.

Postpartum work in Olympia at that time was almost non-existent. When it did happen, it was often birth doulas and midwives who recognized that their clients needed more support and came over more often out of their own pockets. In the few instances where they were paid, the going rate was somewhere around $15 an hour. 

In San Francisco and the surrounding area at the time I moved here and wrote an original post on the costs of being a doula (around 2010) postpartum rates were around $25/hr. Even with the increase in the cost of living (my rent was $850 a month back then), the rate at which doulas were being hired, how organized they were as a group, and how many opportunities there were to continue our education for a smaller fee made this move seem like a wise decision. My birth partner and I tenuously increased our birth rates to $800, but after just two births, we realized we were grossly underselling ourselves…plus we could barely pay rent on one birth a month. Eventually, we were up to $1,000 per birth and $25/hr postpartum ($30/hr for overnight care). 

Currently, $35-45/hr is a pretty standard national rate for daytime postpartum care. In major cities, the rate varies from $35/hr for a doula-in-training to $75/hr for a more experienced doula, overnight doula, and / or a doula with advanced lactation support training. 

Now, $45 an hour for a doula might seem totally ludicrous to some (and currently, it’s on the low end of the fee spectrum for doulas in the Bay Area), especially when folks still often don’t understand that we’re more than just glorified babysitters, but I want to break it down into what the doula is putting into her services and what you are getting out of it:

Doulas are business owners:

  • In most cases, doulas are interviewing for new clients constantly. That means they are driving to you, either to your home or to a cafe, and spending money (on drinks and food and gas) and time to get about 1 out of 3-4 interviews ending in a hire. At one point in my career, Jasmiene and I were going to 2 or more interviews every week and shared no more than 6 clients in our practice at any time. More commonly, we had half that. And parents should want to work with doulas with a low-client base and with the ability to rest and take days off to ensure reliability and presence of mind during appointments. That means that they have to pay for that accommodation so we can subsist on this work.

  • Advertising alone is an incredible financial burden and it’s often hit or miss. Printing business cards, pamphlets, flyers, advertising online, in newspapers, and keeping up a personal website really adds up. In the Bay Area, we were spending about 15% of each fee for these costs alone. If we took a hit one month or couldn’t take on more clients for some reason, those costs still existed. IT IS A BUSINESS.

  • Printing other materials is just as expensive. We always came to our prenatal visits with a wealth of information as well as necessary documents to fill out so we could be the best support persons possible. Contracts, hand outs, sleep plans, feeding advice, favorite articles, readings specific to each family situation, etc. We weren’t employees of an office with a big, efficient printer, either. Every other month, we would go to the office supply store and buy several hundred dollars worth of printing materials ourselves. We also regularly had to go to a print shop to get things done more professionally and that cost really added up, despite having to do that maybe once every three months.

  • Despite having the same needs as many other small business owners and freelancers, since doulas are still considered to be working in a "fringe" field, it is rare that we would qualify for small business loans, adjustment programs, grants or scholarships for continuing education, and other perks offered to small businesses in this country. However, we’re still taxed at 40%. It’s rare that we qualify for tax write-offs other businesses might have— like an “approved” home office — since we are in-home support. In-home provider tax credits max out at just under $5,000, by the way.

  • Parents increasingly want us to be able to process payments electronically, which is more convenient for them, but we are still charged the 1% transfer fees or the up to 10% credit card processing fees, which we are unable to make up down the road in volume, the way other high transaction small businesses often can. Other electronic business tools range from costing $15-65 a month, which adds up quickly in a solo practice, but are becoming necessities in some markets to stay competitive and keep doulas from burning out on non-billable hour work.

  • Office insurance plans, paid time off, sick leave, paid vacation, family leave…none of those things exist for doulas. If we miss a client visit, we miss upwards of $500. This is why I stress to the doulas I work with on contract writing having some system of rescheduling and illness clauses that don’t leave them super vulnerable. The reality is, though, a few times a year there will be a situation that arises that takes money out of the pocket of the doula that can’t be made up. Keeping doula rates to a livable amount ensures this work can remain as an available and accessible option at all. And it can be seen as a two-way street where the high rates can keep a doula accountable to their clients out of respect for the transactional nature of this beautiful and important work.

Doulas require continuing education:

  • Most parents are concerned about our credentials. Not only is it expensive to get and keep up with our certifications, most families are looking for doulas who are constantly continuing their business education. These classes aren’t cheap. There are workshops starting at around $35 for a one-day session and they go up to $5,000 for courses offering a specific credential. This can often cause a catch-22 situation where it’s not always the “best” doulas (or the “best” doula FOR YOU) who is able to advance herself and her business, but rather the ones that can afford it and will thus generate more business and be able to get more clients.

  • Doulas often gather in collectives to help learn from one another and support one another. This takes up an extraordinary amount of time. Like it or not, time is money. We’re not paid hourly for the work we do outside of our interactions with clients and we’re not on a salary. Same for the amount of time we spend reading research articles, books, blogs, and discussing / debating this information with one another. If our collectives don't put money aside for subscriptions to various journals (and most can't afford to do it), those become out of pocket expenses, too.

What are parents getting out off all those behind-the-scenes expenses anyway:

  • Doulas make themselves available for parents in a way most other traditional care providers can or will not do. They cater their business to their birth / postpartum experience. They are often the only ones there specifically for these families and not for some outside agenda of profit, public health number, political pressures, hubris, generational opinions, etc.

  • Too few parents understand how alone they will be in the postpartum period. There is an increased awareness about postpartum depression (luckily), but there is very little education and support around the non-pathological changes in the early parenting period. Ditto to the manifestations of postpartum depression that don’t look like sadness — like the prevalence of postpartum OCD and anxiety that is often culturally dismissed as being “thoughtful” parents. Postpartum doulas are trained to recognize and support these mood fluctuations from the normal to the severe and to help families get the support they need. Doulas can then adapt and adjust care according to these changes unlike the many apps and gadgets meant to replace human guidance and interaction in health and parenting.

  • All that education and community building is what makes doulas the gurus in pregnancy and beyond. Attendance at childbirth education and parenting classes is steadily declining, unfortunately. It’s been shown that most parents are getting the bulk of their information on pregnancy, birth, and postpartum from books and increasingly from websites and social media. Where that might not seem terrible at the outset, but isolating that information doesn’t leave much room for personalization or nuance. Or conversely, there is often too much chatter in the comment sections without any particular vetting or emphasis on sourcing. Parenting books and websites are known hellscapes of opinion and bias, and often have less to do with research driven support than cultural trends and efforts to create a broad network of further brandable items. That’s in no way impossible to avoid in working with a postpartum doula, but there are ways of thoughtfully combatting the shallow and judgmental nature of those sources in working one-on-one with a doula who doesn’t have any incentive to push a particular system upon a family. That level of connection and trust takes time and effort to build, which can happen with a doula contract, but not with a book or blog.

  • Postpartum doulas come directly to parents, which has well researched and long lasting health benefits and offers a great deal more than a 15-min office appointment with a pediatric care provider. It’s also very draining on our end. There is a great deal of physical and emotional trauma present in birthing in the United States. Sometimes that comes from situations beyond anyone’s control, often, though, it is a symptom of our failing healthcare system. Many new parents fall through the cracks of our assembly-line style of care and it is not uncommon for parents to feel hurt and alone after birth, on top of the normal amount of healing, joy, and exhaustion. Postpartum doulas are there to listen, validate, and counsel parents in this position. It is a calling, and most doulas are happy to do it, but that does not mean that it doesn’t take away from our emotional and physical reserves. So $45 is a bargain compared to the cost of the psychologist couch we’re often keeping families from having to jump into or the expensive and overused treatments like surgical tongue snipping, pushing medications on infants for normal gastrointestinal changes, or unresearched supplements or dietary suggestions. There is a great deal of value in preventative and patient emotional care in this vulnerable time period.

  • Doulas are there for families soon after baby comes home / the midwife team leaves. They know us. They trust us. That helps when it comes down to figuring out the myriad of details of being a new parent. Doulas may be the only ones that notice marked changes in mood and can stave off worsening postpartum mood disorders. Doulas may be the only ones supporting the choices for feeding, sleeping, pacifiering, diapering, etc. in these families. The community resources doulas work exhaustingly to gather extend into the postpartum support community as well. Doulas are often experts on breastfeeding and infant massage in addition to doing laundry, holding baby so they can shower or go for a walk. They talk families out of late night deep dives down the black holes of mommy blogs and their false alarms. They can be crucial lynchpins against the rising anxieties often falsely pushed upon new parents.

  • Studies show that this support reduces the need for all sorts of interventions, items, and gadgets, which in the end not only makes the experience more enjoyable and empowering for most folks, but actually saves time and money. Plus, added perk — better for the environment!


postpartum doula cost infant doula sleep santa cruz

The sad truth is that our obstetrical care system does not fully support pregnant people and their families. The US has rising rates of maternal and infant mortalities it is slow to properly acknowledge let alone address. Making the investment of hiring a doula does not form a magical protective shield around you in birth or postpartum, but the studies point to numerous benefits to having this continuous support in pregnancy and early parenting. It is worth the investment in time and money to consider hiring a doula that suits your needs. 



Here are some ways you can afford to hire a doula:



  1. Ask for part of the fee covered through baby shower gifts. Truthfully, you DO NOT NEED THAT MUCH BABY STUFF! If someone was going to spend $50 on baby clothes, that could easily go toward your doula fund instead.


  2. Ask your doula if they accept payment plans or work on a sliding scale but please keep in mind everything that she is putting in in order to be a great advocate for you and your baby.


  3. See if there are programs at your hospital, birth center, midwife practice, or community center that can help either connect you to a doula who works on a reduced budget, or one who’s fees are covered by a program or foundation. There are programs for young parents, homeless folks, recent immigrants, veterans, those without insurance, those with lower insurance coverage, high risk parents, and more in many communities, but it takes a bit of effort to find sometimes. Some church programs might have connections to these centering and doula groups, too.


  4. Consider hiring a newer doula. The studies show that working with any person who is there just for you, providing continuous support and encouragement in labor increases safety and satisfaction in the birth process. There are many benefits to working with a doula who has been practicing for a long time, but if they are out of your price range, you could potentially still get a lot out of hiring a recently trained doula for a fraction of the fee.


  5. Call your insurance agency and see if they will cover your postpartum doula costs. This may take calling and asking for several people at different times. It’s all about finding the person with the magic code, asking for specific details for what information you need to have laid out on your claim, and following through. Some doulas are well versed in how to write up their invoices to maximize coverage. If you have Medicaid in some states/cities, there is now growing insurance coverage, so it’s worth asking.


  6. Some midwives and birth centers offer discounts for working with doulas. Every so often, a doula will match that discount (I do!). That can save you upwards of $1000.


  7. Start putting aside money early in pregnancy for support like doulas, lactation consultants, acupuncturists, postpartum care, etc. Resist the urge to spend that money on needless things from Amazon Prime and think about the investment you are making into a smoother transition into new parenting.


I hope you found this rundown helpful in explaining the costs and benefits of working with a doula.

Doula to Doula : Talking Sleep with Parents

For the past several months, I’ve had the really wonderful opportunity of teaching Infant Sleep Basics for Doulas with Cornerstone Doula Training. Though I wasn’t trained by Cornerstone apart from their Nutrition for Midwives course, I’ve worked with many doulas trained by them and have been so impressed. I knew I had big shoes to fill in being taken on as one of their instructors — especially on a topic as loaded as sleep training.

Well, so far it’s been awesome and I’ve been so thrilled to be apart of so many doulas’ expanding knowledge. One doula-in-training reached out to me recently about a particular struggle and the back and forth exchange was deeply resonate with what I hear from many other doulas and parents in my sleep training practice that I asked her if I could share it. Luckily, she said “yes” and so here it is! I hope this sheds come insight into the common struggles of new parents and their in-home care takers in navigating the tricky territory of sleep support.

J : I run into a situation frequently where a baby 1-6 months will SCREAM and fuss as soon as you take them into a sleeping area, or they know it’s going to be time for a nap. Which has resulted in parents holding them for naps etc. Is there any way around this? These babies also only sleep one 20-45 minute cycle at MOST. And maybe even just 1/2 naps for a 12 hour day. 

I would appreciate any insight you have! Thank you!! 

Me : Easiest solution - have them sleep wherever. Stick a basket in the living room. Who cares? They are responding to some other stress than the room itself since they have no object permanence anyhow. But anyway, infants can just sleep wherever.  Or they can start staying in the room with baby longer with a hand on baby’s chest. Check out Kim West’s Sleep Mommy Shuffle. 

If they insist on baby being in another room :

Is the baby swaddled? - They will transfer better if so and will sleep more soundly if they are not put down till at least a few minutes into the deep sleep phase. 

What sort of space are they sleeping in-basket, crib, etc? - Trying to transfer baby into many sleep spaces can be challenging since they are often quite deep (triggering a baby’s reflexes to stir), too large (messing up baby’s vertigo and causing them to feel alone and thus “unsafe,” which will impact deep sleep), they may need to be closer to a human body for the sake of developing their biorhythms and there is really no need for an infant to sleep in a separate space since they can’t sleep well on their own and don’t have object permanence to cause a “bad habit.”

Are the parents generally anxious or stressed around sleep rituals in a way that might cause overstimulation in the baby? - often this becomes a vicious cycle where parents and care takers feel pressure about sleep and then start routines with anxiety which these primal little blobs soak up like sponges, causing more stress and crying, and ever onward till someone caves. They can either accept the need to hold/carry baby for some naps (which is certainly an ok thing to do  if it works for their life) or accept that it will take some adjustment if they are not thriving. Adjustment can be gentle or difficult so it’s a balancing game that will be different for each family. I’ve worked with many families who thought it was near impossible to get babe into their own sleep space without using harsher methods, but time (TIME TIME TIME) and observation and gentle care for everyone involved (and for me at least, Glenn Harrold in my earbuds) did the trick 99% of the time. 

Do the parents do a lot of “development” activities in between naps? - you can help them see that those aren’t really necessary and can overstimulate baby and make it harder to get them settled for sleep. Two articles to look into on this: Leave Those Kids Alone from the Atlantic and this one.

My advice to you and family is to keep tuning into baby over reaching for quick fixes or giving up. Both lead to more confusion and suffering most of the time. 

Hang in there, this is normal. You’ll develop your rhythm and approach to all this as you hang with more babes and families and see the possible pitfalls and solutions. 

J : I think the root of the question is really just WHAT is normal? 

I know some babies who have slept through the night at 6 weeks without crying and others just never want to be put down. 

I feel like in our culture people feel it is abnormal for babies to want to be held and co-sleep. Do you have any resources that are nice and REALISTIC about what you can actually expect from a baby?  And what do healthy sleep "habits" actually look like? I totally understand if you cannot answer these questions! I am happy to read articles or books or listen to podcasts, it just seems everyone is either so far on the left or far on the right when it comes to what a baby sleep should actually look like and who qualifies as a "baby". 

Me : So pretty much everything is normal. That’s what crushes parents. There are going to be LOADS of circumstances where you try everything under the sun and nothing seems to help. We are a culture obsessed with diagnosing and “solving” things, but that doesn’t totally jive with the primal blob nature of infancy. 

Over time you will feel desperate in some way and it will lead to a cool trick or some deeper understanding that helps you better communicate these things to parents. If you fight the urge to make promises, rely on crappy information, or feel that your role is to give definitive answers to things that aren’t actually “problems,” you and the folks you serve will be better off. It’s hard when word of mouth and testimonials are such a big part of our business, but you have to keep in mind that you’re teaching parents to be parents, not acting as a contractor mending a collapsed wall. Our help is more subtle and nuanced and can take time to be appreciated or understood — even within ourselves. 

Instead of furthering the bullshit idea that there are “right” and “wrong” ways to sleep/hold/feed/rest/care/bond/teach/parent, keep pushing the notion of filtering and thriving : Filter through information + Pick things that help your family thrive (regardless of the other book sitting next to the one you picked that says the opposite thing than what you’re doing). HARD and EASY are relative. 

This isn’t the same as doing nothing. Making shifts and observing then adjusting when folks aren’t thriving is a great thing. You being there to normalize that, give options, validate choices, and take some of the physical load off implementation is priceless. 

This all sounds floofy, trust me, I’m a legal researcher who pushes evidence constantly, but the truth is no matter how deep you dig into trying to find a solid answer with newborns, they exist on some other plane not quite here on earth, talking to faeries as my Irish grandmothers would say, and so logic doesn’t always prove solid. And almost always, the answer is be gentle with them, be gentle with yourself, be firm in your ideas of what is necessary to thrive, and give it time. 


I hope that helped give some insight into my process of postpartum and sleep consultation work and gives some validation to the struggles you might be facing as a doula or new parent. You’re not alone in not being able to feel confident in navigating what is “normal” right from the go.

Books are currently open for all consultation services, including sleep training. I have two sleep classes scheduled at Mini Mint Studios in Santa Cruz next month — May 9th from 1-3 for parents and May 13th 4-7 for doulas and midwives. You can register for both on my Contact page.

More about my sleep training philosophy

I am really not on board with formal sleep training before 4 months at MINIMUM, but more likely 6 months. And even then, I only advocate for “cry it out” methods when there is some clear lack of thriving in one or more of the family members and only when other options have been exhausted.

ahhh the sleepy baby and his lovie

ahhh the sleepy baby and his lovie

What I'm offering is sleep education that actually has a strong focus on helping families put off sleep "training," understanding that it's not biologically appropriate and then explaining why, while still leaving them with some resources to hopefully get more rest. My sessions / classes focus on going over the basics of infant sleep patterns + cues and how feeding / digestion / overstimulation can affect these things. It's trying to cut out the stress around sleep by giving healthy and realistic expectations and some tricks for gentle sleep routines (that are often more for parents in the first months than a baby that can't be trained to notice anyhow). 

My hope is by helping families access high quality resources (versus opinion based books and blogs), have someone they can touch base with easily, and someone in home working with them one-on-one to help them understand their baby's unique patterns and needs, they can have a less stressful approach to sleep issues and can maybe avoid sleep training entirely. 

Honestly, I've talked every person who's contacted me about sleep training before 6 months out of it, so that feels good. Most families are starting some sort of drive toward scheduled sleep starting too early and it's a huge reason why I've started to do this education more since I was getting so many parents emailing me in pregnancy or with 2-3 week olds asking to be sleep trained.

Too many parents are getting bad intel about how you either need to get on the ball with scheduled and formal sleep training at such and such an age or else your baby will be developmentally stunted, not independent, a crappy sleeper, and stuck in your bed full of bad habits till their in middle school. There is not such a binary in the process of choosing what adjustments you want to make in getting babe sleeping longer and more independently. I want to be able to help guide parents through their options (not make decisions for them or tell them they’ve failed) so they feel intuitively connected to the needs and development of their children and confident that they’re making the most appropriate decisions for their own families.


If you are interested in getting some more education and support around infant sleep issues, there are a number of ways to access my care : Hourly consults, daytime observation and support packages, overnight observation and support packages, bringing me to a new parent group, or taking one of my longer courses. Check out my Infant Sleep Support page to learn more about each option.

…AND! I teach doulas about infant sleep basics, too! If you are part of a doula group or training organization and want to chat about these exciting and informative classes aimed at giving postpartum doulas more resources for supporting families through this minefield of misinformation, judgement, and anxiety please contact me.

cute picture. terrible swaddle. i have thoughts here.

cute picture. terrible swaddle. i have thoughts here.

Pregnancy Challenge Week #2 -- Save for a Doula

I’m starting a series of challenges to expectant parents to encourage them to take small steps toward better care, more informed decision making, and a smoother transition into parenthood.

Over the next few weeks, I’ll be posting on action item in this vein, with some information for why and some resources for how. I imagine the challenges will be steeper for some families than others. I also imagine that it will vary person-to-person which action items are more difficult than the others. Some families, too, I imagine won’t face a ton of barriers, but just needed some guidance on the fact that these things are available.

What’s on the docket for Week 2?


I challenge any expectant family to start budgeting for a doula.

budgeting for a doula


So I might need to start with answering What is a doula?

A doula is a secondary support person trained in non-clinical support in the childbearing year and sometimes beyond.

Doulas are not primary caregivers, so they work in tandem with midwives, doctors, nurses, midwife assistants/apprentices, lactation consultants, etc. Most often you will hire a doula independently, though some birth centers and hospitals have on-staff doulas you can or are required to choose from. Most doulas work primarily in a hospital setting, but can join you for an intended home or birth center birth, as well.

Evidence shows that the one of the best ways to reduce the number of unnecessary interventions, improve maternal and infant birth outcomes, reduce disparities in care and outcomes, and create more satisfying birth and postpartum experiences is to have continuity of care that includes continuous labor support. Most families are very surprised somewhat late in their pregnancies to discover that they aren’t going to get that from their primary care providers in a hospital setting (and this includes hospital-based midwives who work on a shift schedule), hospital staff, or pediatricians. This is where doulas have come in and where the evidence shows that they can help families have better birthing experiences -- both in emotional wellbeing and in reducing unnecessary medical interventions. Following the first publications of these findings, one author famously said, “If ‘doula’ was a drug, it’d be unethical not to use it.”


Most birth doula packages include 2-4 appointments prenatally to discuss your individual pregnancy and desires for birth as well as common coping practices, community resources, advice on having good communication with your primary care providers and other staff and loved ones that might be present at birth, your options in pregnancy and birth, the typical stages of labor, and some newborn advice. They are on call for you 24/7 for a window typically two weeks prior and two weeks following your guess date (it is a total guess when your baby will arrive, btw). They are available for phone, text, and email support throughout your contract. They will set a plan of communication around the early stages of labor to be your primary point person for what’s going on in your individual birthing situation. They join you when you are in active labor and need additional support and help you stay at home longer if birthing at the hospital help with the communication around when to call your midwives if you are birthing at home or a birth center. A doula will then go with you/stay with you at your intended place of birth till baby has arrived and for a short while after to help talk about baby feeding, what to expect in the first few days, and to check in on how you’re settling in after birth. Most doulas include 1-2 follow visits in your home in the first two weeks following birth to cover a wide range of topics on healing, feeding, newborn care, and other items of need.

Postpartum doulas focus primarily on care for parents and infants in the first 2-4 months after birth. Some birth doulas are also postpartum doulas and are available for extended care packages through the childbearing year. However, it is possible to hire an additional or exclusively work with a postpartum doula, too. They typically work either daytime shifts of 3-5 hours a few days a week or overnight shifts that shouldn’t be longer than 8 hours each. Though it may seem amazing to hire a postpartum doula for around the clock care, most families feel very well educated and supported with having a trained, thoughtful person come in to check on them 2-3 days or nights per week. Ideally, you are working with them on a tapered system where there is denser coverage in the beginning that fades to maybe one day or night shift a week to help you transition into caring for baby on your own once you have a rhythm established.


The cost of a doula varies based on what’s typical in your community, what their packages include, and their level of experience. It is possible to work with a doula who works on trade, sliding scale, or on a volunteer basis, though I encourage you to explore the value of the time, effort, and resources this person is putting in to being your support person in this immensely intense time in your life. Having said that, if you are really wanting to work with a doula and it isn’t in your budget, there can be lots of avenues for finding a fantastic doula that can fit your economic needs. Many doulas will be more than happy to reach out to their community to find you a good fit or to connect you with an organization that offers volunteer support.

Even in high income areas, the upper reaches of birth doula fees are typically under $3,000 for full care and the national average is around $1,500. Postpartum care, especially overnight care, can run into the tens of thousands of dollars over the course of several months. The highest fees don’t always reflect the level of support you’re getting or denote who might be your best fit, so it’s worth researching a wide number of doulas and asking even the higher fee doulas if they’re willing to work within your budget or have a strong recommendation for someone who can.

For this challenge, I want you to imagine setting aside at least $2,000 for doula support if you can. According to Fortune, folks spend an average of $1,300 on Amazon per person per year. Individuals in the US spend about $1,500 each on vacations per year. The average cost of a wedding is almost $26,000, which is also an enormously important day for many, but also just a single day and doesn’t carry quite the same lasting benefits and risks as having a positive birth experience...I mean, even the cost of the cake on average is $500. What would it mean to put that towards several hours of personalized postpartum doula care?

You can make up these costs in a lot of different ways. I have an earlier post on how postpartum preparation can help save you a ton of money you can put towards doula care I’d encourage you to take a peak at, but the gist of it is

BUY LESS BABY STUFF

Can I challenge you to try this : Every time you are about to purchase something for baby, can you either do without it (the answer is almost certainly yes) and put that same amount into a savings fund for a doula? Or can you put a matching amount in that savings fund? Many useless baby items will run you about $35 a pop and will likely wind up in the Goodwill pile where $35 is about the hourly rate of many postpartum doulas. That $120 countertop sterilizer machine…? Guess what, there’s no sound evidence on sterilizing bottles and a lot of good evidence on why not to so there’s $120 closer to your birth doula fund. There is no gadget out there that can replace having quality labor support or someone helping you to navigate the tricky first months with a newborn.

Friends, family, and co-workers are often very very excited to help you greet your little one and want to show you. This often leads to them purchasing a ton of stuff, and it’s up to you to direct them into another option, if you really want support around having a doula. Don’t be shy about talking about your process of hiring a doula, trying to reach your budget goals, and that if you’d prefer it, that you’d rather have some money to put toward doula support over another book or pile of onesies.

What about expensive gender reveal or baby showers? Can you have a celebration with friends around this that isn’t full of cheap decorations you’re just going to throw away? Have it be a potluck with fun games around baby names and the like and ask your guests to chip in to your doula fund in lieu of obligatory baby gifts you might not ever use. You can ask your doula to attend, even, and talk to your guests about how beneficial their support might be to you in the long run. If it doesn’t feel too tacky, you can put out a box/jar/whatever with the label “doula fund” and even if you just get a few bucks, you’re a few bucks closer to $2,000.

Or, if you don’t feel like making a ton of swaps to your plans for celebrating before baby arrives, can you just set a goal of how much money you’ll set aside per week till you hit your doula fee goal? If you have a partner, you can ask them to do the same and set up a mutual savings spot and even make it kinda fun somehow. Maybe get an old school piggy bank and smash it when you’re ready to hire your doula!?

Did you go out for a regular giant fancy coffee drink or regular cocktail that you’re abstaining from in pregnancy? You could calculate how much that cost you per week and put that money directly into a fund for your doula, who will be your new self care and indulgence guru.

Have you ever found yourself saying something like “I’d pay $X for a nap right now?” Well, put a number on that, start setting aside a few naps worth, and think about the beneficial rest your postpartum doula will help you take once baby’s here and think about paying them to help you achieve that when you need it most.


If $2,000 is an unrealistic goal for you or is much more than you need based on fees in your community, just pick a different amount and save away!

To read a bit more about the true cost of a doula, you can check out my article on the cost breakdown here.

If you want more information on how to find, save for, and hire a doula, you can set up a 1hr phone consultation or sign up for one of my full pregnancy and/or postpartum consultation packages where I’ll talk to you about doulas, how to save money in this process, and much more.

If you participate in these #pregnancychallenge ideas and want to share, please comment below, send me an email, or tag us @Rosewoodrepro on instagram and let us know how you are doing! Happy saving!