Kelly Rutan is a certified Postpartum & Infant Care Doula with over six years of experience supporting families as they transition into parenthood.
Georgie Kovacs: What is a doula?
Kelly Rutan: There is a very traditional definition of a doula. It's a word of Greek origin and defined literally as a woman who serves. What does that mean, though? We can talk about birth doulas and postpartum doulas, but my favorite definition for what a doula does, and it's something I'm my own mentor in this field uses is, a doula is somebody who instills confidence and power and reduces fear and anxiety. And when we define it that way, you can see how it can work in the birth and postpartum field.
Georgie Kovacs: What is the difference between a birth and postpartum doula?
A birth doula assists a pregnant family. Most birth doulas are hired before you're actually in labor so that you can develop a relationship with that family. As you go through growing a baby, thinking about how you want to labor and bring this baby into the world, your doula is there to build your confidence, answer your questions and help reduce any fears or anxieties or worries you have about the pregnancy and the birth.
Take that over to the postpartum side, and this is where I do think we don't focus enough as a society - the postpartum period. During this time, you have a brand new family. This family has just been born. We have two parents, and all of a sudden, we've dropped a new person. They are learning about each other. They're learning this baby. I think the way our society is structured today, a lot of parents, when they become first-time parents, don't have a lot of newborn care experience. We don't grow up in these communities with 12 siblings and 100 cousins.
You’ve just given birth. Maybe your birth lasted three days. Your body is sore. You're exhausted. You've never fed an infant before. You've never attempted to feed anything from your body. You're lactating. You're learning this. What do you do?
In comes your postpartum doula, and my role is to help guide this new family. So I want to build these new parents’ confidence, be there to answer questions for them. And through that process of learning the baby of answering questions of being their cheerleader, reminding them that they're doing a fantastic job and building that strength and confidence and really reducing these fears and worries. That’s the big picture, that emotional well being of the family.
From a practical side, there's little stuff happening too. I'm helping them get some sleep, then feeding them great foods and making sure the house doesn't fall apart. But some of these little things that fall through the cracks, the postpartum doula picks that stuff up, too.
Georgie Kovacs: What plans should a family make for the postpartum doula?
Kelly Rutan: When we think about planning for your pregnancy, people talk about a birth plan. They come up with this long list of everything they want to happen at their birth down to something like keep the lights low in the delivery room or the conversation quiet. They think about all these things. They write it up, and they hand it to their care provider.
We don't do that for postpartum though. That's that list that I want new parents to feel confident to say, this is what and how I need to be taken care of and postpartum. For example, please don't come over just for baby facetime and baby snuggles. We've got that covered. Instead, I need you to help take care of me on a hole. And so I do love, you know, giving new parents the permission to do this. I think every new parent should feel like it's okay. To ask for help. Yeah, and specific about it, too.
Georgie Kovacs: What are the training requirements for a postpartum doula?
Kelly Rutan: We definitely need training to be doulas. We are not medical in any way, but we play the support role. I do encounter some people, occasionally, who think they can be a doula without any training because they've had their own children or they’re a grandmother of six.
So what do we need training for? And that's the important part, because without solid training, you miss some of the key parts of this job, which is meeting parents where they're at, providing true, unbiased, non-judgmental support, and learning how to be a really great active listener. Those are the things that, without proper training, you can bring in your own baggage and your own judgments. And that's a terrible way for a family to get started.
We're all human beings, process our own baggage, our own life experiences, and, through training, we learn how to leave those at the door for any client. We walk into learning how to be truly non-judgmental when you support somebody.
And of course, a good training should also be teaching people from an evidence based background. We've all heard old wives tales about heartburn and reflux and getting people's milk to come in.
Georgie Kovacs: How can you effectively screen a postpartum doula?
You definitely want to look for somebody who has trained and certified as a doula. The reality is, we're not because we're not medical, there's no state licensing requirements. There's no federal boards. It really is an industry that doesn't always have the best oversight.
So from a personal perspective, you definitely want to make sure you're not hiring somebody who is just saying, I'm a doula because I love babies. Ask your doula, where did they get trained? When did they take their training? Have they been certified?
I think one of the best questions if you're looking to hire a doula, whether it's a birth doula or a postpartum doula is to ask them what their philosophies are around birth and parenting in the postpartum period. It's kind of a trick question. And this is how I can always kind of tell if a doula who really understands how to be unbiased and non judgmental will let you know that they don't have any personal philosophies. They're there to support yours. And a good training will teach a doula how to attune to their individual client. Because I feel like I can support you well, Georgie, and I can support somebody down the street and somebody over here, and they're all unique women doing parenting their own way. But I can support all of them, because I know how to be non judgmental and just tune in to what they need. A good training will teach the doula how to do that.
Georgie Kovacs: How often and for how long should a postpartum doula support the family?
Kelly Rutan: Most postpartum doulas will be available for support during the daytime or at nighttime. But again, this is going to depend on the unique doula. I know when we were working together, I was helping you out during the day. And a lot of times, it would be maybe a four hour shift. Some doulas come for five or six.
We'd schedule a time block. I'd come during the day, that four hours is a good time to make sure that you got time to take a shower, have a nap. We could catch up about anything you wanted to talk about. We could work on helping with feeding, making sure breastfeeding was going well, or however you're feeding the baby. I’d talk with your partner about how to do some of the swaddling and soothing techniques. You can fit a lot of good stuff in at about a four-hour chunk of time.
How often do you want your doula to come? That also depends. I've worked with families that have me come every day. I've worked with families that just need a little check in once or twice a week. And we also will come overnight as well. If you need nighttime support, that's really focused on maximizing sleep. It is such a vital piece to your emotional and postpartum recovery to get good sleep. It's really hard to be your best self when you haven't slept well.
Georgie Kovacs: Let’s talk about the postpartum doula role and the dynamics of our healthcare system with minimal doctor visits for the mom.
Kelly Rutan: One piece that I feel pretty passionate about because I just think it's missing in our society in this country, the way the US healthcare system works. You give birth and you get to go home, maybe 24 hours later. You're not in the hospital for very long and for the most part, the birthing parent does not see a medical provider for six weeks. And there's so much potential for mental health or physical health issues to fall through the cracks.
For people that are hiring postpartum doula support, it's one of the things that I feel very strongly about, we're there to, again, I don't serve a medical role, but I can check in with you and I know the right questions to ask to make sure that you're healing well, there's no red flags for things like postpartum complications that come up. I'm trained to spot the signs of postpartum mood and anxiety disorders. So if we suspect there's something going on there, we can try to get you connected to resources as soon as possible.
The physical help of the mom, the birth parent, I think gets ignored far too often. In this country, we don't have enough check ins to make sure they're okay. So and even for the woman who is not hiring a postpartum doula, I really encourage you to just find some good resources about what is normal and what is outside the range of normal and the postpartum periods. So you would know it's not normal to have a headache that never stops. It's not normal to be bleeding this much. It's not normal to feel dizzy all the time. These physical symptoms that can arise after birth can be serious complications, and unfortunately, most people don't have anyone checking on them to make sure they're okay.
Georgie Kovacs: It’s true. My son had many doctor visits before I had mine.
Kelly Rutan: I think this speaks to everything you're doing with this podcast, which is amazing, that there is a critical piece of education missing for women in this culture, where we grow up just not being educated enough about our own bodies. What's normal? What is not normal? From the time we hit puberty through the childbearing years and all the way through menopause, where do we learn this? It's not taught in schools. It is passed down from generation to generation. Is that evidence based, who knows? So this is one piece where, from my perspective, from the postpartum field, the childbearing years, I see a lot of people not understand what their body does, after they have a baby not know that this is normal, or this isn't normal, and we need to call your doctor and get help. So I love that you have a podcast to help people to help women learn like, this is what's normal, or this is not like, we need to know these things.
Georgie Kovacs: Thank you. One of the themes on this podcast is you've got to just listen to your body and do what's right for you and get the proper support. And that's really the theme with women's health in every single aspect.
So one thing I do want you to share before we go is how you got into this because I love your story.
Kelly Rutan: I did not grow up saying I want to be a doula when I grow up. I had no idea that doulas existed for most of my life. I did not know about postpartum doulas until I was in my 30s. My first career was as an attorney. I went to law school at American University. I worked for a large law firm in Washington, DC. I did antitrust litigation.
Georgie Kovacs: Which is completely related to babies!
Kelly Rutan: Yes, not at all related to anything babies. I was a very busy and overworked professional. Maybe sometimes I'm still overworked and very busy, but the difference is I now do what I'm very passionate about and love. And so I did not love being an attorney. It was just expected that I would go on to school and get a higher education and all of these things.
But when I had my son 12 years ago, I was the person who had no experience with babies before having a baby. I was an only child, and I did not come from a big family. And I lived far away from where my family was at the time. My husband and I were in the Washington DC area on our own. I remember the night sitting in my bedroom, with a two-week old and him just crying and red faced and it meets in tears. I think about how I can write a brief that gets argued and an appellate court, but I can't make a baby stop crying. What's wrong with me?
And I look back now and I was like, there's nothing wrong with me. It was the lack of support. That was what was wrong. I didn't even know about postpartum doulas. I would have hired one if I had known they were a thing. I really needed support in that time of my life. And I had none of it.
And to shorten the story a little bit, we eventually moved back to North Carolina, which is where my family was, and I had another child. I supported a friend through a very difficult pregnancy. And it was at that moment, seeing the impact that I had made with her.
I remember having a conversation with my husband and say, “If that was a job, supporting women and supporting families and helping them through such a challenging time in their life. That's what I would want to do with my life.” And he said, “Who's to say it's not a job, Kelly, like, just because you went to law school and practice, you know, went to the bar exam doesn't mean you have to stay in a job that you hate. So if this is what you feel like your passion is, let's see what it is that a thing? Let's find out.”
And it was being a postpartum doula. So I changed course. And I don't miss a lot about the law firm, that's for sure. I love what I do now.
Georgie Kovacs: Amazing story! What is your greatest hope for women's health?
Kelly Rutan: My greatest hope for women's health would be access to education and opportunity. I do think that there is a critical lack of good quality education available for most people. And without that, without access to those resources and to the knowledge, how do you empower yourself? I do think that each individual woman should feel empowered to take control of her health and the way that is right for her. If you don't even know what your options are, how do you do that? More opportunity, more access - that would be incredible.
About Kelly Rutan
Prior to her career as a doula, Kelly spent years as a workaholic litigation attorney, trying (and often failing) to balance the demands of a busy career with a fulfilling family life. After surviving her own anxious and lonely postpartum experiences, Kelly was convinced that new mothers deserved more. Through her work as a postpartum doula, she provides hands-on help and education, as well as uplifting, emotional support to new parents as they navigate one of the most exhausting and overwhelming times of their lives.
Today, Kelly lives in Cary, North Carolina and is the co-owner of a busy doula agency, Doulas of Raleigh. She is also a trainer for the training and certifying organization, ProDoula, and has trained hundreds of new Postpartum & Infant Care Doulas. She is passionate about providing nonjudgmental support to new families and spreading the word far and wide about what postpartum doulas really do.
About Fempower Health and the Founder
Georgie Kovacs, is the founder of Fempower Health, the go-to resource for all things women health serving women, their providers, and companies looking to build/improve on products for women. She also hosts the Fempower Health Podcast, where she interviews experts to help women better understand how to navigate their health both day-to-day and in partnership with their providers. Her mission is to minimize the years many take to seek proper diagnosis and treatment.
Georgie founded Fempower Health after her first-hand experience with infertility and endometriosis. Leveraging this experience along with her 20+ year tenure in the biopharmaceutical industry and consulting, she leads this movement to empower women. With limited research dollars and women’s “training” to grin and bear it, both women and doctors are in the impossible position to diagnose and treat conditions with little information. Women deserve more and better information, insight and innovative health solutions.
**The information shared by Fempower Health is not medical advice but for information purposes to enable you to have more effective conversations with your doctor. Always talk to your doctor before making health-related decisions.