It takes a village… but who should be in yours?
Everyone has heard the saying “it takes a village”, but have you thought about how the “village” applies to your own prenatal and postpartum health care? You wouldn’t be alone if you haven’t given this much thought. In fact, many new moms often put their own healthcare last, feel the need to lie about their wellbeing to doctors and may even skip preventive care.
As an International Board Certified Lactation Consultant (IBCLC) with over a decade of experience, I’ve had the privilege of working alongside thousands of families, observing these villages as they are formed. They all look different, because every family has unique needs and preferences. However, pulling together the support you need starts with understanding who does what. From physical health to mental health, pregnancy to postpartum, let’s take a look at who these practitioners are and how they can support you.
Who should be in your village? Practitioners to consider
Obstetrician & Certified Nurse Midwife
Obstetrician-Gynecologists (OB-GYNs) are highly-trained doctors who provide specialized medical care during pregnancy, labor, birth and the postpartum period, and are trained to care for female reproductive health. OB-GYNs are qualified to diagnose and treat complications that may arise during pregnancy and birth, including interventions and C-section deliveries. There are also maternal-fetal medicine (MFM) specialists who take care of women experiencing complicated or high-risk pregnancies.
Certified Nurse Midwives (CNMs) are healthcare providers who also specialize in pregnancy, birth and the postpartum period. They often work alongside OBs in hospitals and other medical settings. Families with low-risk pregnancies, who are seeking holistic care with fewer medical interventions, may choose to work with a midwife.
Typically women meet with their OB or midwife for the first time around 8 weeks. Whether you work mainly with an OB or a midwife may vary depending on where you live, the healthcare system you belong to and your preferences.
Birth doula
Birth doulas are non-medical birth professionals who provide emotional, physical and educational support to families during pregnancy and birth. Some birth doulas also provide support in the early postpartum period. Many families hire birth doulas as part of their birth team to work alongside their medical providers. They advocate for the family and help them to have the birth experience they desire.
Pediatrician & family physician
Pediatricians are highly-trained medical doctors who specialize in healthcare for infants and children, whereas a family physician is certified to provide care for all ages. Pediatricians and family doctors are both qualified to provide specialized care for infants and children.
International Board Certified Lactation Consultant (IBCLC) & Lactation Educator
Finding expert support for your breastfeeding journey is essential to success. In fact, we know that no matter the breastfeeding plan, the chances of success are increased with support. There are two main types of lactation care providers, International Board Certified Lactation Consultants (IBCLC) and educators.
IBCLCs are highly-trained healthcare professionals providing individualized clinical advice to parents. They can provide prenatal education, identifying factors that may affect breastfeeding and lactation, help with low or over milk supply, plugged ducts, feeding multiples, nursing strikes and pumping education. They are also able to handle more complex issues like establishing a milk supply with a baby in the NICU, working with preterm infants, assisting with special needs feeding, breastfeeding after a mastectomy, induced lactation and more. If you plan to breastfeed, you should connect with an IBCLC in pregnancy for a prenatal breastfeeding class or consultation, and in many cases, working with an IBCLC is covered by your medical insurance.
Lactation educators can also be incredibly valuable resources for providing tips and evidence-based lactation education both during pregnancy and postpartum.
Mental health professional
Perinatal mental health disorders (PMHDs) are a highly common complication associated with childbirth. They affect 1 in 5 birthing people during pregnancy and/or during the first year after childbirth. Unfortunately, there are still stigmas around accessing mental health support. If you are not already connected to a mental health professional, consider researching where to reach out for mental health support should you need it. Your doctors, and other specialists on your team, are typically a great resource for local recommendations.
Postpartum doula
A postpartum doula is a professional trained to work with families in the postpartum period. They provide education on topics including infant feeding, newborn care and transitioning to parenthood. They may also help with light housework or errands. Some doulas provide support at night to help families get more rest.
Pelvic floor therapist
Pelvic floor therapists are physical therapists who are specifically certified in treating pelvic floor muscles to restore their strength and function. After birth, some women find their pelvic floor muscles are weak or tight, which can cause symptoms such as incontinence, discomfort during sex or pain.
Other considerations for a supported pregnancy and postpartum
From your personal community to broader support groups, here’s what else to think about as you plan for this exciting new journey.
Your friends and family
Your village would not be complete without your family, friends and partner (if you have one). They play an essential role—lending advice and providing both emotional and physical support.
If you have a partner, talk about your feeding and sleeping goals before the baby arrives. A recent study shows fathers are key in supporting breastfeeding and safe sleep habits for babies. For breastfeeding parents, aim to align on your plans for what you’ll feed your baby, how you’ll feed your baby and how you’ll manage nighttime feeds.
Think through what the division of labor will look like. Will you both take your newborn to all pediatrician visits? Keep in mind that your body will be healing from birth, and you will need care as well. Some families hire extra support (for example, a postpartum doula) to help them navigate the early weeks.
Or you may also want to consider taking friends and family up on their offer to help. Consider having a trusted person help at night, or even just stop by for a couple hours to care for your baby while you take a nap.
Prenatal, birth and postpartum classes
Attending prenatal classes with your partner, family or friends can have several benefits. Many parents feel like there’s a lot to learn in a short period of time, and it can feel overwhelming. If the classes are in-person, it might feel good to travel together and have company. When your support person attends with you, they also gain additional knowledge and resources to support you and the baby.
Make a postpartum support plan
Consider creating a support plan in advance for your friends and family. Think through what you’ll need, and how those around you can best support you. Do you need a friend who is available during the day to run last minute errands? A family member who can take care of shopping or light housework? Or someone who is available to lend emotional support?
Set up a meal train
Many families say that having meals provided for them makes a big difference when you first settle into life with your new baby. That might take the form of a meal train, or frozen meals that are dropped off in advance. Appointing a friend to be in charge of that for you takes the task off your shoulders.
Make it yours
Just as every family is unique, so is the village that you create to support you through your birth, postpartum period, and beyond. When choosing the specialists on your team, consider what’s important to you. Do some research, ask for recommendations, and when possible connect with the specialists in advance to make sure you’re aligned on goals, communication, fees and availability. If you don’t have the benefit of local family and friends, consider connecting with other families online or reaching out to local parent or breastfeeding support groups. These communities can be incredibly valuable!
