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Mom Talk: On Hiring A Night Nurse

Written by Terra Becks

Photography by Photographed by Maria Del Rio

Just the thought of hiring a night nurse during those early newborn days, weeks, and months can spur waves of relief in some families, and waves of judgement in others. In today’s Mom Talk essay, San Francisco-based mother of two Terra Becks tells us about her positive experience hiring a night doula, and the dash of guilt that came with it, as well. -KHZ

Early on in my first pregnancy I was talking with a friend who lives in New York City about all the things we were doing to prepare for the arrival of our son: prepping the nursery, buying clothes, taking hospital tours, signing up for an infant CPR class, putting together a registry, planning the baby shower…and, she added, “Finding a baby nurse.” “A what?,” I asked. Apparently baby nurses are much more common in NYC than in San Francisco, where I live, because she asked fully expecting that the first thing I did upon finding out I was pregnant was hire one. She went on, “Well you don’t know what kind of labor and delivery you’ll have, and you don’t really have any family support, and he could be colicky!” As her list continued, my well rested, pregnant self quickly went into panic mode. I had been so busy thinking about all the logistics of having a baby that I forgot about what life would be like once he was actually home with us. My husband would only have a few weeks off work and then it was just me and the baby (Ronan, who is now 5 years old). So, I set out to research how to hire a baby nurse and also to try and figure out how to pay for one because, if nothing else, the one thing everyone knows about hiring help at night to care for your child is that it’s expensive.

As I began my research into this foreign world, I learned that baby nurses are in fact a lot more common in New York City than San Francisco and are a lot cheaper. According to my friend, they typically cost $300-$350 a day, roughly $15/hour for around-the-clock help, but you need to have an extra room for them, which we did not have. By comparison, night doulas can be hired for an 8-10 hour period, day or night, and cost anywhere from $35-$50/hour. Most have a 2-night minimum, but people usually have them come 4-6 nights a week. This was a lot to wrap my head around.

Interviewing and hiring. Hiring someone to be in your space for such a deeply intimate and raw period of time, and arguably during one of the most transformative in one’s life, is no small task. I cannot underscore enough the importance of finding the right person. Most people I know who have hired a night doula had a positive experience and one they would take out a second mortgage to make possible again, but a few did not and I think their experiences were solely due to a bad fit. We interviewed four potential night doulas who had been recommended by people we knew and trusted. Without much deliberation, we both knew we liked and wanted to hire a woman named Olive. She was personable, warm, knowledgeable, and most importantly for me, she seemed nurturing. She answered most of our questions without us even having to ask, but a few on my list were: Can you give us an example of a typical night time routine? Do you sleep when the baby sleeps? What do you do? And what are three guiding principles of doing your job well? I was looking for someone who was supportive, non-judgmental, nurturing, and informative. I didn’t know what kind of hot mess I’d be after delivery—Would I need a c-section? Would I tear? Would the baby be ok? And how would the transition into fatherhood be for my husband? How would we navigate those early months together as new parents? My husband’s parents passed away many years ago and my parents don’t live close by nor are they very involved in our lives. There would be no grandma to show up and wash dishes or cook meals, exercise your dog by taking him for a walk or tell me the best way to nurse or deal with a gassy baby. Olive filled in those gaps of familial knowledge and became the support system that helped us work together to navigate those difficult first few months. We didn’t need to read books, she was our book. So, we signed a contract and paid a deposit. We originally agreed to have Olive for 4 weeks but ultimately hired her for 6 weeks, 5 nights a week. I’ll never forget her saying, in her cheery Irish accent, “Oh pet, you’ll want me to stay for longer.” At the time I couldn’t wrap my head around having someone in our house for two months, but she was right. She stayed for 10 weeks until our son was sleeping 8 hour stretches. We got it.

Our first night home from the hospital. Ronan’s entrance into the world was not without its complications. My pregnancy, labor, and delivery were all fairly normal as these things go. I was in labor for 24 hours, had an epidural, and he came out rather quickly after 10 minutes of pushing. About thirty seconds after he was placed on my chest he turned blue and didn’t appear to be breathing normally. What followed was a whirlwind, a blur of nurses yelling at my husband to push the emergency call button which didn’t work, so the nurse yelled into the hallway for “HELP!,” which lead to a team of doctors running in to whisk our barely 1-minute-old baby away for examination. This was followed by a trip to the NICU for observation, where my husband followed. Ronan was going to be ok and later we learned that sometimes it takes babies a while to breath properly or “rally,” as they say. Nevertheless, my husband and I were both in a bit of shock. I’ll never forget sitting in the delivery room, alone, when a nurse brought me the veggie burger I had ordered 12 hours before. It was cold and tasteless, but I was starving, so between sobs I tried to eat something while waiting for news on our baby. Shortly after, I was able to go to the NICU, but those first few hours after he was born left me feeling traumatized and incredibly emotional. We stayed in the hospital for 4 days and then began the slow drive home into the unknown world of parenting. I don’t really remember a lot about those first few months of hazy newborn life, even with a good night’s sleep, but I do remember that first night and the relief that washed over me when Olive arrived promptly at 10pm (a typical night shift is from 10pm-6am).

I quickly learned that having Olive around wasn’t just about the luxury of a good night’s sleep—it was also, I had hoped, an investment in the entire first year of life with our baby, since most night doulas establish a healthy sleep routine from the beginning. And she did! Our son slept through the night when he was just 3 months old. Looking back and after having a second child, this is something I could not fathom having the strength to do while sleep deprived. And then there were the invaluable 3am chats about breastfeeding and having someone to fetch the nipple shield (which she purchased because I had no idea such a tool existed) that I left downstairs because my nipples were cracked and on fire. Not to mention the advice about remedies for the first cold, what to do when they start rolling over in their crib, and when to transition out of a sleep sack. Also there was the water and snacks she would leave next to the glider, the washing of the pump parts, putting the pumped milk in the fridge, tidying up our kitchen, and folding the baby’s clothes. The investment was realized in all of these things; the nuances of daily life that I couldn’t imagine being so hard before our baby came earth side.

Judgement and confusion. Throughout this process I learned that a lot of couples were not only hiring night doulas, but doing so secretly for fear of the judgment that often comes with it once revealed. The first taste of mom guilt if you will, and I experienced it too, and before our son was even born! Not only had we hired a night doula, but a few family members had offered to pay for it—double mom guilt! How could I tell my other pregnant friends that we had just been given the greatest gift of all: sleep? Nonetheless, I did tell them, and mostly what followed was a slew of questions about what exactly this person would be doing to help us at night. After talking to several people, I realized that a lot of the judgement around hiring a night doula comes from the confusion of not knowing what they actually do. Plus, there’s the notion that as a new mom you’ll just able to “figure it out.” Society assumes that women, with enough exposure to their babies, will naturally know how to care for them. But what if this divine maternal intervention doesn’t happen right away? I have suffered from depression in the past and was worried I’d be a prime candidate for postpartum depression or the less common, but certainly prevalent illness, postpartum psychosis, in which mothers suffer from delusions, paranoia, and hallucinations. I knew I needed all the help I could get. We are conditioned to think that asking for help is weak and that moving through this process alone is just the price you pay for the rite of passage into motherhood. This passage was certainly easier when it was common practice for families to live together or close by, when knowledge was passed down by mothers and grandmothers, but the village archetype has been broken down and the tribe dismantled.

The maternal healthcare crisis. Why is there so much controversy over hiring a professional caregiver to help parents during the postpartum period? Yes, it’s a luxury and a privileged one at that, but I think the negative response is part of a larger, national crisis we are currently experiencing in this country. We are one of the richest countries in the world, yet our healthcare system continues to fail women when it comes to perinatal and postpartum maternal care. One has only to look at the increasing maternal mortality rates (currently the highest in any developed country). What’s more, as rates decline around the world, ours increase. Other countries are doing a far better job and in a variety of ways. We have friends raising kids in other parts of the world, in particular Northern and Western Europe, and they have said that home visits after childbirth are common practices covered by universal healthcare. In the Netherlands, postpartum care is a matter of national interest and does not discriminate. Dutch friends have said that every new mom is offered an ongoing postpartum home care program by way of someone called a “kraawverzorger” or professional maternity nurse, which includes care for the mother, children, and the house. All of this is also covered under basic health insurance. In Taiwan, mothers can choose to stay in a private maternity center for weeks where they are cared for by trained nurses, and in China it’s a common practice for new moms to be cared for by family members for one month postpartum. I hope that one day, the U.S will join the rest of the modern world when it comes to caring for mothers.

Present day. When we found out I was pregnant with our second child, Olive was the first person we texted even before family, because the good night doulas can sometimes book up a year in advance and I knew she was in high demand. Ruby, now almost 2 years old, has been going through a pretty dramatic and consistent sleep regression complete with multiple nighttime wakings and climbing out of her crib. A few weeks ago I tried to make coffee with half and half instead of water and left the house with my shirt not only inside out but backwards. I decided it was time to seek professional help, yet again. I wrote and reflected about our initial process of hiring and having a night doula in my head while holding Ruby’s hand, part of our new sleep training plan, as I lay on the floor next to her crib. Multitasking, it seems, is sometimes part of this parenting job! Olive has become a friend, we stay in touch and the kids love her. Maybe we got lucky, but I do know it was the best decision we ever made. I only wish she was here now, as we slog through another sleep training experience.

I’m still not an expert at parenting, in fact the more I learn the less I know. But I’m more confident and I have an arsenal of “tricks” of the trade, if you will. Most parents would say they’d do anything for their children, and for me that meant asking for help. And the arsenal I’ve built—a lot of what’s in there can be attributed to the help we had in those first months with our night doula.

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