November is Prematurity Awareness Month. November 17 will be recognized around the globe as the fourth annual World Prematurity Day. More information on this day is available here. According to the March of Dimes, 15 million babies are born prematurely, (before 37 weeks) worldwide. Depending on the gestational age of the baby, the location of the baby’s birth, and the resources available, some babies face greater adversity and health impacts than others when they are born prematurely.

Doulas can and should be prepared to support clients who have given birth prematurely, and I would like to share some tips that can help the doula be prepared to support those clients:

  1. Consider yourself on call from the time you contract with a client. Have back up in place from that point on. It is very unlikely you will attend a premature birth and you are free to travel and make other plans, but having back up in place means that if something should happen, your client has the support they need.
  2. If your client has a premature baby, you may find yourself staying longer after the birth than usual. It may take some time to get the parents up to the NICU to be with their baby, or the baby may not be stable quite as soon. When circumstances include a premature birth, I always plan on a longer period in the hospital with my clients immediately postpartum.
  3. Before you leave after the birth of a premature baby, check in with your clients to see if they would find it helpful to have a family member or friend arrive to support them. You might assist them in identifying the right person and reaching out to facilitate their arrival.
  4. Plan on a postpartum visit with them while the baby is still in the NICU.  Find some time to visit and maybe bring a meal for the parents at the same time. If the baby is going to be in the hospital for a while, it will be helpful for them to see you sooner than the baby’s discharge.
  5. Additional lactation support will be useful. Even babies who are close to term may still need some finishing touches before they are successfully nursing. Encourage your clients to meet with the hospital lactation consultant and begin the process of pumping (and storing if baby is not yet taking milk) to maintain a good supply.
  6. Make sure the birthing parent is resting, eating well and staying hydrated. After all, they did just have a baby and may even be recovering from cesarean surgery.  Many NICUs do not even have comfortable chairs for parents to use while remaining near their newborn. Encourage them to do self-care so they can “go the distance” while their baby is in the hospital.
  7. Having a premature baby who may be in the NICU is very stressful. This can create ideal circumstances for postpartum mood and anxiety disorders in both the birthing parent and the support person. Be sure that your client has access to names and contact info for therapists and support groups. Consider connecting your client with a previous client of yours who has had a similar experience, with the permission of both, of course.
  8. Let your client know that there is a NICU social worker available to support the family. Encourage them to connect. This social worker could help them with onsite housing after the birthing person is discharged, connect them with resources and support them during their baby’s stay.
  9. March of Dimes has a NICU app that can help your clients manage the situation. Encourage clients to download the app for their phone and see if it might make things a bit more easy to track. There is a lot going on when a premature baby arrives. Juggling all those balls is very hard.

Most people birth at full term, but some of our clients may, unfortunately, have their baby earlier than expected. This can be scary, stressful and be a real roller coaster of a ride. Having a doula who knows a few tips to help make this unexpected event a little bit smoother can really go a long way to helping a family to adapt to these new circumstances. Is there anything you would add to this list?  What has been your experience with clients who birthed prematurely?