Feature Article—Continuing Education Module—Reimagining Postpartum Support

Abstract

This article introduces the author's emerging new paradigm (“perinatal participation”) that re-imagines postpartum support by helping expectant parents have more peace of mind, confidence, self-compassion, and emotional wellbeing over the course of their perinatal journeys, with special focus on feeling more prepared for all that happens after baby arrives. The author's work rests on the shoulders of her 1992 book, Mothering the New Mother: Women's Feelings and Needs After Childbirth. Perceiving a new urgent need to support expectant parents three decades later (the need to alleviate the high stress levels in expectant parents she was talking to) the author explored filtering the expectant and new parent's experience through what she calls a “peace-of-mind lens.”

Pregnancy and new parenthood can be a time of extremes—very high highs, very low lows, and everything in between. And perinatal waters can be difficult to navigate. With this in mind, I have been exploring and experimenting with ways to help expectant parents have more confidence, awareness, self-compassion, and peace of mind over the course of their perinatal journeys, with special focus on feeling more prepared for all that happens after baby arrives. In 1994, my book, Mothering The New Mother: Women's Feelings and Needs After Childbirth, written when I was a new first-time mother, filled the need to acknowledge the new mother's experience by looking at the first year of new motherhood through what I called a “mother-centered lens.” Thirty years later, I'm filtering the new parent experience through a different lens. For want of a technical term, I call it a “peace-of-mind lens.” What follows is a look at how it came to be, what I've learned, and how I'm using it with expectant parents today.

BACKGROUND

When my first child was born in New York City in January, 1987, I was definitely part of the “I'll figure it out later” school of new mothering. At 37, I was classified as a “geriatric” mother. My then-husband and I had no siblings, let alone siblings with children, and no wise elders to come and help out after the birth. I felt exhilarated, but on some level, insecure. I was isolated without even realizing it. Everyone had told me I'd “just know” what to do. It was instinctive. It would all come naturally. (I did follow my instincts, but in retrospect, I wish someone had told me there was a difference between hormonally mediated maternal instincts and learned skills.)

Towards the end of 1987, still trying to make sense of my new mother's journey, I crossed paths with Jane Arnold (RN, MSN, CNM, DNP, professor emerita Midwifery Division, UNC Chapel Hill, and pioneer in the postpatrum doula movement in New York). Jane suggested I read anthropologist Dana Raphael's 1955 book, The Tender Gift: Breastfeeding, which Dana wrote after struggling to breastfeed her first child in the mid-1950s. In it, I learned about the concept of the doula—a term Dana coined almost 50 years ago—and the many cultures whose automatic response to a birth was the presence of a circle of females who nurtured and cared for the new mother, tended to her recovery, took over daily chores, protected her from stress, and let her know that she had done something amazing by bringing a new life into the world.

This vision was transformational. I had found the missing piece, and it was a simple, yet totally validating discovery: There was a different way to embody this life transition—with community, ritual, protection, special foods and teas, soothing herbal and flower baths, healing body rubs and massage, strict guidelines on visitors and when to bring baby out in public.

I needed to know more. I was a writer and public radio producer, and before long, I was writing and producing a National Public Radio documentary on Supportive Postpartum Traditions in Diverse Cultures. Sarah from Uganda, In from Korea, Luz from Colombia, Gerita from Jamaica and other women generously shared with me stories about the nurturing care they had experienced themselves as new mothers or had been told about by their elders. New mothers in New York revealed—some, for the first time—the isolation and insecurity they experienced after their babies were born. Dana Raphael, who graciously accepted my invitation to be a guest, talked about how she coined the word “doula” and introduced me to the term “matrescence”—which she defined as the developmental process of becoming a mother.

The program struck a chord with many listeners. Many mothers who were listening had never put their feelings of isolation or struggle into words. They felt shame or guilt for even having them. But on hearing these stories on the radio program, they recognized themselves. I knew, then, that this program was just the beginning of my quest. It was 1988, and I was on a mission to create a safe space for new mothers to talk about how they felt and to give voice to the kinds of support they really wanted or wished they had had. I saw a glaring need to start a new conversation, bust myths, create connection, find solutions. The second part of my mission—in the days before the Internet—was to identify and include in the book every mother-centered resource I could find to help people over the first year of new motherhood.

A second child and 4 years later, my book, Mothering the New Mother: Women's Feelings and Needs After Childbirth, was published (Placksin, 1994, 2012).

FAST FORWARD A COUPLE OF DECADES

It's Spring, 2012. I am revisiting the world of new motherhood and am attending a panel discussion on “Making Your Birth Plan.” Four couples with month-old babies in tow are speaking to an audience of expectant parents. When one of the babies starts crying, her mother, in an aside, says, “I wish I had spent 10% of the time I spent on making a birth plan making a plan for what was going to happen afterwards.”

“There's no scenario for that,” offers a care provider in the audience.

That moment stayed with me. For over two decades, I had been away from the world of new parenthood, writing and producing a public radio series on language and literature. I had been immersed in story-telling, narrative, conversation, deep listening, truth-telling, words and their nuanced meanings. That chapter had just ended, and that night at the panel discussion, a new chapter of inquiry opened. How were new parents doing in the 21st century? What had changed? What remained the same? What would I discover? How could I bring to bear not only my work on Mothering the New Mother, but all of the life and work experiences I'd had in the intervening time? Could I begin to create a scenario that would help expectant parents connect more constructively—joyously, even—with what they would need after baby arrived? How could I engage them in such a process for even 10% of the time they had spent making their birth plan.

I started this new quest with curiosity and passion. I interviewed such childbirth visionaries as Michel Odent, Dr. Sarah Buckley, Debra Pascali-Bonaro, Jane Honikman, Tanya Wills. I read research papers and parenthood blogs. Most importantly I talked with expectant parents, usually meeting first with the pregnant person and a week later with both parents together. In what I was calling “Postpartum Planning Sessions,” I listened to their concerns, asked questions, offered suggestions, resources, information. At one session, a woman who was four months pregnant, started out in tears, feeling pressured and hopeless about finding childcare that was still many months down the road. We talked it through, put it in perspective, and came up with a way to approach it that was less anxiety-producing. When the session ended, I asked how she was feeling. Her answer—“Relaxed!,”—nailed for me the ingredient that was missing for so many of the expectant parents I was talking to.

That night, my conception of “postpartum support” began to undergo a transformation. Three things became clear:

1. In order to help ease the transition after baby arrived, it was not just a good idea, it was imperative to reach and engage people during pregnancy—ideally, in a way that did not require too much of their time or prior preparation, and left them feeling positive, energized, and relaxed. The challenge was how to do this, when so many pregnant people say they can't focus on anything beyond the birth. Tanya Wills, CNM, IBCLC, and founder of Manhattan Birth said to me several years ago, “We can talk till we are blue in the face to somebody who's pregnant. If you ask them 3 or 6 months after they have the baby, ‘What do you wish you could tell your pregnant self?’, it would be exactly what we're trying to tell them, which is, ‘Pay attention, this is going to be big, you're going to do better if you plan for it with your partner and friends and your family and your support system, you're going to do better if you expect to enjoy your baby, you're going to do better if you're just ready to see where it goes. But you're going to do worse if you think that it's going to be perfect and that it's going to be easy and that you don't need to know about it.’ So, what's happening is that new parents are learning about it on their feet. I would say, I don't know, 90 percent of the new parents that I talk to, which is a lot of new parents, if I talk to them 6 months postpartum or a year postpartum, that is the one thing that they regret. But they all say that they don't know any way that they could have received the message.”

   That was one of the challenges. I needed a workaround—a new way to start folding postpartum awareness, information, building blocks, self-compassion, into the expectant parent's scenario, wherever they were in their pregnancy.

2. There is no one-size-fits-all support plan. Recognizing that everyone's experiences, needs, priorities, expectations, resources, cultural and family traditions were different, I wanted to combine the generic with the specific in a way that could be quickly and easily accessible to people I was working with, even if the sum total of our time together was only 3 or 4 hours over the course of several weeks. My goals were to start with them wherever they were in terms of their present supports; share relevant information, tools, resources, inspiration, action suggestions; create a realistic, customized, personalized vision and plan; and help them implement it so they were making the best use of all their resources (both internal and external).

3. Using Mothering the New Mother as a model, I would now filter everything through what I was calling a “peace of mind” lens. When I wrote Mothering the New Mother, I filtered things through a “mother-centered” lens, because the glaring lack at that time was validation and acknowledgement of the new mothers's experience. Now, I found that the great lack was peace of mind, self-confidence, emotional well-being.

In 2012, I interviewed Jane Arnold, who told me that she was struck by how many pregnant people she saw coming into labor in high states of fear. “They are terrified when they come into labor. Terrified. Absolutely terrified. It's the first thing I started working with at UNC when I finally got that, was just to decrease their level of fear.”

Fear runs high for many reasons: racial and economic disparities in care and maternal mortality rates, closing of maternity wards, diminishing access to care in rural areas, rising rates of postpartum mood and anxiety disorders (PMADS), and most recently, an unprecedented global pandemic. (Among the varied and important initiatives addressing these crises are the Black Maternal Health Momnibus Act of 2020; ChangingWomanInitiative in Sante Fe, New Mexico; the About Birth and Corona Project in New York City; and the American College of Obstetricians and Gynecologists's Revising Postpartum Initiative.)

Prenatal care can also contribute to worry and stress. According to Judith Lothian (PhD, RN, LCCE, FACCE, College of Nursing, Seton Hall University), we know more than ever before about “how exquisitely nature has designed this whole processes [of pregnancy, birth, and life after baby arrives.] … And then we've got the whole prenatal care thing that expects trouble and looks for trouble and does nothing to increase the birthing person's confidence.” In her 2008 article, “The Journey of Becoming a Mother,” Lothian observed that, “the women I teach go through pregnancy intensely worried that something might go wrong.” She referred to this as a state of “worried pregnancy.” Today, she says, women are even more worried.

We've got a tremendous increase in prenatal testing and pressure for women to do prenatal testing, so that women go through pregnancy, even more so than 10 years ago, with the worry from one prenatal appointment to the next, is everything going to be ok? [They have] this underlying feeling that, “I hope everything's gonna be ok,” because at any point in time it could go terribly, terribly wrong, which simply isn't true. Now, women are frantic, so we've got someone who all through pregnancy, through birth, through postpartum has this tremendous stress of, “Something might go wrong. Can I possibly do this?”

This is called the “nocebo effect.” In 2004, Michel Odent wrote about the “nocebo effect” in an article discussing gestational diabetes:

There is a nocebo effect whenever a health professional does more harm than good by interfering with the belief system, the imagination or the emotional state of a patient or of a pregnant woman. The nocebo effect is inherent in conventional prenatal care, which is constantly focusing on potential problems. Every visit is an opportunity to be reminded of all the risks associated with pregnancy and delivery. The vocabulary can dramatically influence the emotional state of pregnant women. (Odent, 2004)

Or, as Deepak Chopra put it more colloquially, “Whatever you pay attention to will grow” (Chopra, 2008).

With this in mind, I was interested in trying to help shift the focus for expectant parents, or at least, shift the balance. I wanted to offer them the possibility of a map—even if it was a supplemental map to the fraught one they already had—that connected the dots in new, more anchoring and uplifting ways that they had, perhaps, not thought of or been exposed to.

The first step was stretching the childbirth timeline.

STRETCHING THE TIMELINE

“Everything that happens once a baby is born is the outcome of all that has come before” (Kitzinger, 1994).

When my children were born in 1987 and 1989, there were disconnects for me between pregnancy, the birth, and everything that happened afterward. My knowledge about the physiology of childbirth (including the most basic benefits of skin-to-skin contact in the first hour after birth and how that could impact everything else down the line) was virtually non-existent. So, when I wrote Mothering the New Mother, I began my support timeline for new mothers after the baby was born, at the start of what I knew as the “postpartum period.” To me, this meant as soon as I got home from the hospital.

The traditional medical divisions of the prenatal/birth/multiple stages of labor/postpartum/fourth trimester (or, more often, forgotten fourth trimester) timeline continue to create a “compartmentalized” mindset for pregnant people and their spouse/partners (not to mention their caregivers). This does a disservice to women, babies, and new families. As Debra Pascali-Bonaro, Chair of the International Motherbaby Childbirth Organization, Co-chair of the International Childbirth Initiative, and Dona Doula trainer, said to me several years ago:

[the stages of pregnancy and birth] are so segregated in our language that we segregate it in how we deal with it. We have different caregivers, we go to different resources, and I think what we're seeing come back really strong is this perspective [that] … this is part of the life course, and … we must see this as a whole. We must educate women about pregnancy and birth and parenting when they're young so that they're prepared for it when their time arrives, and [so] that we have continuity of care and caregivers, especially doulas that can take them from early pregnancy through … that journey … into motherhood. I always say, “from maidenhood to motherhood.” When they can have a comprehensive support structure around them through that time, women will feel safer, and that's what they need [in order] to have the confidence to trust in their body, their intuition, and their baby.

Working toward this kind of model meant a shift in mindset and vocabulary. The terms I heard most often from expectant parents were prenatal and postpartum. (In addition, postpartum has, inaccurately, become shorthand for “postpartum depression.”) Taking Debra's suggested scenario as inspiration, I introduced into conversations with expectant parents the idea of a using a longer than 9- or even a 12-month timeline for our support planning purposes. If they were thinking in the prenatal/postpartum split, I introduced the term perinatal, [Latin: around birth] as a new way for us to think about this journey they were on. The word perinatal has various clinical, medical, popular, and cultural definitions for when it occurs and how long it lasts.

The World Health Organization (n.d.) says, “The perinatal period commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth.”

According to MedicineNet.com., “The perinatal period is defined in diverse ways. Depending on the definition, it starts at the 20th to 28th week of gestation and ends 1 to 4 weeks after birth.”

Looking to the mental health sphere for an interpretation of how long the perinatal period lasts, in a section on Perinatal Mood and Anxiety Disorders (PMADs) on Postpartum Support International's website (n.d.) we find, “Symptoms can appear any time during pregnancy and the first 12 months after childbirth.” This defines an expectant parent's period of vulnerability as any time from conception till the end of the first year, and suggests that we can interpret the perinatal period as being as long as 21 months.

When I invite expectant parents to explore new ways of drawing and thinking about their timeline for the purpose of focusing on postpartum support, if they're comfortable with it, I suggest we use 21 months—from conception till the end of the first year. Looking at a 21-month timeline also provides expectant parents with a gentle reminder (and sometimes, an eye-opening realization) that they have valid emotional needs and vulnerabilities at every stage of the parenthood journey. Giving them time, space, and permission to explore and acknowledge this—to make the unspoken spoken—can help lay the groundwork for a more realistic sense of what they'll need after baby arrives and how to honor that. As Liz Koch, founder of The Doula magazine, said in Mothering the New Mother, “[If, during pregnancy,] we began to get in touch with those places of vulnerability and softness, then I think maybe if someone said, ‘You're going to need help afterward,’ you wouldn't immediately say ‘Oh, no, not me. I don't need that.”’

CONTINUITY OF CARE

The benefits of continuity of care in the midwifery model have been well-documented. Continuty of care also plays a role in long-term health implications for birthing persons, as is emphasized in the American College of Obstetricians and Gynecologists (ACOG)'s Revising Postpartum Initiative. “Continuity of care clearly plays a role in the redesign for several reasons,” says Dr. Haywood Brown, Senior Associate Vice President of Academic Affairs for USF Health and the Vice Dean of Faculty Affairs for the Morsani College of Medicine, Professor Emeritus in the Department of Obstetrics and Gyneclogy at Duke University Medical Center, and past president of the ACOG. Dr. Brown spearheaded the Initiative when he was president in 2017–2018. One revision in the initiative is scheduling the first post partum visit at 3 weeks rather than 6. “Many pregnancy complications that have long term health concerns—preeclampsia and diabetes—are associated with greater risk for cardiovascular disease or developing diabetes or developing hypertension,” says Dr. Brown. And so that [3 week postpartum] visit then has a different set of relevancies to it. The whole objective is about appreciating the fact that heart disease is one of the leading causes of death for women. Women have an earlier risk for it and there are certain pregnancy complications that, if you modify your lifestyle, can impact that. So that's part of that continuity of care model.”

Extrapolating from the principle that continuity of care yields benefits, I explore with expectant parents “continuity of care” elements they can identify for their personal perinatal timelines. This can be anyone or anything that impacts them positively, is present during pregnancy, and will also be available after baby arrives. It might be a caregiver, a supportive friend, or a relative helping them through the ups and downs of pregnancy. It could be a new parent support group they can connect with prenatally. Or a meditative practice they want to continue after baby arrives. It might even be a neighbor they hardly know who is also pregnant and due at the same time, possibly even giving birth at the same site. (This happened to me 34 years ago, when I met Donna, a neighbor I hardly knew, in the elevator of our apartment building. Today, we are still BFFs.)

I also offer them new options to add to their well-being timeline: for example, a 7th-month affirmation from Luz Garcia, former Lay Breastfeeding Doula at North Central Bronx Hospital in New York, that they can use to help carry them through pregnancy with positive thoughts about their ability to give birth. If they don't have information about the birth I suggest that it's a good time to learn a few basics about the subject (one resource I recommend is Pathway to a Healthy Birth: How to Help Your Hormones Do Their Wonderful Work, a free download available at the National Partnership for Women and Families).

The new perinatal timeline can be used as an exclusive “peace-of-mind” timeline that we start creating together, and that they can add to on their own. Or, they can conflate it with other milestones and dates to make one timeline with everything on it. In either case, it is a way to give prominence and acknowledgement to all the supports, wise words, helpers, practices, and tools that can maximize benefits and enrich their perinatal journey.

BROAD CATEGORIES OF SUPPORT EMERGE

Over time, as I met with expectant parents, the things we talked about started to group themselves into categories in interesting ways. Some of the themes that emerged were: protection, practicalities, emotions, environment. The words were familiar, but what we did with each one was new. We were examining things through a peace-of-mind lens. How could everything we talked about contribute to the expectant parent's sense of confidence, self-compassion, emotional well-being? How could stressors be reframed? If they couldn't, what resources were available to provide support?

The categories are fluid. There is room for overlap in conversations. For instance, couple communication may crop up when we talk about emotions and practicalities. Practicalities might involve asking for help with chores, which might connect to emotions—is it hard or easy for you to ask for help? If it's hard, let's practice a comfortable way to do it. This overlap provides an opportunity to convey information more than once, and to reinforce it from multiple points of views.

We also delved into language and nuanced meanings of words we use around birth and perinatal support. For instance, in order to open up some of the “places of vulnerability and softness,” Liz Koch would like people to be able to access before baby arrives, I might invite people to unpack the word “nurturing,” a word we hear often around birth and newborn/new parent care. I ask them what qualities or behaviors would make someone a “nurturing” helper for them. Answers I've heard include: They listen deeply to me; they respect me and my sacred time and space with baby; they smile at me; I can be honest with them.

In my experience, giving time and focus to this sort of exploration can be new terrain for expectant parents. Having the time and place to articulate things like this helped people realize how they wanted and deserved to be treated. It also helped them think about who in their life possessed these qualities. If they couldn't think of anyone, we explored other avenues they could pursue—an expectant or new parent support group or a faith community that offered support for new parents. We talked about getting specific with “asks” so as to maximize the benefits from each helper (this can not only help the new parent, it can also help the helpers, who may not know exactly what to do).

One way we unpacked emotions was by looking at something I am working on and refer to as “The New Parent's Scale of Opposites.” I noticed that there were opposing feelings or pulls a “newborn parent” might be experiencing simultaneously, without even realizing it, for example, the need for privacy vs the need for social support; what can go wrong attitude vs what can go right attitude; what your body is telling you it needs vs social or cultural pressure to “bounce back” quickly. Each set of opposites opened up conversations for self-exploration, personal growth, empowerment, and self-awareness. I invite people to use this tool prenatally, to get a sense of the lay of the land before they get there; I also invite them to use it as a check-in tool in a rough moment after baby arrives, when they can't find the words or identify the stressor. (Note that this tool is not meant to help a new parent become perfectly balanced at the midpoint. Rather, it is to help someone identify which set of opposites they're caught up in at any given time, do a quick check on where they are on that line, and ask themselves: What do I need more of? What do I need less of? Do I need more privacy (as in “I have to get off this phone call now”) or more social support (as in “I'm feeling really insecure about bathing this baby today, and I need to call someone who can talk me through it and tell me I'm doing a great job!”).

IN SUMMARY

Much of this planning approach is based on breaking things down and making them simpler and more manageable. That might mean checking something off in each category, getting comfortable with more nuanced understandings of the language we use, or naming more places on the emotional map of new parenthood. While the categories are generic, this approach also gets down to specifics. Within each broad category, every person can customize and personalize a perinatal peace-of-mind plan based on their needs, traditions, preferences, priorities, resources. There is no agenda. No “right” or “wrong” way. Just their way, and the opportunity to discover, in more depth and detail, what that is. Because it is both generic and specific, it can be adapted and offered in culturally congruent contexts, making it inclusive of all family structures, all gender identities, and all Black and Indigenous people of color.

We created this in a space that didn't exist before. (personal communication, Jane Honikman, founder of Postpartum Support International and Postpartum Action Institute, co-author, Parental Mental Health: Factoring in Fathers).

In the 1970s, Jane Honikman and a group of colleagues who were also new mothers started a support group in California called Postpartum Education for Parents (PEP). A decade later, she founded Postpartum Support International, and is currently establishing Parental Mental Health, a movement to include expectant and new fathers. When I talked with Jane in 2016 about her early work on emotional support for parents, she shared this perspective: “It has been a social movement. We have to remember that we created this in a space that didn't exist before.” These words stayed with me. We created this in a space that didn't exist before. Of this movement and space, she said, “It's organic, and we need to let it move and grow and revisit words and language and impressions and failures.”

Jane's words inspire me to keep experimenting with an evolving paradigm in a space that didn't exist before, revisiting words and language and impressions and failures.

The words of two women I worked with also inspire me, and validate my belief that there is a great unmet need that we can begin to meet in new, creative, and simple ways.

I met with Molly twice, in person, when she was in her third trimester (pre-COVID). Without realizing it, she hit the “nocebo effect” on the head when she wrote me: “Honestly, just talking about the postpartum time as being positive was so helpful for me. I have had so much information thrown at me during this pregnancy it was a breath of fresh air to have you talk about finding a quiet/happy corner for myself and baby, and ways to make the first 4-6 weeks successful. Focusing on all of the things that we can do, as opposed to everything that can go wrong … was very important and helpful for me…. By me having a clear idea of what I think will work best, it is helping everyone (who wants to help but didn't know what to do).

Rosie and I met twice, via Zoom, during COVID, when she was weeks away from having her second baby. She confirmed how important it is to give dedicated focus to an overall and uplifting vision that enhances confidence, self-awareness, and perinatal well-being. She wrote me,

Thank you for listening and guiding me and mostly for giving “being mother-centric” the thumbs up—I needed to hear it, and I wish I had heard it with my first. Feeling heard, by you, is and was incredibly comforting … Overall, I head into this postpartum experience with a much clearer vision of what is to be held on to and what is to be let go of. I can't express how much more confident I feel going into this knowing I have touched these bases with you.

NEXT STEPS IN AN EMERGING PARADIGM: “PERINATAL PARTICIPATION”

In the winter of 2021, I launched a new website that focuses, in part, on what I call this emerging paradigm of perinatal participation. I work with individual pregnant people, couples, and small groups of pregnant people (4–6).

I want to underscore the importance of including spouse/partners, not only in the role of support people for the birthing person, but also as participants who are undergoing their own multiple transitions and deserve their own support system. I stress this with every couple. We try to identify who or what those supports might be and explore ways to bring them into the scenario.

The small groups sessions emerged when an individual I was working with expressed her desire to have a session together with other pregnant persons to combat the isolation she was feeling as a result of the pandemic. The small groups allow for intimacy within a safe, and focused context and can create connections that sometimes continue long after our sessions are over.

My goal is that people experience the sessions as nurturing, informal, informative, practical, uplifting, even adventurous. After all, new parenthood is an adventure into the unknown. If we can take the time to gently acknowledge some of that vulnerability in our sessions, it may help people get comfortable with asking for and accepting help later on—especially after they have gotten confidence and clarity about what they want to ask for.

One hope I have is to see this targeted perinatal participation paradigm become part of every pregnant person and couple's preparation and adapted in culturally congruent ways and settings. In addition to the important work childbirth educators are already doing, they are uniquely positioned to raise awareness about the importance of having a support plan for after baby arrives, reframe the approach, and plant seeds about creating plans in ways that shine a spotlight on peace of mind, self-confidence, and a sense of emotional well-being. One simple way to begin to do this in classes that already focus on postpartum support could be to introduce the concept of an expanded timeline, discuss the benefits of continuity of care elements in a support plan, offer examples, and encourage participants to start thinking about who or what in their own lives could be brought to the foreground in this way.

Going forward, in addition to working with expecting parents, I'm working on a book and other materials about the perinatal participation paradigm and more peace of mind on the perinatal journey. I'm also developing sessions for doulas who want to learn about and bring this perspective into their practices.

I'm grateful to the pregnant persons, spouses, partners, and new parents I have worked and talked with for sharing this intimate time in their lives with me and to all those who are dedicated to finding and implementing new, responsive, uplifting, culturally congruent ways to help people have a smoother journey throughout the perinatal period—especially after their precious babies arrive. I'm looking forward to continuing the conversation!

Biography

SALLY J. PLACKSIN is a New York-based multi-award-winning author and public radio writer/producer of over 300 public radio programs in the fields of jazz, literature, arts, and parenthood. She works with expectant parents to help them create postpartum support plans that highlight peace of mind and emotional wellbeing. She wrote and produced a National Public Radio documentary on Supportive Postpartum Traditions in Diverse Cultures. Her 1992 book, Mothering the New Mother: Women's Feelings & Needs After Childbirth, continues to be on required reading lists for doula certification programs. She is a Birth Story Medicine Listener and a Becoming Us New Parenthood Tour Guide.

DISCLOSURE

The authors have no relevant financial interest or affiliations with any commercial interests related to the subjects discussed within this article.

FUNDING

The author(s) received no specific grant or financial support for the research, authorship, and/or publication of this article.