Postpartum Support Isn’t Spiritual. It’s Science.

By Shanna Harding, Food Scientist and Certified Postpartum Doula, Resting Rituals

Can I tell you what quietly frustrates me about my own industry?

Postpartum support keeps getting dressed up as something mystical. And if ceremony and ritual speak to you, genuinely, no judgment. There’s room for meaning-making in this season, and I believe in marking it. But somewhere along the way, the framing has put off a lot of women. The ones who see moon ceremonies and crystal talk and think, ‘that’s just not me.’ And if you’re anything like me, you want to see some evidence before you invest in anything.

I’m a food scientist. Before I’d hire support for the most demanding season of my life, I’d want to know what the research says.

So here it is.

Support cuts the risk in half

One of the clearest pieces of evidence comes from the Listening to Mothers in California survey, an analysis of around 2,700 women after birth. Women who reported receiving consistent social support had half the rate of elevated postpartum depression and anxiety symptoms compared to women who didn’t. That held even after researchers controlled for demographics, pregnancy factors, and prenatal mental health (adjusted odds ratio 0.50).

Half. Not a marginal improvement. Not a nice-to-have. One of the strongest protective associations in the postpartum literature.

And it’s not a one-off result. Systematic reviews and meta-analyses consistently identify low social support as one of the major risk factors for postpartum depression, across countries and cultures.

What about doula care specifically?

A large 2022 study published in eClinicalMedicine followed women across three US states and compared those who received doula care with closely matched women who didn’t. The women with doula support had 57.5% lower odds of postpartum depression or anxiety.

I want to be precise here, because precision matters to me. That study looked at doula care across the whole maternity continuum, from pregnancy through to postpartum, in a US population. Research on postpartum doulas specifically is still growing. One small pilot trial found mothers supported by postpartum doulas showed greater improvements in depression scores at six months than those receiving telephone support, but it was a pilot, and researchers themselves are calling for larger studies focused on the postpartum period.

So no, I won’t tell you doula care guarantees anything. What I can tell you is that the direction of the evidence is remarkably consistent: supported women fare better, and the effect sizes aren’t small.

Why support works: it’s physiology, not philosophy

Here’s the part that makes sense of all those numbers.

Support isn’t a warm abstract feeling. It changes the concrete inputs your body is working with. When someone is cooking for you, you eat properly, and nutrition affects healing, hormones, and mood. When someone holds the practical load, you sleep more, and sleep deprivation is one of the most reliable disruptors of mental health we know of. When someone steady is in your home, your nervous system spends more time in a regulated state and less time braced for the next demand.

I’ve written more about both of these before, in Your Body Needs More Nutrition After Birth Than It Did During Pregnancy and Why You Can’t Switch Off After Birth, and What to Do About It. Support is the delivery mechanism for everything in those posts. It’s how the good advice actually happens when you’re running on two hours of sleep.

The argument that convinced me most

Researchers studying postpartum depression make a distinction between risk factors you can change and risk factors you can’t.

Your history of depression or anxiety. Your hormonal shifts. How your birth unfolds. Whether your baby feeds easily. Most of the things that raise risk in postpartum are partly or wholly outside your control.

Support is different. Study after study points to it as the modifiable factor, the lever you can actually pull, and you can pull it before your baby even arrives. That’s why researchers keep recommending it as a target for intervention. You can’t plan your hormones. You can plan your support.

Not all support is equal

One more finding worth knowing. Research following women through pregnancy and the postpartum found that two dimensions of support mattered most for depression and anxiety: feeling genuinely valued, and having someone reliably in your corner. Reassurance of worth, and reliable alliance, in the researchers’ language.

In other words, it’s not just about someone dropping off a lasagne. It’s about consistent, dependable care from someone who sees you, the mother, not just the baby. Both practical and emotional support matter, and they work together.

That’s not a coincidence with how I’ve structured my work. It’s the reason for it.

If you’re looking for support, look at the training

A last practical note, because “doula” isn’t a protected title in Australia. Anyone can use the word. So if you’re considering postpartum support, ask where they trained and what the training actually covered.

I certified through Newborn Mothers, a postpartum doula training grounded in the research on maternal mental health, and the postpartum brain, breastfeeding, physical and emotional well-being (and so much more) and I pair it with my food science degree and yoga teacher training. I’m telling you this not to list credentials for their own sake, but because the evidence above is only as good as the person delivering the support. Training matters. Ask about it, whoever you’re considering.

What this means for your postpartum

If you take one thing from this post, let it be this. Planning support for your postpartum is not indulgent, and it’s not a spiritual lifestyle choice. It’s one of the most evidence-backed decisions you can make for your own recovery.

That might look like hiring a postpartum doula. It might look like organising your village deliberately, a meal roster, a weekly visitor who does dishes instead of holding the baby. The research doesn’t say it has to be me. It says it shouldn’t be no one.

If you’d like support that’s built on this evidence, that’s exactly what I do. My 6-week in-home package supports families from Caloundra to Noosa, and my 1:1 sessions are available Australia-wide. And if you’re starting with food, The Ritual of Nourishment puts the nutrition piece in your hands for $29.

You can’t control everything about your postpartum. This part, you can.

References

1. Falconi AM, Bromfield SG, Tang T, Malloy D, Blanco D, Disciglio RS, Chi RW. (2022). Doula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching. eClinicalMedicine, 50, 101531.
2. Listening to Mothers in California survey analysis (2022). The relationship between social support and postnatal anxiety and depression. Women’s Health Issues; consistent functional support associated with adjusted odds ratio 0.50 for elevated perinatal mood and anxiety symptoms.
3. Milgrom J, Hirshler Y, Reece J, Holt C, Gemmill AW. (2019). Social Support: A Protective Factor for Depressed Perinatal Women? International Journal of Environmental Research and Public Health, 16(9), 1426.
4. Bedaso A, Adams J, Peng W, Sibbritt D. (2021). The relationship between social support and mental health problems during pregnancy: A systematic review and meta-analysis. Reproductive Health, 18.
5. Gjerdingen DK, McGovern P, Pratt R, Johnson L, Crow S. (2013). Postpartum doula and peer telephone support for postpartum depression: A pilot randomized controlled trial. Journal of Primary Care & Community Health.