WASHINGTON • There were many things about being a new mum that Ms Courtney Lee-Ashley did not know, such as how to remove infant poop stains and how often baby bottles must be sterilised.

But there was one thing she did know. She and her husband would be primarily on their own, with limited family help.

So before her son was born in April, she interviewed Ms Betsy Quilligan, a postpartum doula.

For US$3,600 (S$4,900), the couple bought 100 hours of her time, to come to their home two to three times a week for the first three months to help the family adjust to their new arrival.

She knew that new mothers were at risk of postpartum mood disorders, including depression and anxiety. She wanted to be sure that she had support.

Postpartum doulas are different from birth doulas, who support a mother during labour and delivery, and have different training than night nurses, who typically watch and feed a baby while parents sleep.

Neither of the Lee-Ashleys knew much about postpartum doulas before they met Ms Quilligan, but both are emphatic that she has been a valuable helpline.

The new mum credits Ms Quilligan with helping her establish a breastfeeding routine, something she struggled with initially, and facilitating better communication between her and her husband.

Countries with routine home visits after birth, such as the Netherlands, where professionals check in on the mum and baby at home and investigate any problems before they escalate, have lower rates of postpartum mood disorders, higher breastfeeding rates and better maternal and infant health.

The American Congress of Obstetricians and Gynaecologists has updated its postpartum recommendations to include such support.

Ms Quilligan, herself a mother of two, left her career on Capitol Hill to become a postpartum doula after her own experience with postpartum anxiety.

After her son was born in 2011, she suffered panic attacks. She sought psychiatric care and relied on her parents and husband for support.

"Seeing how common an experience it is for new parents really made me want to help others going through it," she said.

To earn the title of postpartum doula, she enrolled in a three-day, 30-hour workshop, focusing on maternal and infant care, breastfeeding and perinatal mood disorders.

Postpartum doulas are not certified to give clinical advice, but can provide professional referrals for additional assistance.

Ms Nikki Wray, one of the founders of Metropolitan Doulas, has more than 20 postpartum doulas on its roster, but demand exceeds supply.

Both she and Ms Quilligan agree that home visits can be a better barometer of how the parents and newborn are adjusting.

"Parents can put on a brave face when they go out (to see a paediatrician). When we see families in their own homes, we get to see how things are really going," Ms Quilligan said.

Postpartum doulas are not covered by insurance, with a four-hour visit costing US$140 to US$160.

Often, grandparents or friends will purchase postpartum doula services as a baby shower gift.

Ms Wray said when clients call, often sobbing and needing support, she will work out a plan and reduce the cost if necessary.

"As long as people know about it, they know they have options.

"They don't feel stuck."

WASHINGTON POST