I’m a type-A person and an avid rule follower. I love a schedule and feeling prepared. As a first-time mother, I had no idea what to expect, which made me extremely nervous. Growing up, I spent countless summers babysitting toddlers in my neighborhood, but I knew that newborns were a different story. So, in the months leading up to my due date, I tried to become an expert on both labor and delivery and the newborn phase. I sought out as much information as possible to tame my nerves. I read books, took classes, practiced deep breathing, and strapped fake babies into car seats. It still wasn’t enough.
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Once I was in the hospital for my scheduled induction, nothing went according to “plan.” But, to my surprise, the actual birth of my daughter was a relatively smooth experience. This is even with a failed epidural, and a quick visit from the emergency c-section team, who ultimately were not needed. During those challenging moments, I was fortunate enough to feel completely supported by an amazing group of nurses and my obstetrician. While I was pushing, I felt like I had a personal cheerleading squad guiding me through each contraction. We were a team. We were in this together. All of us were working towards the wonderful goal of delivering “our” beautiful baby girl.
It was the two days following labor and delivery that ended up being the most stressful. It felt like all of the information I tried to process in the months prior was never absorbed. In those two days, I was drowning and trying to grasp for anyone or anything to help me care for my child. But unfortunately, with multiple factors at play, this control-freak left the hospital living her worst nightmare: feeling both mentally and physically unprepared to care for my baby. Here’s why and how I’d be better prepared (and more empowered) if I could do it all again.
Why I Left the Hospital Feeling Unprepared to Care For My Baby
No Nursery Meant No Sleep
Gone are the days of the hospital nursery, where babies could be monitored while the mother recovered and got some much-needed sleep. Instead, more and more hospitals are practicing “rooming-in,” which is when the mother and baby are together the entirety of their stay to promote bonding and increase the likelihood of breastfeeding. This is part of the Baby-Friendly Hospital Initiative (BFHI) launched by UNICEF and the World Health Organization in 1991.
Presently, nearly 30 percent of births in the United States occur in a Baby-Friendly certified hospital. In order to achieve this designation, hospitals must adhere to the W.H.O.’s 10 Steps to Successful Breastfeeding,” which consist of procedures such as rooming-in, not providing formula unless medically necessary, and supporting mothers in starting breastfeeding immediately after birth. Parents can search to see if their hospital is Baby-Friendly certified on the Baby-Friendly USA website.
The Downside of “Rooming In”
While spending as much time as possible with your baby may sound positive in theory, after giving birth, I was doing everything in my power to stay awake. Rather than take the baby to a nursery, I was wheeled by a nurse into my new room with our baby in my arms.
My daughter slept in a bassinet next to both me and my husband for our 48-hour stay. I use the term “sleep” lightly. The three of us slept in half-hour increments. We were complete zombies. Even with my husband on baby-duty while I tried to rest the first night, it’s pretty hard to sleep with a screaming newborn inches away from you. I would have given anything for even an hour of sleep while our baby was safely monitored in the nursery. When both parents aren’t getting sleep, I’m not sure how much “bonding” is possible. And it was difficult to learn how to care for our newborn when our brains were not functioning properly. It was survival mode at best.
Unfortunately, I’m not alone in my feelings of exhaustion and desperation during my hospital-stay. Many new mothers resent the policies in the BFHI. There are stories on the Fed is Best Foundation website about mothers dropping their babies while sleep-deprived, or babies suffering from malnutrition due to hospital staff pushing breastfeeding, even when it wasn’t working. Likewise, a paper published in the 2019 Journal of Pediatrics found that mothers who delivered at Baby-Friendly hospitals were no more likely to start breastfeeding than other mothers, which is the sole purpose of the initiative.
What to Ask During Your Hospital Tour
Since not everyone is on board with the BFHI, and not every hospital is certified baby-friendly, expectant parents should feel empowered to ask for options. It might be a good idea to tour different hospitals and ask if non-emergent nursery care is available. If not, you could ask if they offer quiet times, when lights are dimmed and baby assessments are minimized so mom and baby can sleep. Finally, don’t be afraid to be direct. Ask about the hospital’s policy on taking the baby to a nursery should you need a few hours of sleep.
Little Support After Labor & Delivery
Minutes after our daughter was born, she was shoved on my breast as I was given the ever-so-helpful advice of “feed her.” Simultaneously, another nurse gave my husband a pink, striped hat to put on our baby. He asked her if our daughter was supposed to wear this hat while she slept, to which the nurse replied: “Why are you asking me? You’re the parent.” This cold, tough-love response to a genuine question truly set the tone for our stay.
Our cheerleading squad seemed to have been left behind in labor and delivery. We were essentially dropped off in our room and told to feed our daughter “when she was hungry.” What that looked like, or how to feed her, we had no idea. There was no lactation consultant; no nurse offering to instruct; just a baby and two new parents eating vending machine salads trying to weather the storm of first-time parenting.
When any medical staff did offer advice, so much was contradictory: “Feed on-demand;” “feed every three-to-four hours;” “cluster-feed;” “don’t over-feed;” “don’t pump before the baby is six weeks old;” “let’s teach you how to pump now;” “pacifiers can cause nipple confusion;” “there’s no such thing as nipple-confusion.”
These contradictions left me, the avid rule-follower, feeling completely lost. Who do I listen to? Each comment was said with such conviction that I felt like I was doing something wrong when the next piece of (opposing) advice was given. Where was the consistency?
One thing was certain: I had no idea how to feed my child when leaving the hospital. Could I use a bottle? Was giving her formula acceptable? Will she ever breastfeed again if I give her this pacifier? Why did they give me a pacifier in the first place if I’m not supposed to use it?
What to Know About Postpartum Care
I acknowledge new parents experience varying levels of support based on the hospital resources available and individual nurses assigned to their care. Looking back on my experience, I should have asked for more help, or inquired about recovery support before my delivery. While I didn’t meet with the lactation consultant until the morning, I didn’t even realize that every nurse on staff was certified in lactation. In other words, I could have asked for help with feeding from my nurse in the middle of the night, had I known, or felt more confident. I didn’t have to wait for a consultant.
There are also interventions that can be implemented by nurses to make rooming-in more comfortable for mother and child, such as more frequent check-ins, orienting the patient, and patient teaching. New mothers will leave hospitals with a positive rooming-in experience if they feel supported by the staff, and knowing what supports are available ahead of time makes asking for help much easier.
A Diagnosis of Postpartum Anxiety and Depression
One month later, I was sitting in the pediatrician’s office as a complete shell of my former-self. Since leaving the hospital, my head was spiraling with questions and doubt. Thankfully, I had the support of my family and friends, but now there were more voices and opinions to add to the mix. I had barely left the house, let alone my baby’s nursery, and was continuing to operate on very little sleep and nutrition. I still had no idea how to stop my daughter’s cries, how to feed her without losing my sanity, or even how to swaddle her at night in fear I was “doing it wrong.” I was debilitated.
So, when our pediatrician told me she was concerned about my “very high” PPA and PPD results, I wasn’t surprised. I was confronted with the fact that my mental health was completely compromised, and if I didn’t get it in check, it could affect the baby. Our doctor gently explained how the mother is the heart of the home, and if she doesn’t take care of herself, how could she be expected to take care of a baby? This was my wake up call.
Editor’s Note: Postpartum anxiety and depression can feel isolating, but you shouldn’t have to feel as though you’re going through it alone. Please reach out to your doctor, a therapist, or another trusted professional for support.
If you are experiencing suicidal thoughts or actions, please get help immediately.
National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255)
Crisis Textline: text CONNECT to 741741
Reflections on My Postpartum Experience
After six months of therapy, medication (thank you, Zoloft!), support from loved-ones, and sleep, I don’t blame my ultimate diagnosis of PPA and PPD entirely on my postpartum hospital stay. However, it triggered doubt in my ability to care for my child, and that doubt paired with no sleep was a dangerous combination.
I do acknowledge that my overall hospital stay was indeed privileged. I’m fortunate to have given birth to a healthy child, while staying in a clean and safe environment with modern technology and medication. I know this is not the case for everyone.
However, I still wonder if this type of hands-off, “you’re the parent” approach is the best route hospitals should take. After talking to many of my friends who have given birth, it’s clear this approach was not limited to my hospital. These women described the same sensations of feeling “dropped off” in their rooms while rooming-in with their babies. It’s one thing to be left to figure things out on your own, it’s another to navigate contradictory information while also sleep-deprived. Is this truly the best form of care for new mothers? Does this set us on the right path for the hardest job and undertaking?
I believe society and hospital systems also need to more closely consider the mental health of women who may not have a supportive partner; women who don’t have mothers or mother-figures to teach them the tricks of motherhood; women without the means for a therapist, or access to medication.
My Advice to Expectant Mothers
If I could, I would tell my pre-child self, along with any expectant mother, to not stress so much about preparing ahead of time for labor, or life at home with your baby. So much of it is out of our control and may not go according to plan. Take a deep-breath, (lamaze or not) and do your best to relax.
If anything, I wish I prepared more for my actual postpartum hospital stay by researching the type of support I would be given ahead of time, such as availability of lactation consultants and nursery policies. And while I can’t change the fact that nurseries are closing, I can advise you to ask questions when you don’t understand and push for clarification over the contradictions. Don’t be afraid to hit that pager-button connected to your hospital bed. Be annoying. Advocate for your child and your needs. This is a human life we’re talking about, and if you’re anything like me, some consistent guidance will help you leave the hospital feeling a little more confident. You may be tired, but you’ll at least know how to swaddle.