Are hospitals sending newborn mothers home too early?
I rarely read the newspaper these days, but today the front cover caught my eye.
"Australian Medical Association president condemns hospitals sending mums home ‘too early’."
The article mentions a statement by the Australian Medical Association that women are pushed out of hospital too quickly after giving birth, and should be given more support before being discharged.
Back in our grandparents' day, mothers would have stayed in the hospital for two weeks. Whilst having many advantages, this was not always well executed in the details. Many babies were separated from their mothers in the nursery and cuddles and breastfeeding was restricted.
I have seen the degradation of postnatal care even in my short seven years of motherhood. When my first was born many women chose private hospitals simply so they could stay in for five days afterwards with better food and a private room they could share with their husband. But in more recent years even those mothers still paying the same insurance premiums are being sent home after one or two days.
As someone who has been working and advocating for postpartum support for a decade this comment, in particular, got me a bit wound up...
"Dr Gannon Questioned Why The Women’s Movement Had Not Done More To Help."
In one way I agree, motherhood is one of the last areas to be reached by feminism. Acknowledging the changes and differences that come about as a result of motherhood is difficult when we've spent our whole lives embracing the idea of wearing the pants and doing whatever men can do. It can come as quite a shock when we become mothers and realise just how DIFFERENT our life experiences, brains, biology and opportunities are from men's. Feminism is still catching up.
The lack of focus of the women's movement on postpartum is also partly due to the fact that there are SO MANY other more extreme and violent struggles facing us as women - domestic violence, homelessness and poverty to name a few. There simply isn't a whole lot of bandwidth left.
But most of all it's very interesting to me that mothers and midwives have been lamenting the lack of postnatal care for many, many years without any response. Suddenly Micheal Gannon, a white, male, obstetrician, mentions it and the issue appears in multiple newspapers - even on the front page - and on national morning television.
Whilst I regret the lack of leverage we as women hold with the media I must thank Dr Gannon for bringing this to their attention. Social media was suddenly filled with mothers comments and experiences and opinions on what I consider to be a very important subject.
The responses varied. Whilst a few women had excellent extended hospital stays many women would have preferred to stay longer and felt their health and their baby's health suffered because they were sent home too early.
But perhaps a more surprising response was the huge number of mothers couldn't wait to leave the hospital as soon as possible. I would argue that this has something to do the quality of care offered. There are a number of reasons why hospitals are not the loving, gentle and cosy place you'd choose to spend your first few days snuggling with a newborn. For example:
Barely edible food, fluorescent lights, poor central heating and cooling systems.
Time spent away from partner, children and other family who would like to be included in this bonding experience.
Interruptions to sleep (day and night!) and shared rooms.
Lack of support for safe co-sleeping, uncomfortable beds.
Conflicting and unhelpful advice on breastfeeding.
Judgmental staff and lack of evidence-based care.
I personally opted for early discharge after my third baby was born, choosing to leave the hospital at 3 am rather than stay get some much-needed sleep! Other than the actual trip home in the car on the cold, dark, winter's night, it was a completely blissful experience! But only because I had support lined up at home, which brings me to the obvious solution to this challenge.
The support that mothers need after childbirth is largely non-medical. Pregnant, birthing and postpartum women are not always ill, but still, require an enormous amount of emotional and physical support. Hospital is expensive and medicalised, so I suggest the best result is early discharge with a publicly funded intensive home support program.
Newborn Mothers don't only need help with obvious things like breastfeeding and fundamental parenting skills, they also need practical help with cleaning, cooking and childcare whilst they recover, catch up on sleep, fall in love and learn to breastfeed.
Whilst visiting midwives are excellent and essential, I would add home visits by lactation consultants and GPs.
But the most important and biggest impact addition to this in-home care program would be a doula. Postpartum professionals are trained and experienced in guiding mothers through postpartum with confidence and ease. Postpartum professionals can help to normalise many new and surprising experiences of motherhood. Postpartum professionals can support normal breastfeeding and refer to more specialised support when needed. Postpartum professionals can help with practical tasks such as cooking, tidying and managing visitors. Postpartum professionals are trained to spot red flags and refer clients to medical professionals, perhaps before families even realise there is a problem.
Quite simply, postpartum professionals bring Newborn Mothers peace and joy, in the safety and comfort of their own homes. And I think all mums would appreciate that.
The article particularly pointed the finger at public hospitals saying early discharge is a 'cost-saving measure.' But surely the finger should be pointed at the government's systematic cuts to public health and privatisation of more and more of our public services. Instead of demanding an answer from the Department of Health, we should aim fire at our politicians.
Ultimately the slow and simmering problems of postpartum get little notice in our culture of mother blaming. The results of neglecting postpartum mothers can take months and years to surface. And the challenges we face as mothers can be kept excruciatingly private for fear of being blamed, ridiculed or deemed unfit.
Occasionally the results of postpartum neglect are total and devastating, with suicide the leading cause of maternal death in Australia (and much of the developed world.)
But usually, the results are more quiet and private. It's time we started to speak up. And most importantly, it's time that we stop blaming mothers and start listening. Neglecting mothers is neglecting babies, and the entire future of humanity depends on this.
Do you want to make a difference in the lives of new families?
Postpartum Education and Care Professional training is an evidence-based course run by Julia Jones in collaboration with a midwife, breastfeeding educator and a social worker. The course teaches how to care for new families with guidance on everything from supporting nutrition, breastfeeding, sleep and mental health to listening with a non-judgemental ear, celebrating with rituals and rites of passage and setting up a business.
The course is recognised by the Australian College of Midwives, DONA International and the Australian Natural Therapies Association.
Click here to learn more about stepping into a professional postpartum care role and making a difference for mothers and babies.