Tough Times For New Moms


Out of the hospital in two days, overwhelmed by relatives for the next three, new mom Denise Smith was exhausted when her husband left for a business trip. From her window in Glen Arm, she couldn't even see another house. There she was, all by herself, 24 hours a day, with a fussy new baby who refused to go to sleep.

"I laid her in her crib, went to the guest room and cried, and ## came back and said, 'OK, let's try that again,' " she says. The next morning, she gathered her strength to sign up for a new mothers support group at St. Joseph Medical Center. When she arrived, Mrs. Smith was in tears. "If not for this group, I would be in Shephard Pratt (the psychiatric hospital)," she says.

Exhausted, isolated and desperate for the companionship of others who understand their experience, new mothers call hotlines, sign up for groups at hospitals, or walk the malls in search of other mothers. For some, a special mother's lounge at Nordstrom's is the closest thing they've got to a support system to guide them through the difficult physical and emotional changes that accompany birth.

Across the country, the rituals of welcoming the next generation are caving in. Neighbors who once stopped over with a tray of lasagna and a sympathetic ear are working; parents and in-laws who once lavished attention on their new grandchildren live in other states; and friends who once filled hospital rooms with flowers don't order them anymore because the stays are so short.

The lack of organized support makes the 1990s a terrible time to have a baby, says Marian Malinski, a veteran labor and delivery nurse and educator of new moms at St. Joseph Hospital.

"Emotional support for the mother is not there," she says.

The societal changes come at the worst time for new mothers, who are being pushed out of hospitals in a day or less and forced to return to work in six to 12 weeks.

"There really is no post-partum care in the United States" once new mothers leave the hospital, says Dyanne Affonso, dean of the school of nursing at Emory University in Atlanta. In other cultures, new mothers are aided in their healing and recovery process by being relieved of all responsibilities except caring for the baby.

"In the U.S., we see childbearing as a product. Once the baby is done, it is done," she says. Yet, she says, "reproduction is a social event. You are reproducing for the next generation. With 12- and 24-hours stays, society is saying to women, 'You will do your healing on your own.' "

Perhaps in response, the number of women experiencing post-partum depression is on the rise, affecting between 12 percent and 20 percent of new mothers. Dr. Affonso calls it a cry for help.

"We are pleading for help. No one is hearing. Women are silent sufferers," she says.

Full recovery takes a year, says Dr. Affonso, and "the people who know that best are fathers -- in the U.S. fathers are overwhelmed by the needs of women."

Dr. Affonso has charted the state of childbirthing by talking to new mothers and fathers for five years in a project for the National Institutes of Health. Her conclusion: "We need to redesign the whole system. If we can't deliver care at the hospital, we have to deliver it at home."

Back to work

For most of this century, giving birth was considered a major event that took months to recover from. Members of the extended family tended to the new mom for weeks after the birth, often taking charge of cooking, cleaning and caring for other children. Through the 1940s, most women stayed in the hospital a week and those who could afford it often hired private nurses to stay with them another week or two at home, says Regina Cusson, associate professor of nursing at the University of Maryland.

In the 1960s and 1970s, a routine birth was still a three- to four-day hospitalization and a C-section was a week. And even in the 1980s, when parents began shortening hospital stays on their own, women didn't return to work as often and as soon they do now.

In the 1990s, 53 percent of women return to the workforce after childbirth, according to the U.S. Census Bureau. Many of them are older, college-educated and have moved away from home and family to establish their careers. Their mothers and grandmothers, sisters and brothers who would be aunts and uncles, either don't live nearby or are themselves working. Their husbands work, too.

Pushing women out of the hospital in 24 hours for a routine birth or 48 hours for a C-section is the latest blow to an already frail post-partum system.

Yet the stress of labor and the needs of women who go through it are unchanged.

In those first 24 hours, a new mother nurses eight or more times, tries to eat and get major bodily functions working again. She is bleeding, cramping and sore from nursing.

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