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Drive-Through Deliveries
Are they "Bad Medicine?"
By Holly Richardson, CD(DONA)
"Frightened and alone, new parents are thrust into the cast, intimidating wilderness of parenthood by unforgiving insurance companies who don't care if their babies live or die. Is that your perception of short hospital stays after the birth of a baby? For many media members and much of the American Public, it is. Senate hearings on the issue included parents whose baby died of meningitis, truly a tragedy. But is the answer really longer hospital stays? The issue is more complex than it may seem on the surface. Yes, it is difficult to learn how to breastfeed well in the first 12 to 24 hours, especially if mom was medicated. Yes it is a big transition, especially for first-time parents. Yes, babies can get sick in the first two days of life. And most definitely moms need extra attention and care. But, are hospitals the best place for new mothers to have their needs met? In most cases the answer would have to be no.
The reasons are many. For example, many nurses in the hospital have little knowledge of breastfeeding. Mothers receive faulty, often detrimental, advice such as "Limit your breastfeeding to three minutes a side, dear. It will prevent sore nipples." Even where lactation consultants are there to help, it does not mean that moms must be hospitalized to benefit from their help. This help can be given on an outpatient basis, even in the mother's own home if necessary.
Another very serious concern is that of "nosocomial" or hospital-acquired infections. It seems kind of silly to keep babies in the hospital to watch for infection that can be acquired by being in the hospital. Nosocomial infections cause millions of dollars of otherwise unnecessary treatments and days in the hospital.
In a recent study, it was found that the "taking hold" time of postpartum - that is, becoming comfortable with being a parent - is delayed until after the parents and baby leave the hospital. In other words, as long as the babies are "hospital property," many new parents will not assume their rightful place as sole care provider for this infant. Just look at how often new moms must ask permission to hold or breastfeed or bathe their new babies while they are still in the hospital. And, astonishingly enough, the answer is "no" on a regular basis!
So, what is the answer? Some hospitals and insurance companies provide for one or two postpartum follow-ups by a nurse. Many people are complaining, however, that the follow-up just isn't there. The nurses are never notified of the birth, they are too busy to come by, the moms don't want to "burden" anyone by calling and asking for help, etc. Many mothers are also uncomfortable sharing difficulties the may be having with breastfeeding, soreness, family relationships, etc. with someone they have never met before, and who is only there for 30 minutes. So, many questions go unanswered because the mother does not feel able to voice them.
I believe the answer is to have excellent postpartum care. Postpartum doulas are a wonderful means of providing this much-needed care. These doulas who are (usually) mother themselves, and come to "mother" the new mother. They can fix meals, do laundry, take care of older children, run errands, mop a floor or any myriad of things that should fall by the wayside after having a baby.
Besides these very practical aspects, a postpartum doula knows about breastfeeding, "baby blues," and what changes are normal, but can seem overwhelming to someone who hasn't slept for a week. Most importantly, a doula has a listening ear and a caring heart.
When new mothers are taken care of during the postpartum period, there are faster recoveries and fewer problems 9including mastitis, breast infection). Moms also experience more maternal confidence in parenting this new little person, less postpartum depression and better family relationships in general. Many countries with the best infant mortality statistics combine skillful midwifery with competent, thorough postpartum care. Every new mother has someone to take care of her during her immediate postpartum, no matter where or how she delivered.
That is definitely a huge plus for a national health care system. Doulas do not provide medical care. However, they do know what is normal and what is not, and have extensive reference lists for other needed resources.
Postpartum doulas are a cost-effective, joyful and fulfilling way to take care of new moms in the days and possibly weeks following the birth of their new baby. They are one of the best answers to the "drive-through" dilemma
Copyright © 1998 by Childbirth.org All rights reserved.
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