A Tale Of Two Births: How The U.S. Fails To Deliver Adequate Postpartum Health Care
My daughter was born on a snowy Saturday morning. We were released from the hospital Monday, and as is the case for most new mothers in the United States, my husband returned to work the very next day, leaving me alone to care for our newborn daughter and our 2- and 4-year-old sons. At three days postpartum, my bones ached as I stepped out of the car and onto the frozen pavement of the parking lot at my doctor’s office. My deflated uterus contracted under the strain of the baby’s car seat; I braced myself against the car to keep from slipping on the icy ground. For a moment I thought I might not make it the 25 yards from the parking lot to the door. I remembered the hospital’s recommendation not to lift anything heavy for a few weeks and almost laughed. If only that were possible.
My labor had been induced due to high blood pressure and pre-eclampsia, which hadn’t resolved by the time I left the hospital after the baby was born. Puzzled, the doctor asked me to return to the clinic a few days later to recheck my vitals. When I arrived, my toddler jumped eagerly from the car, beaming with a frenetic energy that my combined six hours of sleep over the last three days couldn’t match. My heart was pounding in my ears as he ran ahead of me in the parking lot of the clinic, my broken body too heavy and tired to keep up with him. I arrived at the nurse’s station gasping and shouting at him between breaths.
Unsurprisingly, my blood pressure had not returned to normal and the nurse asked me to repeat the journey again in two days for yet another checkup. There was talk of bedrest, anti-convulsive medication, and the possibility that I wouldn’t be allowed to continue breastfeeding my 3-day-old baby. The nurse looked into my wild, tearful eyes and urged me to get more rest. I laughed out loud this time, hoisted my limp toddler onto one hip, slung the baby carrier over my opposite arm for balance, and dragged our tired bodies out of the exam room so that we didn’t all collapse in a heap on the floor.
I wanted to be angry at my husband for leaving us so soon, angry at the doctors for making me come into the office days after my baby was born, and angry at my own body for betraying me at a time when I needed it to be nothing less than superhuman. Instead, I sat nursing my squalling infant and watching my son put everything within a 10-foot radius in his mouth, and reflected on how different the postpartum experience is in the United States compared to the rest of the developed world.
When people find out my first son was born in the United Kingdom, the first question they ask is, “How was it different giving birth in the UK compared to the United States?” While there were a few notable differences in labor and delivery, for me, the most glaring discrepancies are in what happened afterward: the quality and accessibility of postpartum care.
Britain’s National Healthcare System provides everyone living in the country with the same level of support, even moms on student visas like I was. Additionally, in the UK and throughout most of Europe, fathers and domestic partners are entitled to at least two weeks of paid parental leave, allowing them time to bond with their newborns and care for their wives as they recover from the harrowing experience of childbirth.
Then again, had my daughter been born in the UK, there would have been no need for me to haul my newborn out in the cold weather, expose her to countless germs, and risk rupturing my own stitches simply to check my blood pressure. For two weeks after my son was born in the UK, he and I were assigned a team of local midwives who would visit us at home whenever we required a checkup.
There was no need to book appointments with a pediatrician or schlep a car seat around town every time my son had a rash or a cold. If I had a question about my health or the health of the baby, I could call the midwives 24 hours a day for a phone consultation, or ask them for a home visit during working hours. When I had difficulty breastfeeding my newborn, I simply called the midwives, and a lactation consultant arrived at my home the next morning and stayed for several hours and multiple nursing sessions. I never even had to put on a bra or leave the house.
After two weeks, my husband returned to work and I was discharged from the midwives’ care, but my support system was not entirely disbanded. My son was assigned a specially trained nurse, called a health visitor, who would look after his well-being for the next five years. At first, his health visitor dropped by our house several times a week, then gradually spaced her visits further apart until she only checked in every few months. However, she was available by phone or text message whenever I had a first-time mom moment of panic or insecurity.
When my son was 6 months old, I called her crying because he’d started violently resisting breastfeeding. She knocked on my door two hours later just to check him over and reassure me that he was happy, healthy, and chubby as a cherub. Her words of encouragement put my mind at ease and probably kept me from banging down my pediatrician’s door in a blind panic at 2 a.m. So too, studies have shown that when a new mother has adequate support and help during the perinatal period, she is less likely to suffer physical and mental health complications such as postpartum depression.
The stress of trying to “do it all” takes its toll on new mothers, and having a support network built into the medical system relieves some of that pressure. When my daughter was born in the United States, the responsibility of caring for three children under 5 years old, running the household, cooking meals, and getting all four of us to various appointments throughout the week drained me of every ounce of healing energy I had left after labor and delivery. I was drowning, so, of course, my body was locked in a fight or flight response. I needed help to come to me, and the American health care system wasn’t delivering.
Sitting in the waiting room of my ob-gyn’s office that day, surrounded by expecting mothers, I was overwhelmed by the realization that many of them would be forced to return to work after only six weeks or risk losing their jobs. Those who stayed home might wind up so exhausted and isolated from solely caring for their babies that they would succumb to the darkness of postpartum depression.
How can we call ourselves a civilized nation if we can’t even do something so basic as to care for mothers after the birth of a child? It’s time for the United States to catch up with the rest of the developed world and recognize that it is in everyone’s best interest to raise happy and healthy children, and the first step to achieving that is by giving mothers the time and help they need to heal properly after giving birth.
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