Erin L. Murphy
The chatty technician stood up to leave the ultrasound room. I asked her if everything was OK, and she gently responded that she was unable to explain anything without the doctor. My partner and I looked at each other. We held each other’s hand, knowing something was wrong.
We waited.
When the technician returned with the obstetrician, she confirmed the problem. The baby was fine in utero, but I had a condition called placenta previa in which the placenta grows above the cervix. I would hemorrhage if I went into labor, and in a worst-case scenario we could both bleed to death.
We scheduled a cesarean delivery. We stopped attending our birthing classes. Instead, we prepared for surgery and potentially a longer and more difficult postpartum recovery.
We were lucky in some ways, though: Our family rallied around us. Even though they lived hours away, my mom, my in-law’s, my dad and his wife all offered to stay with us after the baby was born. We would have help for weeks. Knowing this provided us immense comfort as we dealt with other stressors, like related pregnancy complications and our jobs.
Today it is more common than ever to live a long distance away from our parents. Cheaper airfare and video chats help maintain these long-distance connections, but they don’t help with the day-to-day realities of recovering from childbirth and transitioning to parenthood. In addition to these challenges, many grandparents still have day jobs.
What is most troublesome, however, is that many parents have jobs with no paid leave. So, even with the guaranteed six weeks off of work through the Family Medical Leave Act (FMLA), they can’t afford to take it.
When you couple going back to work and not having external support, you have to wonder how these families, mothers in particular, do it? It’s hard enough with help and paid leave.
Well, it turns out, it is even harder to do it without support and paid leave. Shocker, I know.
Come to find out, being without an adequate support network and with no time off are two huge stressors that make suffering from maternal depression much more likely, according Postpartum Progress.
In fact, according to the CDC eleven to twenty percent of mothers experience symptoms postpartum depression, making it the number one complication of pregnancy in the United States. That’s right, number one.
Postpartum care is a public health issue given the likely underreported rates of depression and the physical realities of recovering from birth.
In order to raise awareness about maternal depression, Postpartum Support International designated May National Maternal Depression Month. What exactly causes postpartum depression needs to be investigated further, because unfortunately, there is too little research on postpartum health.
What is truly shocking is how overlooked postpartum care is, in favor of a “babies first after birth” model. We need a cultural shift to create an environment where new mothers feel socially supported, especially to speak out without shame if they are feeling down or overwhelmed.
When at least 10 to 15% of women will experience postpartum depression (self-reported), it is crucial to provide adequate social support. And some work has been done (where Illinois was actually in the lead) to catch these women, such as the mandatory screenings in Illinois for mothers at their postpartum checkups. Building on these improved guidelines, we also need broader community education and resources for mothers and their support networks to use in those difficult times.
Toward this end, a culturally recognized period of postpartum rest would be one of the easiest ways to improve mothers’ postpartum health. Such a rest period would provide mothers a time to heal, recover, and bond with their babies. In countries all over the world, from Europe to East Asia, there are valued cultural practices where family and friends care for the mother and the baby, not just the baby. The mother is expected not to work but to rest. They recognize a mother is born as well.
One recent study found that postpartum depression can actually be alleviated when mothers take at least one hour of time alone for themselves weekly and get adequate rest. This may seem obvious, but without support, even taking a shower with a newborn can seem impossible. And if you are expected to do it all by yourself–by your family or by your own set of expectations–showers and alone time are no longer valued priorities.
In fact, another study of postpartum depression found that lack of social support was a leading risk factor for postpartum depression.
In the northern and western European countries, home visits are paid for by insurance for months (often with a nurse or midwife visiting daily or weekly) as established aspects of a postpartum-care culture. In stark contrast, the United States only guarantees mothers six weeks of unpaid leave (and therefore many can’t take it) through FMLA, with no thought of in-home visits.
According to the Organization for Economic Co-operation and Development, the United States is the only advanced economy where there is no mandated paid maternity leave (and one of only nine with no mandated paternity leave). Mothers in the United States bear a unique societal burden of expectations to get back to work and care for their families almost immediately after birth.
Add to these pressures the increasing isolation many families experience from having dispersed social networks and supporting new families during the fleeting postpartum period is an urgent social need, and I argue social responsibility.
To be sure, there are problems postpartum care programs would face. First, they cost time and money, something scarce in today’s Illinois budget. It seems unlikely that the state would step in to address such needs at this point, even though research for the Pew Charitable Trust has found for every dollar spent on home visits, two dollars is saved later in insurance costs and fewer health problems for the whole family, including reduced maternal depression.
While these programs would not prevent all cases of postpartum depression, in particular where there are biological factors involved, they would help alleviate many of the stressors that contribute to the hardships of overwhelmed, tired, healing mothers.
But postpartum support would not only strengthen mothers, it would also help their partners, many of whom still do not have parental leave, paid or unpaid, or feel unable to take a leave for a variety of social reasons. Thinking bigger picture, creating healthier babies and families also fosters more resilient, caring communities, with children ready for kindergarten.
After my son was born, I had the benefit of our parents having the economic ability to come stay with us, either through paid vacation or by virtue of retirement. But I became deeply concerned with how other new parents, mothers especially, were able to heal, bond with their baby, and handle both activities of daily living and often the return to work without adequate support.
I wanted to do something for new families who needed stronger support networks in those crucial few months after birth.
That led me to co-found Sistering CU, a new organization (currently working toward nonprofit status) dedicated to helping mothers and families. Our programs start locally by promoting educational awareness of postpartum issues and providing weekly in-home visits by volunteers to families who would like a little more support in those few months after birth. At no cost.
Our mission is to alleviate factors that contribute to maternal depression and to support the self-confidence of new parents. We hope our programs will create awareness of postpartum issues and a cultural respect and appreciation for the importance of postpartum care.
If you are interested in how you can contribute locally, you can visit our website at http://www.sisteringcu.org or our Facebook page at http://www.facebook.com/sisteringcu. There you will find more about how to volunteer your time and/or donate. Together, we will provide the sister joists for families around Champaign-Urbana who could use a little support, regardless of income, race, gender, or citizenship. We believe all families matter.