Should Moms Be Required to Keep Newborns In Their Hospital Rooms?

by Katherine Stone | 99 comments

nicole on November 23, 2010 at 8:46 am
I don't believe that rooming in the whole time, or sending the baby to the nursery for the mom to have some rest time, is going to prevent PPD or any of the other PMDs from happening! When I had my youngest, the nurse forced me to allow her to take him back to the nursery so I could rest! And yes, I did breastfeed him. She brought him back when he awoke so I could nurse him!

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Blair@HeirtoBlair on November 23, 2010 at 8:51 am
Just from my experience – absolutely not, it would make no difference. In fact, I would argue that I went into maternity leave & being home with him in even better shape because I got solid nights sleep in the hospital due to sending him to the nursery at night.
Furthermore, I completely intend to use the nursery again with another baby. As a higher risk for Postpartum Psychosis the next time around, I worry about being in the dark room alone with the baby, even if nurses are right outside the door. But that's something that my psychiatrist & OB will need to work on together with me.

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AllisonO of O My Fam on November 23, 2010 at 9:11 am
I would love to see those studies, too. I had a completely non-medicated birth, instant and extended skin-to-skin time, and everything else that is "supposed" to make PPD less likely.
We had Micah room-in with us, but the nurses offered to take and hold him if we needed, which was a great medium, I think.
I can't imagine not having the ability to put space between myself and the baby, had I needed it. Simply cannot imagine. Even those first cries made me feel like the world was going to end if they didn't stop. Knowing someone else could take him if I couldn't handle it was a great relief to me.

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Becky on November 23, 2010 at 9:11 am
Mom's should absolutely have the "time off" option! Those first few days are when reality sets in. You are exhausted, emotionally drained and your head is spinning. Those few hours where I allowed the nurses to take my children to the nursery so that I could rest, was so vital to my physical recovery and allowed me to regroup.
I have a long HX of depression so I can only speak for myself, but isnt PPD a chemical/genetic disposition that is only made worse by outside stressors? To say that rooming in would prevent PPD seems a bit much. Especially for women like myself who's PPD overtook them in a way that the flight instinct was winning over the fight instinct.
I also think forced rooming in would creeate feelings of resentment.
Just my own thoughts =) But this frustrates me. No mother should ever be required to do ANYTHING in her birth experience, outside of physical medical necessity.

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Annie @ PhD in Paren on November 23, 2010 at 9:18 am
I do believe that the default should be for the baby to room-in with the mother. It is preferred for bonding reasons and for establishing breastfeeding. A nurse in a nursery cannot read a baby's hunger cues in the same way that a mom with a baby rooting for her breast can. Skin-to-skin contact can be critical in ensuring a successful start to breastfeeding too.
That said, I do think that moms deserve rest. I think they should plan for other family members to be around to give them that rest when needed in the same way that they would 24 hours later when they are no longer in the hospital. I don't think it is the hospital's job to provide babysitting services. Or, if they do, it should be an additional service offered for a fee and not part of the default care package.
I think it would be great for hospitals to provide a space for family members (or other caregivers) to sit comfortably with newborns while mom has a rest. I just don't think it should be the typical "nursery" with lines and lines of babies in beds and a couple of nurses trying to ensure that all of their needs are met.

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- Erin on March 21, 2015 at 9:28 pm
  But I have no family to come in and help and I will be completely alone. My husband will be home with our three year old. And I had terrible post partum anxiety with my son. If a mommy needs rest after birth, either due to physical or mental necessity, this needs to be supported. You’re telling me I won’t bond with my baby when I am home?!
  
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Diane on November 23, 2010 at 9:19 am
While I can see hospitals making an effort to have mom and baby separated for a shorter time between birth and all that clean up they insist on doing, I don't see how non-stop rooming in would PREVENT postpartum depression/anxiety etc.
For me, I knew my husband would be working the whole week after I gave birth, so I was very glad to have the *option* of nursery care too. Enough with the all or nothing thinking regarding motherhood.

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Miranda on November 23, 2010 at 9:38 am
I absolutely do not agree that there's any correlation between rooming-in and PPD or nursery care and PPD. I can't see how that can be quantifiable with any sort of reliable certainty.
As for me, my birth went so awry from my original plan (which was much like Allison's) that I was completely out of sorts in the hospital. Looking back, I could feel the anxiety creeping in that something would go drastically wrong with breastfeeding and bonding if I let Joshua stay in the nursery. And our nursery was 4 babies to 2 nurses since our hospital was so small. But I refused even though my inability to console him in almost any way imaginable was huge. On our last night there, I did let him go to the nursery for a few hours, but I was unable to rest because I was convinced he was scared/needed me/would hate me for sending him there. I couldn't win.
I also think it's completely unrealistic for every mother to have family lined up to help her after she comes home. Is it ideal? Yes. But not all of us are living an ideal life surrounded by family able to take care of us. (And I realize that's totally not the point of this discussion, but still…)

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Katherine Stone/Post on November 23, 2010 at 9:54 am
Planning is everything. It's good to think ahead. And I know your docs are awesome, which helps too.

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Katherine Stone/Post on November 23, 2010 at 9:56 am
I have to add that if hospitals are so concerned with moms and babies being together, then why are we discharged before our infants in certain cases? My hospital sent me home while my daughter was still there with jaundice. They didn't seem the least bit concerned about the fact that I lived an hour away, and wouldn't be able to be with her the entire time while she was still admitted and I wasn't.

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Katherine Stone/Post on November 23, 2010 at 9:59 am
You make a great point about ideal situations. Everyone is SO different. Are we to make mothers feel as though they've somehow blown bonding if they don't have that constant skin to skin contact in the first couple of days? That their children will be forever affected somehow? How can that be possible, given how many babies are in the NICU, etc.?
I didn't room in with my son, and I also had postpartum OCD with my son, yet he and I are as bonded as two people can be. Like superglue, only more. I think there are ideal situations, and we always should strive for the ideal. I also think following the less than ideal approach doesn't mean all is lost.

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Pamela on November 23, 2010 at 10:03 am
I quite honestly believe that your are either going to have PPD or you're not going to have PPD (or any other postpartum mood disorder). I don't think you can prevent it. If you're doomed, then you're doomed.
A mother should at least be given the option to have the baby be taken to the nursery. Taking a nursery out of the hospital seems ludicrous to me. What about the new moms that had a traumatic birth? A C-Section? Too long labor? OMG, the list goes on.

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thordora on November 23, 2010 at 10:06 am
As I said briefly on Twitter, where I gave birth the hospital would not take the baby if you had someone rooming with you-which would be great if it wasn't the same person who had slept less than I had, my husband at the time. Once they read the chart, and saw we'd had nearly zero sleep for over 2 days, and I had been hemoragging, they ran in and took the baby so we could sleep.
It should be situational, offered to all mothers. Like someone else said, reality has just sunk in. You're tired, hungry (and in my case waiting for a D&C so I COULDN'T EAT for hours), scared and sometimes alone. Birth isn't a rose garden for everyone.

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Kristen on November 23, 2010 at 10:15 am
For the same reasons that she shares, I agree with Annie @PhD in Parenting that "the default should be for the baby to room-in with the mother."
On the other hand, this is not to say that I think that *all* mothers *must* choose this option or that they should be shamed for not choosing it. There should be some way for mothers to opt out of rooming-in, but the point is that this "opting out" should not be the *default.*
What's more, I think that the "success" of any rooming-in program probably depends upon the additional support that mothers receive in the hospital: Are the postpartum nurses readily available to assist with or teach mother and/or baby care when requested? Are knowledgeable, compassionate, patient, and well-trained lactation consultants available to help all nursing mothers, regardless of what their breastfeeding goals are? Do new moms have unlimited access to other personal support people, such as friends, family, and even postpartum doulas in the hospital? Do they have access to support people at the hospital if they don't have any support people of their own? Do they have access to tasty and healthy meals? Is there any continuity between the support they receive in the hospital and the support they receive at home (such as a helpline or home visit from a nurse, doula, lactation consultant, etc.)?
This sort of support system (along with default rooming-in option) might not exactly *prevent* all cases of PPD, but it still might promote women's postpartum emotional and mental health.

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Brandy on November 23, 2010 at 10:16 am
I haven't seen a nursery with 'lines and lines' of babies in years . . . and some of us simply didn't have extra hands to help us once we got home! With my second child, I knew the sleep-deprived days and weeks were coming and that I had no help except for my husband (who was working from 2am to 7pm every day!!!!). Yes, I sent my baby to the nursery!!!! Yes, I nursed! Yes, we did kangaroo care! And I am a better mom because of it, despite what anyone else may think! Two hours of uniterrupted sleep is a blessing and very much needed. On a side note, the nurses even said they LOVED having my kiddo to watch, since so many people are hard-core into rooming-in!

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Agnes on November 23, 2010 at 10:20 am
When I had my twins, they were in the special care nursery for 5 days after birth, and I didn't develop PPA.
Now I have a singleton, who has been with me pretty much since the recovery room (had some complications with my emergency c-section which required him and my husband leaving the theatre)and i've been hit with PPA BIGTIME. Having said that, I wouldn't have had it any other way than having him with me all the time 🙂

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Brandy on November 23, 2010 at 10:22 am
I am saddened by the thought that something so simple as sending a child to the nursery for a couple hours would even be considered to cause any type of depression or mood disorder! We as mothers are already over-judged for every decision we make. Why doesn't someone try to prove that THAT is what causes PPD/etc?!?!?!?

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Michelle S on November 23, 2010 at 10:29 am
If anything, being forced to "room-in" made things worse for me. The second day, I didn't see a nurse from early in the morning to late at night. I was left completely on my own. It just added to my frustration, my exhaustion, and my sense that my entire life had just been sucked away. I needed a rest, I needed assistance, I needed guidance, but I got none. And now I'm supposed to believe it was really all for my own good?
It just enrages me when ideologues push a certain agenda–the breastfeeding zealots and the attachment parent zealots are the two biggest culprits here–and smugly announce it's for the mother's benefit. (To paraphrase the song from Man of La Mancha–I am only thinking of her.)
And hospital staff caring for newborns is not "babysitting." It's their job to take care of patients, and the newborns are patients too. (Hell, in my case the nurses weren't even taking care of me.)
It's also not realistic to just assume that new mothers will have scads of family members coming in to help. My husband was as clueless as I was. My mother's age and health prevented her from helping much. In this day of nuclear families and women's liberation, not every family has a staff of female relatives on hand who will drop everything else and provide free round-the-clock services.
Depriving new mothers of nursery assistance is an injury. Declaring it's for their own good is an insult.

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Tricia on November 23, 2010 at 10:33 am
Like you so wisely said, each mother is different and needs to be respected for that. With my first baby, it was two days after Christmas and crazy at the hospital and they didn't even give me options at all. They shoved me into a postpartum ward without any directions at all, I still had a catheter that they "forgot" to remove and they told me to drink plenty of fluids, but when I tried to get out of bed with a catheter, IV etc. I couldn't even reach the water! They didn't answer my bell, when the baby cried and I rang it and rang it to get some help, no one came. By the time my husband got there early the next morning, I was distraught, exhausted and confused. It wasn't a good start, but I also know that it wasn't what led to my postpartum depression either. An entire host of circ*mstances led to that, things that I know now, but as a first time mother didn't.
I honestly think that the level of care at hospitals or birthing centres is VITAl though for a good outcome. Both my sisters had babies in Europe, Holland and Germany respectively. Firstly, everyone gets a visiting midwife, whether you have a hospital birth or not and they come every week to your home to check your progress, answer questions and generally see how you are doing both physically and emotionally. Then, if you do have a hospital birth, you can choose to stay for at least a week and two weeks for a C-Section. During this time, you are offered round the clock nursing rooms with support and care for the new mother – with bathing, dressing and breastfeeding the new baby. The new mother is NURTURED and given time to adjust and given rest if she chooses that.
That's where I see the problem in many USA hospitals. Moms are basically chased home 24 hours after the baby is born, some may need more time than others to adjust and heal and they should be offered those options. I had no family here when I gave birth, so it was me and my husband, and no help or support from the start. While I think that this was one aspect of my PPD and anxiety, I honestly think that my hospital stay and the lack of support I received did not send home with much confidence, rest or education. Nurses/midwives also continue to visit the mothers overseas for up to a month after the birth and they can then evaluate how the mom is doing and alleviate any worries about the baby/their mental health etc. I think preventative is what's missing here. Just my humble opinion, feel free to disagree. : )

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Melissa on November 23, 2010 at 11:50 am
hello, I am a 43 year old stay at home mom to 2. I suffer with PPD. Fortunately I had the incredible fortune to have my infants doctor tune in to me from the moment she met me and recognized the signs for PPD in me and we were able to get it mostly under control with injections of IRON and Vitamin B, B12, B complex. I happened to be severely anemic. The other part of my PPD and anxiety that comes from it is related to support. As I was reading the above article and comments there was not much reference to the importance of support. I personally don't feel the issue is whether or not the baby is in the room with you or not after he|she is born it is more about the support that you, the mother, receives. We, as a country, give very little support to woman when they are pregnant, during birth and especially after. We are expected to be super human and carry the strength for everyone . Interestingly enough, in other cultures, the community comes together to support the woman after child birth. There are even post partum doulas (I thought it odd I didn't read anything about doula's above) that can be hired. They are available to you as soon as the baby is born to support the mom; whether it is holding the baby, cleaning the house, doing dishes…whatever the mamma needs.
I've been talking and researching about what can be done and personally feel that our medical system needs to step up and offer support for the mamma for at least a year after her child is born (regular wellness visits for the mamma, insurance to cover the cost of a post partum doula, longer leave for the spouse or something to help support the mamma.
My PPD did not come about until a few months after my daughter was born. Most people want to believe it happens right away or not at all. This is why I feel at least a year of support is needed.
I am sorry to hear so many woman experience PPD. I want you to know that all of your articles and comments have been so helpful to me. Thank you all and I wish all of you the best and most of all, support.
Melissa

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Sam on November 23, 2010 at 12:26 pm
Being forced to room-in with my son was a complete nightmare for me. I had an undiagnosed tail bone fracture (which, 6 months later, still causes me pain) and was left, completely alone, to deal with my son overnight.
When I complained to the nursing staff about the pain and about being unable to cope, they offered me some ibuprofen and lectured me about the benefits of skin-to-skin contact. That was it. My husband found the next morning a complete mess of tears.
I realize that that was an uncommon situation, but one thing that I do feel strongly about is that a lot of these "experts" need to back off when it comes to dictating parenting decisions.

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Karen on November 23, 2010 at 12:48 pm
I think this is a very important conversation for us to be having. I've gotten so much out of reading the comments, seeing what happened in the different situations. It is so tempting to believe that there is a magic bullet – one thing we can do or change – that will prevent or cure PPD and other post-partum mood disorders, but when I see how differently women feel on one issue I alone, it reminds me of how complex mothering is, how complex our different medical histories, families and expectations can be.
There is so much polarization in the birth world right now – it seems you must have it all one way or all the other. Birth professionals – and I include myself as a birth doula and childbirth educator – must continually remind ourselves that our mission is to serve women and babies. We often get in our own way.
When a couple I worked with was unable to send their baby to the nursery b/c it didn't have enough staff to take-in healthy babies, I was happy to stay and rock her to sleep. When I tiptoed out mom, dad and babe were asleep. It was a good day.

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Eileen on November 23, 2010 at 1:02 pm
Wow, that doesn't make sense to me. In fact, it seems controlling and unnecessary. The option should be there. I have heard that skin-to-skin contact is important, but as the mom in your anecdote said, even if it is, not 24/7! I think that getting those hours to rest and recuperate before taking on total care for your infant make perfect sense. Also, FOR ME, it would be likely to help me move my mind beyond the birth experience I'd been focusing on and prepare myself for the new-baby experience, since when I get overwhelmed my depression kicks on harder.
I think birth should be more open and up to what the mother wants overall, and this is a step in the wrong direction. It's her birth and her baby. I don't like how controlling many hospitals are, which is making me want a birthing center/midwife experience…but I'll admit, one of my biggest hesitations is lack of nursery because they simply don't have them. I'll just have to make my mom come take my baby for awhile, I guess 🙂

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Katherine Stone/Post on November 23, 2010 at 1:06 pm
I completely understand what you are saying. And I don't think nurseries are always the perfect solution to every problem, for sure.
I guess what concerns me about the "default" is that a default can end up implying that the person who didn't choose the default is wrong in some way, or not good enough. Does that make any sense? As if, by asking for the option that most people don't take, you aren't a good enough mother, which is already a big issue for those of us with PPD from the start. The people most likely to need the default may very well be the people least likely to ask for it out of fear of being judged.
And what about the people who may have PPD who don't have much support at all, and/or couldn't afford the fee you mention. I hate to say that there are a lot more people like that than we think.
From the comments, it's clear to me that a major issue here is support for the new mom in a meaningful and continuous way. I'm not sure what form that would take so that every mother could have it.

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Katherine Stone/Post on November 23, 2010 at 1:09 pm
I do think in the future there may be ways to prevent or at least lessen the severity of PPD if docs take detailed social histories of moms in advance, know their risk factors, and have a serious plan in place that includes checking in by people who really know what to look for.
At the same time, I still don't believe nursery vs. rooming in has anything to do with PPD prevention.
See Also
Nursery Design 101: How to Design a Nursery

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Katherine Stone/Post on November 23, 2010 at 1:11 pm
I have to say, I'm really interested in how this conversation is going. Thank you ALL for commenting. Hope we get a lot more input here.
I think we need to talk about this more. If it is true that hospitals are changing the way they deal with moms and newborns, mothers need to know and be prepared for that.

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Katie on November 23, 2010 at 1:21 pm
I cannot imagine what hell it would have been if I hadn't been allowed to send E to the nursery every night when we were in the hospital! I had a C-section and totally couldn't even get out of bed by myself. That would have totally added to my stress and my PPD rather than distract from it.
I agree with those before who have said that each mother/baby is unique and needs a something special for their experience. We do not even all bond the same way.
Imposing beliefs (because let's face it, that is what this is. In no way do I believe that this is scientifically or psychologically sound) on others is just wrong. We all need to do what we feel is best.

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Walker Karraa, MFA, on November 23, 2010 at 1:24 pm
Miles of birth rights…
“Society exerts powerful influences to pull people toward social norm" (Walsh & Vaughn, 1993). ya think?
This could not be truer in what I term mainstream mommy culture. There is covert coercion to bend women to a social norm of birth. History of birth has always demonstrated this—be it the women in 1920’s fighting for the right to have anesthesia during labor, or the women today fighting for the right to birth at home without it—we are not immune to this powerful social mechanism, at the cost of advancing the edges, the future of women’s birth experiences.
Our fundamental, universal struggle with our reproductive rights, and the at times extremely ambivalent reality of the birth of our children do not escape these metadefenses. Sadly, the birth culture-women engage in bending each other to meet a social/class norm, but repress any movement beyond. Story of my life as a doula! We in the birth community stop the vertical development of a woman's spirit, her birth as her birth rite, somewhere between the homebirth and the operating room. Social norms of birth remains fear-based, with her locus of control firmly placed, by mommy-businesses, outside of the woman herself, and into the hands of western medicine model, or the spiritual midwifery model. There is a paradox in both paradigms. And our women suffer. And our girls need a future.
We encourage development of mother-consciousness only far enough to a reach a norm of needing other women but refuse to let a women's latent capacities emerge to the point of not needing us.
Net result? A birthing woman’s latent spiritual capacities are covertly suppressed. Women’s capacities to experience true spiritual growth at the most opportune time of her life, is inhibited by other women. As a doula, I recognized early on that telling a woman she would do better, or achieve her goals, or avoid her fears, or phsycial pain, or increase her “spiritual” experience of childbirth by having me there was in fact repressive of her most fundamental right to be normal, abnormal, natural, un-natural.
I can say this: if I am lucky enough to be alive when my daughter, Miles, births her child, I will go with her to the abortion clinic, to the elective c-section, to the pump-station, to the OB, to the midwife, to the hospital, to the shrink for meds, to the ends of the earth without judging her, without comment, without interference, but with witnessing energy of my ancestors, of all the women who faced the dilemma of life and death in the middle of their soul. That, is the right I gave her when I birthed her.

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Walker Karraa, MFA, on November 23, 2010 at 1:27 pm
Miles of birth rights…
“Society exerts powerful influences to pull people toward social norm" (Walsh & Vaughn, 1993). ya think?
This could not be truer in what I term mainstream mommy culture. There is covert coercion to bend women to a social norm of birth. History of birth has always demonstrated this—be it the women in 1920’s fighting for the right to have anesthesia during labor, or the women today fighting for the right to birth at home without it—we are not immune to this powerful social mechanism, at the cost of advancing the edges, the future of women’s birth experiences.
Our fundamental, universal struggle with our reproductive rights, and the at times extremely ambivalent reality of the birth of our children do not escape these metadefenses. Sadly, the birth culture-women engage in bending each other to meet a social/class norm, but repress any movement beyond. Story of my life as a doula! We in the birth community stop the vertical development of a woman's spirit, her birth as her birth rite, somewhere between the homebirth and the operating room. Social norms of birth remains fear-based, with her locus of control firmly placed, by mommy-businesses, outside of the woman herself, and into the hands of western medicine model, or the spiritual midwifery model. There is a paradox in both paradigms. And our women suffer. And our girls need a future.
We encourage development of mother-consciousness only far enough to a reach a norm of needing other women but refuse to let a women's latent capacities emerge to the point of not needing us.
Net result? A birthing woman’s latent spiritual capacities are covertly suppressed. Women’s capacities to experience true spiritual growth at the most opportune time of her life, is inhibited by other women. As a doula, I recognized early on that telling a woman she would do better, or achieve her goals, or avoid her fears, or phsycial pain, or increase her “spiritual” experience of childbirth by having me there was in fact repressive of her most fundamental right to be normal, abnormal, natural, un-natural.
I can say this: if I am lucky enough to be alive when my daughter, Miles, births her child, I will go with her to the abortion clinic, to the elective c-section, to the pump-station, to the OB, to the midwife, to the hospital, to the shrink for meds, to the ends of the earth without judging her, without comment, without interference, but with witnessing energy of my ancestors, of all the women who faced the dilemma of life and death in the middle of their soul. That, is the right I gave her when I birthed her.

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Walker on November 23, 2010 at 1:30 pm
Empowering women never involves taking away her choices.

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AllisonO of OMyFamil on November 23, 2010 at 2:36 pm
You have a great point here. We must have paged a nurse every other hour for nursing positioning, advice, and gosh all sorts of things I can't even remember anymore (probably things like "is it ok that he has the hiccups?" and other new parent scares 😉 ). But I do know that we felt incredibly supported. I would say nursing and staff support is more realistic to implement universally than for every single patient to have ample local family support.

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Walker, Texas Doula on November 23, 2010 at 2:37 pm
As I read these amazing women, I am struck by the theme of personal experience really informing the dissatisfaction with status quo, and moving us out into others…to hear, help and heal.
I also think it is very interesting that the women posting here with you, Katherine, for the most part, are the tweeple who are for the choice to room-in. where are the comments from the other side? I love a good discussion.

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bad mummy on November 23, 2010 at 8:07 pm
I was a patient of the Peri-Natal Mental Health program at Mt Sinai in Toronto because I was ear-marked while pregnant at being likely to suffer from PPD. Had I delivered my daughter at Mt Sinai, I would have been part of a program that allows mothers to stay in the hospital for 5 nights, with the baby going to the nursery over-night and through-out the day so that the new mum can rest. Studies have shown that simply getting enough rest in the early days can lessen the chances of dealing with PPD.
Since I didn’t deliver at Mt Sinai, I wasn’t able to tap into this resource. I delivered at another hospital and my midwife emphasized that I would feel more comfortable at home, so baby and I checked out and headed home just 5 hrs after delivery. I went nearly 2 days w/o sleeping before passing out on my couch with my newborn.
I think that mothers should absolutely have the option to send their baby to a nursery, without additional cost and w/o guilt. Mom’s emotional and mental health far outweighs the need to establish breastfeeding (if that is, in fact, the feeding choice being made. Annie’s assumption that breastfeeding is the default option isn’t fair or realistic). As well, not everyone has an instant support system that shows up when baby does.

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Ami on November 23, 2010 at 3:36 pm
This is a tough one.
As a childbirth educator/doula I am all for rooming-in & skin to skin contact immediately following birth.
But I had PPD symptoms after both my hospital birth when I had a break and also after my home birth. So strictly from personal experience, I do believe moms should have a choice. From a research/birth professional experience, I think the more we can do to keep moms & babies together from the start, the better. Quite frankly, that starts with creating better labor and birth support, but that's another discussion! 🙂

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Emily on November 23, 2010 at 3:42 pm
I think that if moms really want to request to have the baby in the nursery, that is their prerogative, just like every other choice made in birth.
However, the baby can "room-in" and not be constantly skin-to-skin. Having the baby in a bassinet beside you is "getting a break" but helps establish good early breastfeeding and mutual sleep/wake rhythms for both mother and infant.

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Catie Mehl, LCCE, CD on November 23, 2010 at 3:49 pm
On a biological level, it does impact how we sleep and our postpartum mental state. Subconsciously, if our babies aren't near us when we're trying sleep, our brain knows it and goes into hyper drive wondering where the baby is. Think about it, does any other mammal send their baby to another room so they can sleep:
This is not to say a woman and her baby should be left in the room ALONE together. There should be more support there. Support from the nursing staff and family/friends.
However, studies have shown that mothers whose babies roomed-in slept slightly longer and reported a higher quality of sleep than mothers whose babies were in the nursery.
Keef, M R: The impact of infant rooming-in on maternal sleep at night. J Ob Gyn Neonat Nurs 17(2):122-6, 1988
Keefe, M: Comparison of Neonatal Nightime Sleep-Wake Patterns in Nursery vs Rooming-In Environments. Nsg Res 36:3, 1987

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- Erin on March 21, 2015 at 9:35 pm
  Well your statistic is not every woman. I am a very light sleeper and cannot sleep without quiet and darkness. I COULD NOT sleep with my infant next to me, and my son was in his own room since birth. (He is, by the way, happy, healthy, and loved very much)
  
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bad mummy on November 23, 2010 at 4:07 pm
I was a patient of the Peri-Natal Mental Health program at Mt Sinai in Toronto because I was ear-marked while pregnant at being likely to suffer from PPD. Had I delivered my daughter at Mt Sinai, I would have been part of a program that allows mothers to stay in the hospital for 5 nights, with the baby going to the nursery over-night and through-out the day so that the new mum can rest. Studies have shown that simply getting enough rest in the early days can lessen the chances of dealing with PPD.
Since I didn't deliver at Mt Sinai, I wasn't able to tap into this resource. I delivered at another hospital and my midwife emphasized that I would feel more comfortable at home, so baby and I checked out and headed home just 5 hrs after delivery. I went nearly 2 days w/o sleeping before passing out on my couch with my newborn.
I think that mothers should absolutely have the option to send their baby to a nursery, without additional cost and w/o guilt. Mom's emotional and mental health far outweighs the need to establish breastfeeding (if that is, in fact, the feeding choice being made. Annie's assumption that breastfeeding is the default option isn't fair or realistic). As well, not everyone has an instant support system that shows up when baby does.

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Amy Romano on November 23, 2010 at 4:11 pm
Thanks for blogging about this. I was really fascinated by the conversation, too, and frustrated that I only had 140 characters to sum it up.
As I think I expressed (though maybe not) I don't think that rooming in necessarily prevents PPD, nor do I think that sending to the baby to the nursery for a reasonable amount of time while the woman rests causes PPD. The case I was trying to make in my tweets is that we know that separating mothers and babies has other negative effects, and we have no scientific evidence that it is beneficial. So from the perspective of a hospital trying to improve the quality of care and rein in costs, prioritizing those things that might do both things simultaneously, doing away with a central nursery for well infants with healthy mothers seems to be a reasonable policy.
Of course, "no scientific evidence that it is beneficial" does not mean it isn't beneficial. Clearly from the outcry on the blogs and twitter, some women value deeply the ability to get some much-needed rest and support after giving birth, especially when the birth was more difficult or traumatic than expected. I *absolutely* think that we need to support these moms, but I don't know that having a central nursery is the best way to do that. Perhaps there is another way to meet this need. I don't know exactly what that might be, but I'm curious to hear how it is done in other settings.
The problem with having a central nursery is both economic and cultural. In economic terms, having a nursery means devoting a rather large space that could be used to have more postpartum rooms or a family lounge. It also means having to staff the space with at least one nurse. Culturally, the nursery becomes the nurses' turf, and newborn care and procedures end up happening there rather than in the parents room. Whether it is the admission physical, the bath, the weight checks, the Hep B shot, the metabolic screen, you name it. Each time the baby is shuttled to the nursery and the timing accommodates the hospital staff rather than the unique rhythm of the family, which includes the need to sleep, nurse, bond, etc. I honestly would rather see hospitals eliminate these routines (which would require a cultural shift) rather than the physical nursery itself. But cultural shifts are very, very difficult and require a different kind of leadership than an executive decision to close a nursery and require rooming in.
Just to circle back to the link with PPD, I don't know about rooming-in, but there is pretty compelling early evidence that skin-to-skin contact has long-term emotional effects on both the mother and the baby. This study found lower PPD in women who practiced kangaroo care with their preterm infants in the NICU. No study has looked specifically at risk of PPD in term infants as far as I know, but Bystrova 2009, a randomized controlled trial among healthy infants born at term, found that during an observation one year after birth, children who had been clothed or swaddled rather than held skin-to-skin or who hadn’t nursed in the first hour were more likely to exhibit symptoms of dysregulation (irritable, emotionally labile, aggressive, impulsive, or unable to self-regulate). In addition, when researchers observed them at play and performing a structured task, the mothers in this group were more likely to have a flat/constricted affect, lack enthusiasm, or simply seem out of sync with their infants.

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Amy Romano on November 23, 2010 at 4:14 pm
My links didn't seem to come through. The preterm kangaroo care study I referred to is here: http://pediatrics.aappublications.org/cgi/content…
Bystrova 2009 is here: http://www.ncbi.nlm.nih.gov/pubmed/19489802

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Chaoticmama.wordpres on November 23, 2010 at 4:43 pm
While I believe rooming in is the best, it is not always possible. I roomed-in with my first three babies. All three were vagin*lly delievered. I was in the hospital no more than one night after the birth (and in one case, was out the same day!). For two of those births, I was unmedicated, and moving around after the birth was easy. For my fourth child, whom I had insisted again on rooming in when I checked in, I had an unscheduled C-Section after complications arose.
Not only did I have a C-Section, I had hemorraging and lost a lot of blood. I was seriously anemic, weak, and it was difficult for me to move and get out of bed. My husband could not be with me as I had the three children at home to take care of. Also, we had recently moved to the area, and didn't have anyone we knew well enough to either babysit or help me at the hospital. I was on my own. Sadly, for a couple of hours each night, my baby went to the nursery. The nurse was under strict orders that he was not to Cry It Out. If he didn't stay asleep, he was to come back to me immediately. I used that time to sleep, or go to the bathroom, as it took me a long time to get up. When he was rooming in with me, I often had to call a nurse to come help me get to him if he was in his bassinet, or take him from me when I needed to get up to go to the bathroom as I needed both of my arms to pull myself up and out of bed.
I was in the hospital for 6 days.

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TheFeministBreeder on November 23, 2010 at 5:09 pm
The hospital not giving a rats whether or not I could see my baby, I believe, is what exacerbated the birth trauma I experienced, with then exacerbated the mood problems. The hospital prided itself on keeping the babies with the moms, but every chance they got, they were trying to take my baby away from me. I don't believe for a second that it had no impact on me or the mood problems. I think the separation ruined our breastfeeding relationship from the start, and a ruined breastfeeding relationship furthered the PPD. I didn't get any of those wonderful chemicals to help minimize the damage.
The second time, I had a VBAC, kept my baby on me at all times, breastfed like a pro, and managed to ward off the PPD until he began to take less milk at about a year old. Are they related? Some research says yes. And anecdotally-speaking, I'm inclined to believe them.
However, it seems we can't win. Moms whose babies are taken say it hurt them. Moms who say they're "forced" to keep their babies with them say their hurt. What's the right answer? I'm not sure there is one.

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Kirsten on November 23, 2010 at 5:19 pm
I think it is so important to remember that everyone is unique and should be evaluated as such. I understand how important initial contact can be but I also know that a C section is major surgery. After spending some initial time together, having my daughter go to the nursery so that I could get some sleep and recover from my drug haze would have been the best option for me. I remember seeing her in the operating room but have no memory of holding her for the first time. While I don't think that rooming in triggered my PPD, I do think that taking some time to recover from surgery after 7 hours of drug free labor and 2 hours of pushing doesn't seem unreasonable.

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Walkerkarraa on November 23, 2010 at 5:25 pm
I think the answer lies in reproductive rights, and focusing on designing new reproductive education for girls. Then, let's go global and take a look at our sisters the world over, most of whom are girls…losing the battle with birth and mental health every day.
This conversation needs to go global, meta… Once we see that the disparity between those who have and those who don't creates a kind of stress that makes us turn on our own, our sisters, we will learn to regroup, and reclaim our power not for ourselves, but for our daughters.

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Jessica on November 23, 2010 at 5:43 pm
This post brings back so many awful memories of my hospital stay with my second son. In the two years since I'd had my first son, our hospital had decided the nursery would only be open at night and babies would room-in with their moms the rest of the time. I thought that was fair, until my son screamed and cried non-stop the entire time we were there. In 48 hours I got 3 hours of sleep, and not all at one time. I held him skin to skin at all times unless I was changing his diaper or going to the bathroom. The one time I attempted to send him to the nursery, the nurse refused to take him saying he was hungry (he had just nursed). My older child was sick so my husband couldn't stay with me to help out at all. I just remember crying and crying the whole time with no one even asking if there was anything they could do to help out.
Do I think the new nursery policy caused my PPD? Not a chance. Do I think I would have been better prepared to bring my child home if I had been able to send him to the nursery and just gotten 2 hours of uninterrupted sleep? Yes, yes, a hundred times yes.
I think it's so important for new moms to have the option to send their newborn to the nursery so they have time to rest and heal. But more importantly, I think it's important to be supported by the staff caring for you and your baby after the delivery. I definitely wasn't properly supported after the birth of my second son and I think that made all the difference in how quickly and intensely my PPD set in.

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phyllis diller on November 23, 2010 at 8:03 pm
These symptoms are also a spectrum of effects of ppmads. Is it lack of skin to skin or the untreated ppmad in pregnancy?

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Alexis on November 23, 2010 at 8:24 pm
I have a bit of an issue with our being compared to other mammals when it comes to birthing practices. No, other mammals don't send their babies to other rooms to sleep. But other mammals also don't use cell phones and dress their babies in onesies. There's a big difference so it's a little misleading to compare them as if they're the same.
All the studies in the world can't fight against the experience of the single woman who might feel differently, and in this case, I think it's most important to provide options for every woman, regardless of whether or not she conforms to the results of a study. I can only speak from personal experience, of course, but I had a terrible experience rooming-in with my first son. I was anxious, got up every time he whimpered, and had hallucinations about falling asleep while I was nursing him and dropping him on his head. I ended up collapsing in a sobbing mess in the early hours of the morning, begging my husband to take him to the nursery so I could sleep. Needless to say, my second son spent his first night in the nursery, and I slept like a log.

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Alexis on November 23, 2010 at 8:47 pm
I don't think my personal experience with PPD had anything to do with my choices regarding rooming-in vs. nursery care. I roomed-in with my first, but ended up getting so frustrated with our unsuccessful breastfeeding attempts, his refusal to sleep, and my constant anxiety every time he made a peep, that I caved in and sent him to the nursery so I could sleep for a few measly hours, where they fed him formula because his blood sugar was dangerously low. I ended up BFing him until he was nine months old and weaned himself, and my PPD didn't develop until around that time.
With my second son, I sent him to the nursery from the beginning. He was brought to me when he woke for feedings, and I breastfed him exclusively. He slept well, I slept well, and I was depressed before I even checked out of the hospital.
All that being said, I really feel like most of this is inconsequential. The truth is, it's impossible to know what really is better for EVERY woman who will give birth in a hospital setting. No matter how many studies there are, no woman will fit perfectly into a mold, and I don't think women should have to compromise what they feel is best for them and their babies because their hospital doesn't provide options. However, I understand that there are other factors at work, including healthcare costs.
I don't know what the best answer is. What I take issue with is hospitals and other organizations using sweeping generalizations as their guideposts for policy change, especially when those changes coincidentally lead to positive monetary outcomes for the organization. I don't dispute the fact that prolonged skin-to-skin time at birth may be beneficial for both mother and baby. However, I do dispute the fact that a woman would be forced to adhere to this practice due to some relatively arbitrary regulation. I know for a fact that if I had been forced to spend one more moment trying to nurse my son when I was going on 0 hours of sleep over two days, I might have literally lost my sanity on the spot. I had a huge support network of family, friends, and church members who were all there if I needed them. But what I needed most was sleep. And the nursery staff gave me that, bless them.

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Kimberly on November 24, 2010 at 3:24 am
Based on my own experience, my the hospital that I delivered, kept the baby in the room with the mother. Personally, I think it is more of a nursing shortage thing than anything since our area has been hit hard with nursing shortage. When my son started with colic on the second night, I was completely beside myself and had to beg a nurse to come and take him for a few minutes so that I could compose myself…heck…to even get a little shut eye. Know what the nurse said to me "We're short staffed and there are three deliveries about to take place so to answer your question. NO!"
I knew that I had PPD the moment I saw my son and wasn't overwhelmed with happiness…but with sadness. If he was in the room or not in the room, I don't think it would have mattered other than maybe I would have gotten a good nights sleep

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Chris on November 24, 2010 at 4:03 am
This pisses me off. I had a vagin*l hemmorhage after my baby was born and was rushed to emergency surgery – intubated, transfusion started, the whole bit. They didn't let me try to walk until two days after the birth. I wasn't released from the hospital until 5 days after he was born, and my iron count was down to 6. I had them keep my baby in the nursery because I was too weak and exhausted to care for him. I can't imagine how I would have coped if someone sternly said that he HAD to stay in the room with me. I didn't get PPD because he was in the nursery!!!

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Katherine Stone/Post on November 24, 2010 at 4:11 am
I don't know if these hospitals have a different policy for women who've had c-sections or some other such trauma, to be honest. I wonder if any of the people commenting here who have been at rooming-in policy hospitals could weigh in on that.

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Katherine Stone/Post on November 24, 2010 at 4:14 am
So far, it has seemed pretty balanced to me.
Also, go check out the comments on the Facebook page: http://www.facebook.com/pages/Postpartum-Progress… Most there don't think rooming in would have helped them.

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Katherine Stone/Post on November 24, 2010 at 4:14 am
I'm with you. I think the root of this is better labor and birth support, and postpartum support as well.

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Jennifer on November 24, 2010 at 4:17 am
The hospital I gave birth in in Switzerland strongly encouraged rooming in and was a WHO accredited breast feeding hospital (no pacifiers, no artificial feedings without parents' consent, encourages the new mother to limit her visitors and get rest and be with the baby in a calm quiet situation, a one-on-one with an LC before discharge…), but rooming in was not required. There was a nursery staffed 24 hours; it was often empty, but it was there. I had my second with me almost all the time, by choice, but I did give him to the nurses now and again. One nurse even commented to me that I could ask them for *more* help, they'd change diapers if I didn't want to. I don't think a different set up would have prevented my PPD, which came on at about 6 weeks or so post-partum – it was the night after night of sleep deprivation of real life that did me in, not the hospital situation one way or the other.
Aren't women who feel like they had less control over their birth experience *more* likely to experience PPD/PPA? I have that in my head for some reason, does somebody know if that is accurate? Doesn't requiring all new mothers to behave in a certain way take away some of their autonomy surrounding the birth and lead in that direction? And just practically, where does the baby go when the mother has to shower or go for a blood draw or something? I liked that there was a key-code-locked nursery at my hospital where I could put the baby when I had to take a shower rather than just leave him sleeping in a room anybody could just walk into…
As an aside, *requiring* all new mothers to do Behavior A, B, or C really angers me. Different families, different people, different situations.

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Katherine Stone/Post on November 24, 2010 at 4:21 am
To me the right answer would be options, so that moms who don't want their babies taken will have their way, and moms who want the break will have their way.
It seems to me that in a lot of these cases, such as yours, the mom's wishes are not adhered to. The hospital, with whatever policy it follows, does what it wants when it wants and the mom must comply. This seems ass backwards.

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Sarah on November 24, 2010 at 4:31 am
With my first I wanted her with me always, I was a first time mom and scared to death. When I got home and I was exhausted I wish I hadn't. With my other 2 I was happy to send them with the nurse and I felt a sense of comfort because they were with Healthcare professionals. Also the thought of family being at the hosptial with me while I "rested" would not have happend. I had PPD/PTSD with my 4th who ended up in NICU and I had no choice to be away from him. I couldn't even hold him for the 1st 24 hrs of his life I could only touch his small little hand and I was sent home without him. I don't believe if he had been in my room it would have changed my thoughts or feelings about him or his birth one bit. In fact looking at him made the guilt worse and the depression get deeper in my mind. I think it should be up to the mother/father/family where there baby goes and when

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Katherine Stone/Post on November 24, 2010 at 4:32 am
It would be interesting to find out from the hospitals that have the rooming-in policy what their specific plan is for helping moms who have situations like the one you describe.

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Katherine Stone/Post on November 24, 2010 at 4:34 am
Amen –> As an aside, *requiring* all new mothers to do Behavior A, B, or C really angers me. Different families, different people, different situations.

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Fullydilate on November 24, 2010 at 7:28 am
Yes.

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Amy Romano on November 24, 2010 at 7:39 am
Those were both randomized controlled trials, which means that the possibility of bias (i.e., women who already have depression or anxiety are more likely to forgo skin-to-skin contact and then to exhibit attachment difficulties at 1 year) is eliminated. The observed differences are very likely to be related to the skin-to-skin contact.

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TheFeministBreeder on November 24, 2010 at 8:56 am
After reading the many, many comments, what I see missing from this situation is the dads. Where are the dads when these moms need a break? I had a cesarean the first time, and couldn't care for my son AT ALL. You know who cared for him? My husband. He never left my side for a minute (except to go to the cafeteria, and even then, often our family just brought food back for him.) Why has no one mentioned what sort of role a partner can play in all of this?
I can totally see how single moms or moms without help would need help from the nursing staff, but for me, it was my husband who took care of me and his baby. Didn't anybody else have that? Was the nursery the only option? Where was the baby daddy when mom needed a break? This also makes me wonder if she ever got a break when they got home where there was no nursing staff to relieve her. I know (after having seen my fair share of the internet) that my partner is more supportive than most, but a partner's responsibility can't be left out of this conversation. Nursing staff or no nursing staff, if a woman can't get a hand from her partner in taking care of the baby, I don't think a few days in a nursery is going to stop her from getting PPD when she gets home.

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Katherine Stone/Post on November 24, 2010 at 10:35 am
You are right that partners play a very important role. My husband was there, and was awesome. He and I both needed the rest, though, since he had to go right back to work, so together we felt comfortable sending the baby to the nursery for a while.
Some people's husbands or partners have to stay home with the other children. And others just don't have a partner, or at least not one that is supportive. One would hope in that case they'd have loving friends and family willing to be there, but I imagine that's not always the case.

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Annie @ PhD in Paren on November 24, 2010 at 10:35 am
Katherine:
In some countries, like France, women can have access to a post-partum doula/nanny to help them out. This is covered by the government. In the US, I imagine a similar program could be covered by insurance.
We have such a shortage of nurses, that it just doesn't make sense to me to have healthy babies being cared for by registered nurses when there are patients who need their care.
I see it as an essential service for moms/families, but just not a service that the hospital would need to be providing.

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Katherine Stone/Post on November 24, 2010 at 10:37 am
Thanks for your input Amy. I think this is a really great conversation to be having.

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Katherine Stone/Post on November 24, 2010 at 10:40 am
I had a lot of skin-to-skin contact with my baby at home, even while I had postpartum OCD. He napped on my stomach. Possibly not the best idea on my part, since later he didn't ever want to nap in his crib, but having him there on my belly (even with PPOCD) made me feel like at least he could hear my heart beat and my breathing and feel some connection to me … even if, because I was ill, I was having a hard time feeling one to him.

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Katherine Stone/Post on November 24, 2010 at 10:43 am
How much was "slightly longer", out of curiosity?
Did they also compare people who have anxiety, and/or people who are light sleepers vs. people who aren't? In my case, if I could hear my son AT ALL — which I could because he was a noisy little monkey — I couldn't sleep. I realize this probably isn't normal, but I'm a light sleeper and also had anxiety and so, for me, having him in my room (either the hospital room or my bedroom for co-sleeping) meant ZERO sleep. Literally.

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Liz on November 24, 2010 at 12:51 pm
I had originally planned to room in with my daughter, but my own postpartum complications prevented that. I developed postpartum pre-eclampsia and a pericardial effusion. The nurses insisted that she be taken to the nursery so I could rest and try and get my blood pressure down. Honestly, I was so worried about my own health at that point that I was happy for them to take her each night. The combination of a c-section and complications had me both mentally and physically exhausted.
I don't for one second think that her not staying with me contributed in any way to my PPD. I think the extra rest did me some good. I knew I couldn't take care of her if I wasn't healthy.
As far as addressing the partner's role in postpartum care, my husband was awesome. He took on sole care of our daughter (minus the feeding) while I stayed on strict bed rest for 5 days after her birth. He did (and still does) the majority of her night time care once we arrived home. He is even the one who insisted I talk to my OB about PPD. He even threatened to call himself if I didn't do something about it.
I don't think there is a magic answer to how to prevent PPMD. I think that spreading awareness to new and expecting moms and dads is the key.

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Mrs. X on November 24, 2010 at 4:35 pm
I was very happy to send my baby to the nursery so that I could sleep. I needed that buffer because I was just so unprepared for full on newborn care from the start.
As far as PPD, having the baby room in with me would have caused it come on faster, I think. Being able to sleep was such a gift. My OB saw it too, and made sure that I wasn't bothered at night.

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Miranda on November 24, 2010 at 5:31 pm
Like Allison, I also think you have a great point about support. And that support shouldn't be conditional on whether or not the child is rooming-in. MOTHERS need support, too. MOTHERS are also patients. I could barely get out of my bed without assistance after my c-section. I'm thankful that I delivered where I did because there were only three other mother/baby pairs on my floor. I received tons of support from nurses and LCs alike. The food? Not so great. You win some, you lose some.

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Miranda on November 24, 2010 at 5:39 pm
My hospital defaults to rooming-in for all babies, but there is still the option to send the baby to the nursery. There are actually two nurseries in the hospital–one on the delivery floor where Joshua was taken to be cleaned up/weighed etc after the c-section and a much smaller one on the postpartum floor. On BOTH floors, we had the option to send him if we wanted even though our hospital's policy is to room-in.
I think having the option is the key. It's fine to blanket the rooming-in policy. I think that in most cases, most first-time moms aren't aware of any other option since that's the "trend" right now. The nursery, in my opinion, is used by those who specifically ask for it.

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Miranda on November 24, 2010 at 6:00 pm
God love my husband. He's a really great guy. But I think having a new baby when he'd never spent more than maybe half an hour with an infant prior to Joshua's arrival left him sorely underprepared for the roles of fatherhood, especially as it related to the help I'd need from him in the hospital.
I remember my anger when he told me he needed to go get a hair cut. WHILE I WAS IN THE HOSPITAL. He left. Actually, he went out daily for at least an hour or two. And I was stuck with our screaming infant in a shoebox hospital room recovering from the first surgery I'd ever had in my life. But, I also didn't know how to say no to his requests to leave. I was aware that he was leaving, but I wasn't cognizant of what his absence was doing to me.
Once we got home, my anxiety started creeping in and I wouldn't let him help. He couldn't comfort Joshua in the middle of the night, and he was going back to work the day after we were discharged so I was convinced he needed the sleep. Meanwhile I was getting NO sleep.
Next time? If there ever is a next time? We'll know.

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interested on November 24, 2010 at 7:35 pm
My doc has expressly told me that the next time around, if there is a next time, there's no nursing for me, and a pill to put me fast to sleep (so forget about rooming in/bonding!) in my future to ward off a serious case of ppmd. So much for the notion that nursing or rooming in is what prevents postpartum issues – they are, from my doc's. standpoint, triggers for it for me. But I honestly think each woman is different so as the french say, Chacun son gout – to each his/her own!

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Katie on November 25, 2010 at 8:54 am
I am repeatedly thankful for my hospital. they asked each and every night what I wanted to do. And since Cort went home each night (I sent him out too…I needed SLEEP and so did he), I didn't want to be left alone with Eddie. I just wanted to get better so I could be there for him 100% when we got home.
I think it's ok to have a policy, but you're right, the option to NOT have the baby in room should still be there.

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Kira on November 25, 2010 at 1:15 pm
I haven't had the chance to view the above comments, but read this post and wanted to comment:
I wish to G-D that rooming in had not been mandatory at my hospital. After 22 hours of labor and an emergency c-section with subsequent complications, I was exhausted and depressed my birth hadn't gone the 'perfect' way – PPD was already setting in. I'm a licensed MFT, and I can honestly say I believe that my PPD was exacerbated by a five day hospital stay with no real sleep, just a constant crying newborn, not to mention all the hospital interruptions. A 6 hour stretch, hell, a 4 hour stretch of sleep per night would have helped immensely for me to heal, both emotionally and physically. I think having the option would have been key, and it absolutely makes no sense that each individual family is not permitted to make their own choice — it's like the medical establishment is saying 'THERE IS ONLY ONE WAY' which is ludicrous as we know there is no one way for anything.

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Rachel V. on November 25, 2010 at 10:25 pm
I had my son sleep and stay in room with me. However, looking back I wish I would have chose the other way. I did not rest adequately. FOR MONTHS. I did not realise prior to giving birth how high risk I was for PPOCD/PPA. I did NOT want my son anywhere else but with me. I have that classic perfectionist and controlling nature. This may be strange to say but maybe if I had actually let go for a few hours those first couple days, I wouldnt have become so over obsessed with caring for my child. Maybe I would have been okay with him NOT being there for a bit. who knows. I wasnt horrible in the beginning, but it slowly progressed and got worse and worse as time went on. (we are talking washing my hands constantly till they bled because I was afraid to get him sick). I thought I was being super mom. turns out, 6 months after his birth, after never leaving his side, after the stress of it all, I ended up breaking down with panic attacks and intrusive thoughts that hurt my SOUL. Post partum mood disorders are not just of one variety! I didnt have a hard time bonding with my son, I had an impossible time trusting ANYONE with my son..including my husband. some may try to argue that with PPD it is beneficial for bonding to be around the child consistently directly after birth (which i dont particularly agree with)..but for some PPOCD cases, that theory may be actually OPPOSITE. maybe letting go for a bit is crucial, and those moments in the hospitol could be a vital time for setting that boundary. regardless, the only way to figure out if you run that risk would be threw pre-screening (which should be focused on MORE by medical professionals than these little trivial theories that are too one size fits all) or previous births. I KNOW I would do things differently if I decided to have any more children.

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Melissa on November 27, 2010 at 1:50 pm
The hospital I had both my girls in didn't even have a well baby nursery. I roomed-in with both, I didn't have PPD with my first, I did with my second. I don't see the connection. I agree with a previous post about us looking for a magic bullet to say this causes or prevents PPD. It isn't out there. It's a complez disease. I don't think there should be a default, because then someone has to chose the non-default. Why can't it just be an option. No "Baby stays with you unless you want to send him to nursery" or "Baby will be in nursery until you want him" How about "there is a nursery he can go to, there is a bassinet in your room you can use, hold him as much as you want, sleep as much as you want. It's all your decision…

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Laurie on November 29, 2010 at 4:09 pm
So glad you picked up on my original post and sparked a new conversation here! I linked to this post in one of my comments.
Most responses to my original post were quite strong and some even extreme. I just published a follow up post today clarifying my opinion called "Moms Deserve Choices"
You can take a look at . or just click on my name Laurie above.
Thanks Katherine!

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Laura on December 2, 2010 at 1:04 pm
This made me cry. Thank you.

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Roxy on December 3, 2010 at 3:51 pm
Unfortunately, insurance companies are to blame…………nurses would love to provide care for more than 24-48 hours!

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Lori @ I Can Grow Pe on December 6, 2010 at 5:12 am
I gave birth to Porter in a hospital without a traditional nursery. I really like the idea, but now that I think about it my anxiety started right then and there. I remember not being able to sleep–not because he was up and needed to be fed or changed–but because I was too freaked out to sleep. I would just lay in bed and stare at him. I was worried that if I slept that I wouldn't hear him if he needed me.
When my son was rehospitalized for jaundice a few days after we were sent home, we all shared a room together in the pediatric unit. He was under the phototherapy lights in our room and we fed him and changed him every two ours until his levels came down to a safe level.
At this point, in either situation, I don't know if I would have done things differently if I was given a choice.

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Lori @ I Can Grow Pe on December 6, 2010 at 5:13 am
Oh and my son was 5 weeks early–so I just stayed awake staring at him–shocked that he was here already.

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Sarah on December 14, 2010 at 4:25 am
I experienced PPD (even after a problem/stress free pregnancy. But things can quickly change when you combine a traumatic birth (emergency C'Section) and also problems with your babies health as well. My baby had Jaundice and very sore eyes that needed to be swabbed every few hours…he needed to be taken outside for extra sunlight for a few hours each day. He also had colic:(
This was my first child, and I was absolutely overwhelmed because of the combination of all these things. I felt devastated that i wasn't physically able to do these things for my baby yet, or even get up to change a nappy. I was fortunate that at this time my mother came to help me for a few hours each day, and there was a nursery offered to me for the first 2 nights…with nurses bringing my baby back -just for me to breastfeed every few hours. (this much needed rest helped my body to start healing, and gave me just enough energy to successfully breastfeed my baby regularly during the next day as well.
At this early stage i still couldn't lift him…the nurses lifted him to me, and my mother did many nappy changes. The nurses also gave him a bath, and swabbed his eyes which was a huge relief to me.
By the third day, breastfeeding was just starting to get into a good pattern, and i was asked to try to have my baby all night.
I felt pressured into this, i was very sore, extremely fragile & vulnerable – and in no position to argue that i didn't feel well enough to tackle this yet. Unfortunately for me, i could now lift my baby, but with difficulty. I did my best to change nappies throughout the night, and swab his eyes etc, but even these small things were physically exhausting. My first night feed went well though, so i was confident that i may at least get some much needed sleep in between all the night feeds. However the mid-night feed went badly as my baby was constantly falling asleep, waking up and crying. After more than our hour and a half of this, i was very stressed and desperately hoped he would finally be content to go to sleep. He did, for a whole hour!
I woke up to him crying to be feed again, but he did not seem to be getting enough milk – I nursed him for the next few hours. He was still not satisfied, and i was in despair as the sun came up. It was now nearly the end of breakfast time, I was anxious, hungry and exhausted. A kind nurse said she could spare 5 mins to hold him so i could eat before it was whisked away. After this the nurse gave me some formula for him to try, it worked, and he finally fell asleep. I felt like a complete failure and couldn't get back to sleep. I cried all day and had a complete breakdown.
I now strongly believe that the major trigger for my PPD and chemical imbalance was sleep deprivation. If i had been offered just a few more nights access to the nursery, i honestly think i would have recovered really well and not had a breakdown.

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Sarah on December 14, 2010 at 5:34 am
I couldn't agree with you more Michelle. I have always believed that the number one principle in health-care was to "Do no harm", but this practice of forced rooming in IS harmful!!! Each mother is an individual, with different needs and is affected by vastly different support systems and personal circ*mstances. How callous to think that one size fits all.
Any mother who has just given birth desperately needs sleep, especially in those first few days. I believe that this is an inhumane system, because it directly exposes vulnerable new mothers to the very real risk and possibility of sleep deprivation…which is a major ingredient/trigger for PPD, PPP etc. Therefore it should be considered
a completely unacceptable practice, that is in direct violation of the basic 'duty of care'.

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Sarah on December 14, 2010 at 5:43 am
that's an interesting thought, please could you explain Roxy?

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crazy mama on December 14, 2010 at 11:07 am
I had my first baby (via c-section) in a Navy hospital that did not have a nursery option. I was a single mom and didn't have anyone to help me out, although the nurse took the baby for an hour or two to the nurse's station one night. They also sent me home the 3rd day after the c-section. I went home exhausted and quickly fell into an awful case of PPD.
With my second child, I kept her in the room with me the entire time because I was DETERMINED to breastfeed and was worried that sending her to the nursery would somehow hurt my chances of being successful. The nurse came into the room while I was crying uncontrollably after a night of never ending cluster-feedings and suggested that she take the baby to the nursery so I could rest. I could have kissed that woman's feet, and if I knew her name I would have named my next daughter after her. I sent the baby to the nursery, where she had a bottle, and I slept soundly. (By the way, I successfully breastfed that baby until she was 11 months old).
With my 3rd baby I went into the hosptial prepared. I sent her to the nursery if she wasn't nursing. Not just at night. I knew that I would get more than enough time to bond with my baby, and I knew that for ALL of my kids' sakes I needed to get as much rest as possible. After 5 days in the hospital, my husband and I went home rested, refreshed, and ready to take care of our baby. This post-partum period after this baby has been BY FAR the best for me…and I attribute some of that to the fact that I didn't start out with a sleep deficit.
Bottom line, you have to do what's best for you, which is what's best for your baby.

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Annie @ PhD in Paren on January 6, 2011 at 7:57 pm
This post illustrates one reason why moms who are breastfeeding should be extremely careful about handing their baby over to night nurses so that they can get some rest: http://justwestofcrunchy.com/2011/01/06/similac-f…
Be EXTREMELY careful and EXTREMELY explicit that your baby is not to receive any bottles/formula if you are allowing the nurses to care for your baby while you sleep.

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Katherine Stone/Post on January 7, 2011 at 4:56 am
I very much agree, as the nurses were giving my baby a bottle without my permission (not sure if it was the night nurses, or just the nursery nurses in general). I only found out by accident when he started refusing the breast.

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Annonymous on January 28, 2011 at 6:46 pm
I definitely agree. It is hard for me as I work in a facility that believes in this policy. It seems counterintuitive, but it does seem to be trending…

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Debbie on March 22, 2011 at 3:54 pm
Rooming-in can be a wonderful thing, but there should be a choice for new moms. When I delivered, there was not a choice. Babies were expected to room-in. I had a c-section and could barely move, but the nurses told me there was no nursery care available for healthy babies. I also was told that rooming-in promoted the breastfeeding relationship.
While rooming-in should be available, it should not be forced. I could barely lift my baby without horrible pain (from the c-section), and I got barely any sleep in the hospital as a result. I am convinced that the total sleep deprivation from my hospital stay contributed to the severity and the immediate onset of my PPA symptoms.
The feminist in me is still pissed about this. If men had major surgery (like a c-section), nobody would make them feel guilty about wanting a little sleep during their recovery. Instead…the attitude at my hospital was that moms were completely responsible for baby care. If we wanted help at night, we should force our husbands to sleep in the little fold-out chair/bed in the room.
My husband had limited vacation time, and I wanted him to use it when I came home from the hospital — not during my hospital stay. Silly me…I thought hospitals were supposed to care for patients!
But I don't recall much care. A nurse brought me pain medicine, food and clean hospital gowns. But I had to get my mother to come "babysit" in the hospital during the day so I could actually eat and take a shower.
While I know many moms love rooming-in, I felt bullied by the whole experience. Moms should have the option of nursery care, and we shouldn't be made to feel guilty for requesting it. I know that rooming-in promotes breastfeeding and bonding, but the refusal of nursery care made me feel that the hospital was prioritizing breastfeeding over my health (both physical and mental). There needs to be a middle ground here.

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Joanne on January 26, 2014 at 10:31 pm
My story is by no means different 30 hours of labour including two hours of pushing damage to my tailbone which from reading all this I realize was never checked ( I still can’t sit with my feet up or ride a bike) my hospital has room in and nursery options I did a bit of both considering I couldn’t get up after my c section the nurses would bring him to feed I had no milk I pumped colostrum. One nurse told me I pumped amazing amounts an hour later another said I pumped barely anything. They told me pacifiers causing a problem was a myth and never gave any feeding advise. Even when I couldn’t move after operation and I felt blood staining the sheets and called someone I was made to be felt shameful. I was discharged after a two night stay I believe I was sick for weeks throwing up and remember being told by an elderly doctor while I waited in emerg and my son was upstairs with my husband getting heal pricks that when he was practicing there was no way a mom like me would have been on her own already. At a mother group when telling someone I had sent him to a nursery to sleep a mother simply said, I roomed in even after a c section….. Even as mothers we don’t support each other every mother should have recovery I went close to 72 hours with three hours of sleep and major surgery no mother should be made to feel guilty for asking for help or time to heal. We don’t normally force other patients recovering to do everyday tasks for themselves let alone for 24 hour infant care. Every doctor, midwife or parent group should be making parents aware if they have no nursery option so families can at least choose another hospital if needed. Incase anyone is wondering ppd came a month in and I doubt me sending him so I could sleep had ANYTHING to do with it

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Erin on March 21, 2015 at 9:24 pm
I have to say that I actually DO think it would make quite a difference in some cases. . . But not in the way they mean. I had horrible PPA with my son, and it began while in the hospital partly due to exhaustion and the fear of it all being too much- of not getting a break, or sleep! I did not room in with him but was nursing, so the nurses brought him to me every three hours or so for both nights of my two night stay.
I am now due with my second child and am very determined to do as much as I can to prevent postpartum issues again. I feel as if the very worst thing for me is to be alone in a hospital room while my husband and three year old are home, being awakened every 2-3 hours by a newborn while I try to recover from birth. Especially knowing that we will have literally ZERO support system when baby and I come home. (No family at all.) I want that time to have some rest, and the hospital where I deliver claims to have no nursery now, while one of the doctors at my OB practice said if I am persistent enough I can not room in. But if there’s no nursery, where will the baby go during the night?? I am thoroughly confused and thinking of switching practices, which sucks because I live my doctors.

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Ronald Goldman, Ph.D. on August 1, 2015 at 9:59 pm
Let’s do what’s best for children. When we do not do that, we create problems for individuals and society. “What’s done to children, they will do to society.” If you do not want to do what is best for children, consider waiting to have children until you are able to do that. Newborn infants have an urgent need for contact with the mother. This need has been satisfied throughout our evolution. Though culture has changed, the biological and psychological needs of infants have not changed.

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- Becky Schroeder on August 2, 2015 at 9:13 pm
  Infants do need attunement from a caregiver, true. But that caregiver does not need to be the mother in all cases. Especially every few hours for a couple of nights. If someone else is meeting the baby’s needs — a partner or other nurse caregiver, the baby is in good hands and there is no risk to healthy development.
  
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  - Ronald Goldman, Ph.D. on August 2, 2015 at 9:59 pm
    The primary relationship is between the infant and the mother. There are decades of research studies to support that disruption of the primary relationship has long-term effects. It is also part of maternal instinct. When mothers have continuous contact with their infant, they generally do not want to put their infant down. Infants want and need to be with their mothers. It helps them feel safe, secure, and connected. Believing that infants do not need ongoing contact with the mother only makes adults feel better who are not aware of infants’ needs. If you do not believe this, do your own investigation instead of assuming otherwise. I say this so that we can do better for children with the next generation. Mothers need more support, including long-term paid leave from jobs as Europeans receive. Let’s advocate for changes.
    
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Ben Rogers on September 18, 2015 at 11:51 pm
I am pro-choice. Moms should have a choice whether they want to have the baby in the room immediately after birth or instead need a little timee to recuperate. I’ve never had a baby, I’m a man, but I did work as a medic on a maternity ward for six years and the truth of the matter is some moms need more time to recuperate than others. Many a time, I’d pick up passed out bleeding moms from their bathrooms or see moms staggering down the halls like the walking dead holding their hurting bellies. Than other times I’d see moms walking around right after delivering like it hadn’t even happened. So why not give moms a choice and not leave it up to some group of unknowns that think they know what is best for the moms and babies? The moms that I saw that really seemed to enjoy those first days of their new babies lives, the smiling moms, were the ones that were given a break those first couple of days. Happy mothers, in my opinion, have to have a more positive effect on newborns than a mother who is in pain and suffering.

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Christina on February 9, 2016 at 11:20 pm
Oh my gosh… glad I stumbled upon this article. I just toured our hospital today. They are ones that have done away with nurseries and keep the baby in the room with you the whole time. They won’t even change the baby’s diapers for you. This might not be a problem with most moms, but my situation is extremely unique. My husband has a severe disability, and while he will be present most of the time in the hospital, he is physically unable to feed the baby a bottle of expressed breastmilk or change a baby’s diaper. So I am the one to do care 24/7. But yet I will have JUST given birth! Unless I’m awake throughout it all during the day (highly unlikely) I will be craving sleep for some portion of that time. Uninterrupted sleep. Even just 3-4 hours of uninterrupted sleep. So now that I’ve learned this in our tour, I am SCARED TO DEATH of the postpartum period even more than I was before. I’m not a first-time mom, but we adopted our daughter at 11 days old and she very quickly became one of those lucky kids who slept through the night early. So that is nothing compared to the first week of a baby’s life. I can honestly see the hospital actually SETTING ME UP FOR FAILURE and PPD by NOT helping us out for a few hours at a time. I would probably want my son in the room with us most of the time, but please, for the love of God, give me a few hours of uninterrupted sleep so I can function and be my kid’s mom! Thoughts/ideas/advice? Will the hospital be able to make an exception for us at parent request???? Given our unique circ*mstances?

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- Heather King on February 10, 2016 at 12:42 pm
  You do have a unique situation, Christina…a situation that I would think the hospital would consider carefully before saying they cannot help, give you a hand and some compassion. It never hurts to ask and if they say no, maybe there is another nearby hospital that has different regulations? It will all work out, but yes, this is something to get figured out ahead of time. Peace to you!
  
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Ben Rogers on February 10, 2016 at 12:50 pm
I think moms need a few days break after going through the trauma/ordeal of child birth. So what if they are not with the baby 24/7 the first few days? They have the next 18 years to make up for it.????

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Me on April 4, 2017 at 4:02 pm
This is a great question to ask when touring your local hospital!
Know that most hospitals are gearing towards “baby friendly” which equals “rooming in” which equals hospitals do not pay a “Nursery Nurse.” If you want respite care, it falls to your nurse – who is usually providing care for 4 (or more) couplets. You can see why a nurse responsible for 8 patients, may not have the ability to take your newborn for an extended period of time. Especially when that nurse does not have an assistant fetching water, helping with breastfeeding, helping new mommas up to pee, or answering phones!
I agree that there needs to be options! If the public really understood how little care they are receiving in hospitals, they would be up in arms demanding more. As nurses, we fight for your safety. Until the public starts demanding what we know you should have, things will continue to be substandard. Its all about the bottom line – why pay an RN wage for a nurse when all babies stay in the room? – is what a CEO will say. When that CEO has a baby, you bet they will get to rest because they will get VIP treatment. I AGREE that ALL MOMS need these choices!

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