Still Advocating Changes.

Twenty-three years ago my husband and I embarked on the most wonderful journey of our lives--the birth of our first child. Although the labor was a bit rough and ended in a cesarean, we felt on top of the world to have a healthy baby girl. Due to hospital policy at the time, Jerry was not allowed to be present for the birth. A few years later we changed all of that when we successfully lobbied hospitals in our area to change that policy and allow a support person present.

But what stands out most in my mind when I think about our daughter's birth is the pain I felt as a new mother. It wasn't from the incision in my abdomen, but from yet another hospital policy that said my perfectly healthy newborn could not be with me for twenty-four hours after birth because she was born by cesarean.

I lay in my hospital bed aching to hold her, even see her. Strangers were coming to my room telling me what my baby looked like. Jerry was allowed to go into the special care nursery and see her, but not me. I was happy at least he got to hold her hand and talk to her, but resentful at the same time that this was my baby and I had birthed her and I couldn't even see her.

That night I begged a nurse to please let me see my baby. We were supposed to be nursing after all. I made quite a fuss and, finally, a very sympathetic nurse stole her from the nursery for a few minutes after I told her that I was not going to be able to sleep all night if I didn't see her. I held her for what seemed to be seconds, and off she went again, back to strangers in a strange environment.

As a childbirth educator for the past eighteen years I have seen many changes in hospital policies and procedures surrounding hospital birth. Most of the time I believe the strides have been good. Sometimes I question that maybe we are going backwards a bit; and I have certainly seen the pendulum swing both ways.

Five years ago I started my practice as a labor support doula, working full-time helping families to have better birth experiences. But lately I have been very frustrated when I see certain hospitals continuing to separate mothers and babies. Certainly in most cases it is just for a few hours. However, it is no less painful to these new mothers than it was to me twenty-three years ago.

A few days ago I stood and watched as a client gave birth by cesarean and her newborn was taken to the nursery. The mother was moved to recovery and was asking for her baby. The baby was in the newborn nursery, alert and ready to nurse. She gazed around and, if she could talk, I know she would have been asking for her mother. Several hours later my client was moved to her postpartum room and, still, no baby. The father made numerous trips to the nursery to check on when the baby would be released. An hour or so, he was told. Back in the room the mother was beside herself, wanting her baby so that they could begin bonding and breastfeeding. She cried tears of frustration--it was not to be.

Finally, I could stand it no more. I advised the father to go to the nursery and ask what medical condition was keeping his daughter in the nursery. If they could tell him of none, then I told him to tell them he wanted his baby brought to his wife so they could start breastfeeding. It worked, but not until after the nurse told him that she would be in deep trouble for not following "hospital policy." His rebuttal was for her to tell her supervisor to come and see him because he was the one demanding his newborn. Only then did the nurse reluctantly agree to bring the baby to the room.

I was able to stay with this nursing couple until the baby latched on and nursed eagerly, a great reward for persistence. But what about the parents who aren't able to be persistent? Who don't have a labor assistant who "worked the system"? What happens to them?

I am starting to get tired of hearing my clients referred to as "anal" and "neurotic" and "unrealistic" because they want to be with their newborn. Why is it that many medical professionals think something is wrong with women who want their newborns with them after birth? Why can't they understand that something is wrong with a system that would separate this wonderful unit at precisely the moment when it is so very important for them to be together?

As I was leaving the hospital after this particular birth I felt as though this family had been punished for having a cesarean. If this mother had a vaginal birth her baby would have stayed with her for up to an hour-and-a-half after the birth. Instead, this mother got to look at her baby briefly before she was whisked away to the nursery for "observation" and then not hold her until four hours after the birth. A far cry from twenty-fours hours, but nonetheless painful.

What will it take for this country to wake up? We have renowned doctors in the field of birth (noted physicians such as William Sears, John Kennell, Marshall Klaus, Marsden Wagner, and Michel Odent, to name a few) stating that this type of behavior is detrimental to the well being of mother and baby.

Through my work as a birth doula, I have learned there are hospitals out there who do have different practices; one is within walking distance from my home. They have had one-on-one nursing care for many years now and it is working. Babies stay with mothers, and the same nurse cares for both. If this hospital can do it, why not others? What role do we as labor assistants play in this never ending battle to keep mothers and babies together from birth?

When my clients request their baby, it is often interpreted as me placing ideas in their heads. They're not thought of as women who prefer this type of birth and who seek me out.

Common sense would tell us that it is normal for women to want their babies after waiting forty weeks to meet them, and that women have overwhelming feelings immediately after birth that make them want to protect and love their baby. Newborns need to be fed and warmed by their mothers, not some stranger or a machine in a distant nursery.

--Crystal Sada, CCE, CD, is a birth advocate, childbirth educator, and labor support and postpartum doula.