Monday, 20 December 2010

on "rooming-in"

1975, Crown St Women's Hospital (Sydney), rooming-in was practiced routinely, though nurseries were still present and thence babies could be taken if necessary (like if one's mother had to do a university exam).

1977, Royal North Shore Hospital, rooming-in was practiced during the day but babies were taken to the nursery during the night so that mothers could get a good night's sleep.

1980, Nepean Hospital, rooming-in was not practiced at all, the babies spent most of their time in the nursery and were brought to their mothers for feeding. It was the same in 1982.

Rooming-in refers to the practice of the newborn staying with and being cared for by his or her mother during their stay in hospital, instead of being cared for by the hospital staff in a nursery. It has been practiced in all the hospitals in which my children were born and is considered essential to the establishment of successful breast-feeding. Nurseries seem to be a distant memory.

I am in favour of rooming-in. I love having my babies with me. However, I am more and more convinced that there is at least one disadvantage to the current practice, and it is quite significant. It is sleep deprivation.

Hospitals at night tend to be quite noisy places. I have not, in all my experience had one good night's sleep in a post-natal ward. If I am not awake and desperately trying to keep my baby from crying, I am awake listening to the other baby in the ward cry as his mother desperately tries to keep him from crying so that my sleep is not disturbed, or listening to the dong dang ding of the "someone please come and help me" buzzer as someone begs a midwife to look after their baby so that they can get some sleep.

Sleep deprivation is par for the course for a newborn. I know that. But it is worse in hospital because you can't necessarily sleep when your baby is asleep. One might just manage to drift off to sleep in the early hours of the morning and then, the cleaner arrives... and then breakfast... and then there is the morning change-over of staff... and your resolve to stay in hospital as long as possible changes to "give me early discharge, immediately".

I just wonder about the wisdom of sending mothers home with a newborn seriously sleep deprived. Especially when sleep deprivation is a factor in the onset of post-natal depression.

I don't think the solution is a return to the nursery system, but I can definitely see the advantage in ensuring mothers had a good rest before they returned home.

What do you think?


Wayne (Dubbo) said...

Totally agree - Jill was wrecked in hospital so we rescued her and bought her home within 24 hours. It would have been great for her to spend a bit more time in there but she couldn't get any sleep!! (Esp sharing a room with 4 other crying babies, and getting woken up with each nurse shift.) Not sure of a solution though and thankful for a good medical system.

Prue said...

I had my third baby six weeks ago. Rooming-in is used at the hospital where I had her, but because she was having episodes where she turned silently purple and stopped breathing for a minute or two (all apparently normal according to the midwives until a paediatrician saw it and said "Not normal" and she was diagnosed with reflux) they did take her and keep and eye on her in the nursery a lot. So I did generally sleep well in hospital (unlike with my other two) and when we came home I was feeling quite human. Add to that that she is already sleeping through the night (a blessing from God, but an anomaly amongst my children!) and I still feel quite human and very far from post-natal depression. Praise God!

Wendy said...

I totally agree with you Rachael, I could never understand the point of insisting the baby sleep in your room in hospital, especially when we never had any intention of letting children sleep in our room at home. If hospital is for healing and recovery, why not give mothers a good chance of that before they get home?

Each 3 times for our kids we went to a hospital (private I should add, so I did have my own room) that encouraged rooming in. However, it also became clear that you could work the system, so that you could have your baby with you all day, but then when you were falling apart from exhasution at night (often aided by a husband who insisted you needed rest), you could ask the nurses to mind the baby in the nursery until the next feed.

We did that each time, after the late night feed, I would take the baby to the nursery, and if they weren't overwhelmed, they would mind them for a few hours so I could get some sleep.

We knew this was possible because some lovely night nurses offered to take the baby, however it didn't always happen and you had to push for it sometimes. (I can cry conveniently if needed!)

On another note - I think you should be able to stay in hospital until breastfeeding is better established, surely that would also decrease the indicidence of post-natal depression.

Sorry to hear you are seriously sleep deprived! It's a hard stage.

Anonymous said...

When my brothers and I were born in the 1960's, there was no rooming in whatsoever, and when my parents took us home from the hospital, they stopped in a nearby park and had, for the first time, a good look at us (my dad had hardly seen us at all, and my mum had only seen us well wrapped, and brought to her at set times for feeding, then promptly taken away). When my younger sister was born, day time rooming in had been started, and for the first time my mum was able to spend some time with a newborn.

I'm really glad I didn't have my babies at that time, as I have a strong need to be with them when they're small, and I suspect my mum was the same. And I think that my mental state would not be improved at all by not being with my babies when they were so young. But I agree that hospitals are no place to rest, and we always got around it (after the first which was a caesarean birth) by going home as soon as possible.

In the hospital where my eldest son was born, putting babies in the nursery was frowned upon unless they had special needs, but you often saw midwives doing clerical jobs cuddling unsettled babies at their desk late at night, so I suppose provision was made in that way for babies who needed settling when their mothers needed rest.

It would be good if hospitals could be more flexible, as no one "system" is going to fit everyone's needs, but I think it is unlikely to happen.


Karen said...

Rooming in is hard work. I've had to do it for all of our kids. I loved having my newborns with me but struggled with the intrusions of hospital life so chose to spend as short a time as possible there, just 4 hours when our 4th child was born. When I had the twins I was given a single room so expected an extended stay to be nicer. What surprised me was the lack of support given, especially overnight. I wasn't allowed to have a support person stay with me but was expected to manage two babies on my own. When they were both screaming I had to cuddle them, one in each arm. I repeatedly found myself stuck in the chair long after they settled because, after having a caesarean, I couldn't get myself up with both hands full of babies. Like Wendy, I can bring on the tears to add weight to my pleading for help. But the hospital policy of rooming in means the staff were not free to spend the night settling my babies. I ended up going home earlier than I should have because I was so tired and frustrated. There has to be a better way to support mothers of newborns.

Alice Kristovskis said...

Hi Rachael, Congratulations on the birth of little Lachlan!! I had baby Peter James the very next day! He is our third baby and is also doing very well. I like a bit of an option when it comes to rooming-in. I love having my babies with me too, even just so I can look at them if/when they are asleep. However, I do like to know that if I have been trying to settle them and need a break through the night that I can hand them over to a capable midwife. When Pete was born the hospital was quiet and I sent him to the midwives four out of five nights. The trick is having staff who don't make you feel guilty for needing a break and some sleep. Sleep is like money in the bank, get it whenever you can and it all adds up to keep you on top of things.

I hope all continues to go well for you and your lovely family :)

Alice Kristovskis

Rachael said...

Thanks everyone for your comments and sharing your stories!