A maternal rest cure
MONDAY JANUARY 21 2002
A maternal rest cure
BY DEBORAH JACKSON
Mothers who lie in with their newborn gain both physically and emotionally
When the BBC newsreader Fiona Bruce turned up for work at Crimewatch just 16 days after the birth of her second baby, commentators bemoaned the horror of “drive-thru mothering”. Bruce felt compelled to explain that she wasn’t “some mad career monster”, yet her return was hardly exceptional.
Modern life stops for little, even the birth of a child. Within days, sometimes hours, a newly delivered mother typically will be loading the washing machine, cooking the next meal or going back to work. Stories of mothers taking business calls on the maternity ward are legion.
Yet the idea of working, doing household chores, even setting foot out of bed in the weeks following delivery is a relatively recent development. In the past, women spent weeks resting and recuperating after birth, getting to know their babies by lying with them in bed or “rooming in” with the infant close at hand. This time was protected by a month-long taboo, sometimes known as “lying in the straw”.
In Victorian London the practice of providing women with postnatal recuperation time was institutionalised in the British Lying-In Hospital. As late as the 1950s, some mothers stayed indoors for four weeks until the official “churching”, a thanksgiving service which signified the end of postnatal seclusion.
“The idea was that you retreated into a female world with just women around you. It was very comforting,” says Margaret Willes, who explored the theme in a history of beds for the National Trust (And So To Bed).
It is a practice that offers modern mothers many benefits, says Dr Sheila Rosan, a psychologist and researcher on postnatal emotion: “For women who choose it today, lying in works wonders - it gives them a rest, emotional support and practical advice. Enjoying a supportive atmosphere is also one of the factors that help to alleviate postnatal depression.”
Her findings are confirmed by the work of Professor Dominic Lee, a psychiatrist at the Chinese University of Hong Kong, who is studying ancient postnatal customs. In China, postnatal mothers traditionally spend a month in seclusion and are exempt from household duties (family members are expected to provide the necessary support). They also take special tonics, follow dietary prescriptions and observe certain taboos - for instance, eating separately and not washing at all.
According to Professor Lee, 80 per cent of Chinese mothers follow the traditions, adapting them for modern life - for instance, shampooing hair is allowed when certain herbs are added to the water.
“Our data show that mothers who ‘lie in’ have a lower risk of postnatal depression,” he says. “They feel better supported emotionally, practically and in the information they receive. They learn baby-care skills from the supporting relative and, when exhausted, can sleep with someone looking after the baby.
“Lying in can also be a social marker of family support and harmony: being supported by a designated relative symbolises fortune and blessings. It embeds lots of esteem and social status.”
While “lying in the straw” is a practice that has almost vanished from British postnatal life, elsewhere in the world special treatment for the recently delivered mother is practically a right. Indian and Romany mothers wear old clothes and are considered “unclean”, a way of exempting them from cooking, household tasks and their husbands’ sexual advances. Postnatal nurturing is par for the course in Asia, where Malay women will typically receive about 20 massages from the midwife in the first weeks after birth, while Haitian women take long, hot postnatal baths in water strewn with Palma Christi leaves.
One problem in Western society is the shortage of hospital beds and the tendency to turf mothers out if they are not demonstrably ill. According to the latest Audit Commission report (1997-98), 38 per cent of first-time mothers return home in one or two days; 47 per cent in three to five days. Mothers of second or subsequent children hardly rest at all: 42 per cent leave hospital in less than 24 hours and another 38 per cent are home by the second day.
The best chance of being cared for by nurses for three days or more is to have a Caesarean section. Of course, most women are glad to get home - but there is a sense that, once discharged, they ought to be ready to cope alone.
“There are problems associated with getting on with life straight after birth,” says Dr Paula Nicolson, a reader in health psychology at the University of Sheffield and the author of Post Natal Depression: Facing the Paradox of Loss, Happiness and Motherhood. “Women I interviewed reported becoming distressed when everyone wanted to see them immediately.
They had been through a physical trauma - like an operation, but with greater fear and emotion - yet they were having to worry about how they presented themselves. Did they look fat? Should they put on make-up? Would the visitors bring germs? “If mothers get up too soon to do the chores, this detracts from bonding and breastfeeding. It is vital that a mother takes time to get to know her baby, and that baby can get to know her.
“New mothers can only come to terms with their role if midwives and others take lying-in seriously. The mother is not just being lazy if she lies around on the ward. Midwives should offer support - not by leaping in to do everything for the baby, or with unwanted advice, but by staying behind the scenes, ready to answer questions.”
The lack of postnatal pampering in our culture generally is “quite shocking”, says Caroline Flint, a leading independent midwife and director of the Birth Centre in Tooting, South London. She is planning to incorporate postnatal beds into plans for a new Birth Centre in the capital. “We tell all our women to stay in bed for ten days and make sure they have someone who can do the shopping, washing, ironing and cleaning for them. Lying in helps breastfeeding - 97 per cent of our mothers are still nursing at six weeks.”
For anyone whose diary is overcrowded anyway, the idea of putting your life on hold for a new baby may seem risible. But is it impossible? Women are entitled to up to 29 weeks’ maternity leave after the birth. Whether or not they can afford to take the whole entitlement (the basic rate of Statutory Maternity Pay after six weeks is £62.20 a week for 12 weeks), there are clear benefits to spending just ten days in bed. But the key to successful “lying in” is relying on help. Before the birth, fill the freezer, then arrange for someone (partner/relations/friends) to be around to put the food in the microwave. If you have other children, you will need to make arrangements for the school run and shopping.
Block out ten or more days in your diary, but make sure that others are there to take on essential chores - and that work managers do not expect to be able to contact you by phone or e-mail during that period.
In the village of Combe Down, near Bath, one church community has gone a step further in supplying the kind of old-fashioned care that our grandmothers enjoyed. Every day for a fortnight after birth, mothers who belong to Holy Trinity church are treated to a rota of home-cooked meals, prepared according to their own preferences by volunteers. Fiona Firmin, a mother who helped to set up the system, found herself on the receiving end when her third child, Timmy, was born a year ago.
“People were very kind and it meant that I was able to enjoy my baby,” she says. “Friends did my ironing, washing up and brought me breakfast in bed. It made me feel loved and nurtured.”
Baby Wisdom: The World’s Best-Kept Secrets for the First Year of Parenting by Deborah Jackson (Hodder Mobius, £14.99).
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