gThe hashtags that are parading on the social networks of mothers and new mothers are #stories. And all the stories, as we know, speak of love. But there is more here too. There is #anger, #helplessness. There is that each one makes the chronicle of #midwife violence suffered during one’s childbirth and then adds a thought for that woman who fell asleep in the night between 7 and 8 January while breastfeeding her newborn and, upon awakening, found him dead: we are at the Carlo Pertini hospital in Rome, the tragedy gave the go to an unpublished #Metoo which, however, with the “obstetric violence” denounced years ago by studies and investigations (maneuvers in the delivery room, caesareans, analgesia denied, etc.) has nothing to do with it.
The judiciary has opened an investigation into the cause of death of the newborn – rather than accidental suffocation we would speak of Supc (sudden and unexpected post-neonatal collapse: a rare event that affects one case every ten thousand healthy births in the first week of life) – but in the meantime the attention invoked by these hashtags are many. I’m the list of what a mom would like after childbirth: maybe everything. Except loneliness.
New mothers left alone
«No one can stay in the room with you, except the father of the newborn but only for an hour (he stays 24/7 in the solvents department: why?) and you count the minutes for him to arrive because you’ve already taken the cradle to the bathroom when you had to wash and the bathroom is small and you can even trip» says Isabella in a post followed by #partoriresole. This happened: the pandemic is over but “with the excuse of Covid” – as mothers write on social networks – public departments are still inaccessible. AND hashtags are indictments of the post-pandemic hospital practices of the “puerperium”, the six weeks that ferry from the delivery room to the period from which normality should begin.
«It is important that the mother is left with the baby in skin-to-skin contact for at least two hours after delivery» specifies Enrico Ferrazzi, head of the Obstetrics department of the Mangiagalli Clinic – Polyclinic of Milan. «And equally that he has the possibility of living in a room with the child 24 hours a day, that is, of being roomed in: there is scientific evidence that this closeness has positive effects for the little one, on an immune, neurological and cardiovascular level. Furthermore it serves to create the hormonal bond that facilitates the start of breastfeeding, but above all the deep interaction with the child through cuddling and looking. THEHowever, rooming-in, introduced in the late 1990s, remains a right and not a duty. Anyone who doesn’t feel like looking after the baby in the crib next to the bed because she’s tired shouldn’t be blamed. The goal must be well-being. A medicine that is not empathic becomes mechanical application of rules. Alas, robots could also take care of technology» adds Ferrazzi.
You need empathy
By the way, under the post mentioned a few lines ago, Isabella had also added the hashtag #disempathy. That is: lack of understanding, help, inside and outside the hospital. “We have restored thefree admission from 8 to 20 for the partner. Not for friends and family – it’s a way to protect newborns from germs from too many adults. The optimal situation would be to shorten the hospital stay and have a midwife go home in the first few days. Today, when mothers give birth later and later and lead a mostly sedentary life, it has become a priority to deal with pelvic problems, such as light incontinence or prolapse. For these ailments we now give the first appointment to mothers at risk 40 days after giving birth, it used to be after three months» concludes the head physician.
The ghost consultants
In short, a mother is also born with the child. And who takes care of her? An extra midwife, a partner, a mother? «The staff are also changing in the delivery room due to lack of resources» he specifies Alberto Zanini, former head physician of the Holy Family hospital – Fatebenefratelli of Erba. «At night you can often find coin-operators, or rather freelance doctors who work shifts, a reality that is the antithesis of the concept of team and continuity in work. I don’t even think that all these doctors are needed. Or rather: there are departments where the gynecologist still makes the rounds every day but for mothers not at risk the midwife would be enough. And we need more of these» concludes Zanini, author of The clinical risk (edi-hermes).
Yes, the midwives. But also therepediatric nurse and child nurse. They are the professionals a mother should be able to count on. “Here there are but it’s not like this everywhere, sometimes you only find the midwife” says Morena Terracciano, 41, head of midwives in Mangiagalli. «Women then need to feel “connected” to a network even when they return home. In Lombardy the puerperium clinics which provide for three visits after the birth and on that occasion we indicate the consultors to lean on. There are fewer and fewer but luckily today they have more services dedicated to obstetrics »he adds.
In Italy there are 1,800, a number below that established by Law 34/1996, which foresees one for every twenty thousand inhabitants (this was the case thirty years ago), or 60 percent less than the requirement (2018-2019 survey by the Istituto Superiore di Sanità). Yet it is in the consulting room that women learn to feel like mothers and it happens thanks to the others: by taking courses on how to wear the baby carrier or how to give infant massages, they keep #loneliness and feelings of inadequacy away.
The measure in favor of maternity has also been reconfirmed for 2023
New fears of new mothers
«Today’s mothers have new fears. It is the reason why they increasingly choose to be accompanied by a midwife right from the start. As recommended by the WHO, we promote rooming-in and breastfeeding but the choices must be agreed on a case-by-case basis and, if necessary, you can ask to keep the newborn in the nursery during the night or for a few hours during the day. That’s not what compromises breastfeeding. For the post partum we also have the pelvic floor re-education clinic, but only for women who are at risk for this problem. In this aspect, in France they are further ahead: mothers leave the ward with a package of appointmentssays Terraciano.
Examples in Europe
From #sanitapublica to #ladonnasaparturire, the story on social networks continues. «After the case of Rome, breastfeeding, mothering and roomingin have been demonized. But finding yourself as a doctor at the moment when the newborn is about to collapse is miraculous» specifies Anita Regalia, former head of the delivery room of the Irccs Fondazione San Gerardo dei Tintori in Monza, president of irisassociazione.it, which brings together professionals of care and well-being around the birth event, and collaborator of the ISS. «A woman who has just given birth must always have someone by her side. Reopen the doors of the departments to dads, grandmothers, mothers, aunts, friends. And I’m not saying that to cover the lack of staff but just because there is a need for human support and not just for those who monitor the newborn’s signs of vitality. The mother who is next to her son is more attentive than a midwife but when she breastfeeds she is tired because of the prolactin, she still needs someone to let her rest a bit by taking the baby away. Even when she is discharged », she adds.
«In Holland one would find himself at home for the first ten days kraamverzorgster, a woman who helps her with the cleaning, keeps an eye on the baby, checks on the mother’s mood. I don’t think there’s just the pelvic floor to keep under control. The English health system also provides for a midwife visiting at home for the first ten days. In Italy, a similar service was activated fifteen years ago in some hospitals: having verified the positive effects, it had to be guaranteed, but once the money ran out, it was all over. Today I see many midwives who, fearing a complaint, refuse to do many things and I see many new mothers stuffed with instructions for use as if maternity were a job, anxious women because they missed a lesson in the pre-natal class. I would abolish it. I would recommend living a little closer to your mothers and finding serenity by listening to their stories, a return to simplicity» concludes Anita Regalia.
iO Woman © REPRODUCTION RESERVED