The Golden Hour & The Black Hole of Birth.
Denise Bolds, MSW CD(DONA)
January 29, 2016
As a woman who has given
birth and a birth doula business owner, I am aware of a common paradigm when it
comes to supporting women in childbirth. It is called the black hole.
What is the black hole?
Scientific explanation is available; theoretically it’s a void of nothing;
where things get sucked into it, never to return out of it. The Black Hole
Theory applies in The United States maternal health care model.
The current prenatal care
model in the United States decrees a pregnant woman is to have prenatal care
from conception until birth. This paradigm is the mantra of motherhood:
complete with evidence base and public service announcements. Prenatal care is
monthly until the third trimester, where it becomes weekly or more frequently if
the pregnancy is high risk.
The pregnant woman receives a
wave of treatment and intervention during the labor and birth. After birth, the
mother and newborn are rewarded with the Golden Hour: skin-to-skin and bonding
in a cocoon of support. Mother and baby are discharged to home, where baby
begins pediatric care, the new mommy is left on her own with an order to follow
up with her medical provider in six-weeks, the same amount of time
for most maternity leave employer benefit.
New mother quickly spirals
into the black hole: The baby shower is over; she is sequestered from medical
care she received for over nine months. The new mother is adjusts to her body
giving birth in a myriad of transitions and questions. She is in the most vulnerable
aspect of her life; her maternal care provider doesn’t want to see her unless
there is bleeding, shortness or breath or fever.
It is inherently assumed
women know how to give birth and be a mother simply because they possess a
uterus. What is commonly ignored is the bridge of trust that must be built in
order for women to cross into motherhood successfully.
The black hole grows with
missed sleep, adjusting hormones, the pulsing of post birth tear sutures,
engorged breasts, sitz baths, demanding families and the stigma of societal
expectation of motherhood.
The new mother is encompassed
in the black hole; she’s not expected to see a medical professional until six
weeks after she has experienced one of the most profound life changing events
she will ever face, birth. All of the above brews into a void of uncertainty
the new mother slips into. She is
expected to avoid it and to navigate through it without support. Is this the
rite of passage into motherhood or medical neglect?
Twenty-five years ago after
the birth of my son if I could return all the cute little outfits my son was
gifted with in exchange for a post-partum doula, I would have. New mothers need support that contributes to
the bridge of motherhood; empowerment and validation is key. They require sleep
and a sense of security within a hurricane of uncertainty. The Black Hole is a rite of passage many
American mother’s face, which does not occur in other countries or cultures.
It is time to restructure the
American prenatal care model. It is vital for families to invest in maternal
support that goes beyond materialism. This support lasts longer than the cute
outfits that the newborn outgrows or the deluxe stroller. With the high incidences of post-partum
trauma, relapse and depression; it is paramount for the American College of
Obstetrics and Gynecology (ACOG) to rebuild the prenatal care model in American
obstetrics. The result will impact