New moms and newborns need privacy, study shows

Flowers are always nice, but perhaps the best gift you can give a brand-new mom is some quiet time alone with her baby. Now that hospital visiting hours — not to mention staffing — are 24/7, maternity units are taking steps to minimize interruptions and lower the volume. They recognize that lack of privacy can get breast-feeding off to a rocky start, while lack of sleep might play a role in postpartum depression.

A study in the latest Journal of Obstetric, Gynecologic, and Neonatal Nursing found that women typically experienced dozens of interruptions during their first day after delivering a baby.

Researchers recorded the number and duration of visits and phone calls from 8 a.m. until 8 p.m. for 29 brand-new moms who intended to breast-feed. During that period, the mothers on average experienced 54 visits or phone calls, averaging 17 minutes in length. On the other hand, they were alone with their baby (or their baby and the baby's father) only 24 times on average, and half of those episodes were nine minutes or less.

"I can remember when I first got into obstetrics, back in the late '70s, early '80s, fathers could stay on the floor all the time, and grandparents and siblings were the only ones who could come to visit," says lead author Barbara Morrison, an assistant professor of nursing at the Case Western Reserve University Frances Payne Bolton School of Nursing. "I think we've kind of gone overboard in the other direction."

Concern about how the hospital environment affects breast-feeding spurred her to do the study, Morrison says. "They need to breast-feed immediately after delivery and then very, very frequently in the first three or four days. They can't do that if they don't have private time."

Mommy 'nap time'

New moms often feel uncomfortable turning away visitors or hospital personnel so they can focus on breast-feeding, Morrison says.

At Covenant health care, a Saginaw, Mich., hospital that delivers about 3,500 babies a year, nurses are "the bad guys" when it comes to keeping the peace in the maternity unit, says Susan Garpiel, a perinatal and pediatric clinical nurse specialist.

A few years ago, the unit instituted a daily "nap time" from 2 to 4 p.m. For those two hours, the unit dims the lights and discourages — but doesn't ban — visits by friends, family and staff.

"We wanted to be advocates on behalf of our mothers and babies," Garpiel says. "Women who are having their first babies don't realize how much their sleep is impacted with a new baby."

Covenant patient Pamela Williams, who delivered Maegan, her first child, at 3:19 a.m. last Monday, says visitors began arriving around 8:30 a.m. Williams, 36, an elementary-school principal from Saginaw Township, says she welcomed the chance to nap undisturbed that afternoon. "I needed that time just to relax and refresh. They put a sign on the door: 'Mom and baby resting,' which I love. It takes some of the pressure off you."

Since the establishment of a formal nap time, Garpiel says, "we saw a huge turnaround in terms of breast-feeding problems and moms who were melting down at night."

By napping with their babies in the afternoon, she says, moms are more likely to keep the newborns with them at night — facilitating frequent breast-feeding — instead of shipping them off to the nursery so they can get some sleep.

New use for the Yacker Tracker

Covenant is one of 46 institutions working with the Institute for health care Improvement, a non-profit organization based in Cambridge, Mass., to improve the care of mothers and newborns during the perinatal period, or around the time of birth. The institute is encouraging all members of its perinatal network to institute "peace and quiet time," says nurse Sue Gullo, who directs the program.

Gullo came to the institute from Elliot Hospital in Manchester, N.H., where 1:30-2:30 p.m. is nap time in the maternity unit. "You wouldn't believe what it took to implement it," she says. "Notifying every department in the hospital that they can't do their work as usual for one hour just throws people over the edge." But, says Gullo, "when people understood the reason for doing it, they were totally open to the idea."

Oklahoma City's Mercy Health Center, which delivers 3,000 babies a year, has taken a novel approach to keep noise to a minimum in its maternity unit: the Yacker Tracker. The portable device, developed by a teacher to reduce classroom noise levels, looks like a stoplight. Users can set their preferred decibel limits.

"Green means it's quiet, yellow means you're starting to get noisy," explains Cindy Jennings, nurse manager of the Mercy BirthPlace, which also has "privacy please" lights above each patient door.

Some doctors saw red when the Yacker Tracker was first mounted near the BirthPlace nurses' station earlier this year, Jennings says. But it has worked. Nurses duck behind closed doors if they need to talk. Doctors and visitors have lowered their voices.

"Now we notice it's a lot quieter than it used to be."