Staying in hospital or a birthing centre after having a baby

Most mothers gave birth in hospital, with only a couple having their babies at a birthing centre or at home. Women who gave birth in hospital spent up to six nights on a postnatal ward before going home. Hospital stays were typically shorter stays for vaginal than for caesarean births, and in public than in private hospitals. Partners were also able to stay overnight in private hospitals and birthing centres but couples usually had to go home within 24 hours of delivery in a birthing centre. In both hospital and birthing centres, mothers were mainly cared for by midwives; in hospital some mothers also saw obstetricians or lactation consultants after the birth. A few women who had complications after giving birth had longer hospital stays or were re-admitted.

Women’s experiences on the postnatal ward were varied. A few women felt well-supported and valued the opportunity to learn how to care for their baby and establish breastfeeding, although some found lack of continuity of care frustrating. Some mothers from migrant backgrounds said the postnatal care in Australia was better than in their home countries. Tina, a migrant mother from Iran, said: ‘[In Iran] the doctor give you lots of painkillers, but you didn’t have any counselling, like how to breastfeed your baby, how to cuddle her properly, how to cope with the motherhood challenges, nothing’.

Josie had her first baby in a private hospital so she could have a longer stay. She felt well looked after but it was hard to have a good ‘connection’ with any midwife because she saw so many.

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Tolai felt that the care and emotional support from health professionals after her children’s births in Australia was better than what she understood to be the case in her home country Afghanistan.

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Many women found aspects of their postnatal hospital stay challenging, including learning to feed their baby (see also Caring for a baby – feeding and settling. Establishing breastfeeding in hospital was often difficult and many women were critical of mixed messages, inflexible attitudes on the part of midwives, or a lack of support. Jane, a mother of twins, had to use breast and formula milk and described being unprepared for bottle feeding: ‘… because we were intending to breastfeed, nobody actually told us how to sterilise bottles or how to do anything and because everything is so crazy, you don’t know what you need to know and so when we brought [the twins] home from the hospital, we stopped at a chemist and bought the steriliser and we were using temporary bottles from the hospital for a week, until we got others sorted. It was just crazy stuff’.

Elizabeth appreciated being able to stay in hospital five nights and learn how to care for her baby, but struggled with ‘conflicting advice’ about breastfeeding and the lack of support at night.

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The lack of opportunity to sleep and recover from the birth while in hospital was a source of concern for many mothers. Louise reflected on having to learn how to care for a new baby immediately after labour and birth: ‘It’s like you’ve run a marathon and then your next marathon starts that day. There’s no break’. Many mothers echoed the same feelings, describing their first days of parenthood as a ‘blur’ or a ‘dream’.

First-time mothers were often unaware they could ask the midwives to take their baby to the nursery to give them a break. As Sara L said: ‘I felt I was alone, no-one’s helping me, no one’s telling me they can take a baby away so I can have an hour’s sleep. I’d been awake 48 hours … No-one says it’s okay we’ll help you, we’ll take him away’.

Melanie, who experienced postnatal depression after her first baby, felt her worries about doing the right thing and an extreme lack of sleep and time to recover in hospital was when she started to ‘go downhill’.

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Several mothers described encounters with ‘rude’ or ‘grumpy’ midwives. This was difficult to cope with when women were in a vulnerable situation, recovering from birth, trying to learn how to breastfeed and care for their babies, and usually very tired.

Michelle felt vulnerable after a difficult labour and emergency caesarean. The nurses’ insensitive and sometimes ‘aggressive’ attitude made her feel bad and ‘not cut out’ for motherhood.

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Alice needed extra support after an emergency caesarean and postpartum haemorrhage. She contrasted the ‘lovely’ nurses who helped her breastfeed with staff in the special care unit and the postnatal ward, who were sometimes unhelpful and ‘rude’.

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For first-time parents, learning to care for their baby was a very important aspect of their stay in hospital. Parents who had very short postnatal stays or parents via surrogacy missed out on this opportunity. Daniel, a father of twins via surrogacy, recalled: ‘there was some anxiety in those first few days for my partner – we’ve been given these two children and suddenly we’ve got to learn how to bottle feed them and nurse them … I remember him running around the hotel looking for a woman, any woman, when we had the kids come home from the hospital to help us. We found one just to help us learn how to use the bottles and microwave, that kind of thing. Luckily, the clinic gave us access to hire some nurses to help the first few nights’.

Susanne and her partner went home 24 hours after a difficult labour and birth. She felt angry that antenatal information included no preparation for the time after giving birth.

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Despite planning to have her baby in a birthing centre, Cecilia had a hospital birth as there were no beds in the birthing centre the day she went into labour. This experience was very different from what she had expected and she found it difficult to come to terms with afterwards. Beth had a water birth in a birthing centre for her first baby but was critical of aspects of the care she received.

Cecilia planned to have a ‘natural’ birth in a birthing centre but had a hospital birth and experienced intervention. She felt ‘angry’ about the lack of acknowledgement of her feelings.

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Although her baby had a ‘beautiful’ water birth at a birthing centre, Beth was unhappy with other aspects of her and her baby’s care.

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Several women had complications following caesareans and had to stay in hospital longer, be re-admitted or have further major surgery. Michelle spent a week in hospital recovering from an emergency caesarean, went home for a week then had to be re-admitted to hospital for a further week due to ‘abdominal pains’. She felt this contributed to her experiencing postnatal depression, reflecting that: ‘It was just a lot of upheaval to begin with …’.

After surviving the rare and life-threatening condition placenta percreta, Erin was hospitalised for three weeks. She began to experience post-traumatic stress disorder symptoms and was ‘surprised’ this was not picked up and dealt with during her stay.

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See also:

* Labour and birth experiences
* Experiences of health and allied health services during labour and birth