Notes From a Maternity Ward

BY SUSANNE HOEBER RUDOLPH

HAVING a baby is exciting not only because one adds a new generation to the family, not only because a baby has its charm, but because the very process of having a baby is fascinating. One of the things that struck me as I tried to initiate myself into the art of motherhood was the range of philosophies of the various generations from whom I drew my advice. Once you have had the baby, you do not see very much of the doctor anymore. But you do see a great many nurses, who perform a number of functions for the recuperating mother and the baby. In my hospital, a fashionable place for urban and suburban matrons in and around Boston to have their babies, the difference between the older and younger nurses was marked. The older ones were punctual, definite, and specific about directions, while the younger were softer, friendlier, less punctual, and less conspicuously efficient.

I had a couple of elderly, firm, no-nonsense women who would show me how to feed the baby, implying by their manner that there was a right way which everyone had to learn. The younger ones never did show me how, apparently assuming that this was a natural instinct. I’m not sure which I liked better: the older ones were so definite about it that I rather wished they wouldn’t bother; the younger ones would have been a help had they been willing to give an inexperienced person like myself a little more direction. I think the difference in attitude was due not merely to the fact that some were older and some younger, but to the fact that the older generation regarded nursing a baby as a science, while the younger regarded it more as an instinct.

This notion was certainly borne out by my attendance at the so-called “mothers’ class.” Three days after I had Jenny, I was invited to attend one of these and gratefully accepted the invitation. The setting itself was amusing; there were fifteen to twenty women about my age assembled in a room containing some twenty not very cozy straight-backed chairs. Since all of us had had our babies only a few days before, most of us teetered awkwardly on the very edges of these chairs for the hour that we were expected to listen. The lady in charge of the class was a thin, efficient person, wearing one of those hygienic gauze turbans which all the nursery nurses wear. I assume that she wore it on this particular occasion more as a badge of office than as a functional headgear — a badge that one somehow felt had grown onto her in the twenty-five years which, as she kept reminding us, she had been in “this business.”

She lectured for sixty close-packed minutes. Since, owing no doubt to academic habit, I had a pencil and paper in my dressing gown pocket, I took notes and found I had the next thing to writer’s cramp at the end of the hour. Her account was both disconcerting and reassuring — reassuring because I had the best scientific advice for all eventualities; disconcerting because there were so many things to remember that I was sure I could not possibly remember them all. The changes in generational philosophy were perhaps best illustrated by what happened half an hour after the mothers’ class. My young (thirtyish) pediatrician came to visit me in my room, and upon hearing that I had been to the mothers’ class, made a face, and when he heard that I had taken notes, even more of a face.

“Did she tell you to wash all the new diapers before you tried putting them on the baby?”

“Yes,” said I.

“And did she tell you to put a bath towel at the bottom of the baby’s bath before you bathed her?”

“Yes,” said I.

As a matter of fact, I had made very special note of these two bits of advice from the voice of experience.

“Forget it,” he said. “Just enjoy your baby.”

He seems to represent a new style of institutionalized casualness among pediatricians, a style which, I gather from talking to my friends, is becoming general among the present generation of children’s doctors. He pooh-poohs scales, because they make the young mother worry about whether her baby is gaining enough; thermometers, because if the baby is really sick you ought to be able to feel it on its forehead; and even so stable and standard an item as baby powder, suggesting instead that one can always use cornstarch.

The new school is obviously based on the assumption that your instincts will be right. That is a very good corrective for the overconcerned mother who feels she has to obey all the rules in detail. On the other hand, it is not completely comforting for a mother who is not sure that she has any instincts about what to do with her baby. When I got home, I found that a close adherence to the spirit of my doctor’s advice — not worrying too much — made good sense, but that my notes from the lecture by the overly careful nurse were a great comfort when I did not know quite what to do. What pediatricians do not always understand is the magical values of such closely reasoned rules as the nurse gave us in the mothers’ class. All primitive societies have a series of rituals to make the new mother feel at ease, to make her feel that somehow she is doing the right thing to smooth her baby’s path to the future in the best possible way. In our society we no longer believe in magic rites to create a harmony between mother, baby, and the universe. We have substituted scientific rules instead.

The trouble with the new generation of pediatricians is that they are telling the young mother that she can have neither ritual nor science. I think it may be well to give her one or two pieces of absolutely useless ritual to go through when she feels she is not doing everything quite right for the baby. When she sterilizes the formula, she is not merely sterilizing the formula; she is also reassuring herself that she is a good mother and somehow properly introducing her baby to a complicated world.

I suspect that rules like those of the overly finicky nurse may be particularly useful to young mothers in the absence of grandmothers. Apparently our generation is not supposed to call in a grandmother to help in the process of learning how to care for a baby. Everybody knows that the notions of the grandmother are outdated and that grandmother will intervene in the felicitous establishment of an intimate relationship between the parents and their child. Since everybody knows this, including grandmother, my modern, competent, self-confident mother proved remarkably diffident about offering advice. Today new mothers have to fall back on the nurse in the mothers’ class or Dr. Spock, that splendid substitute for grandmother.

Having said all this, I might add that I am not sure I would ultimately have stood for more ritualism than my doctor was willing to provide. That is the trouble with being a member of a liberated female generation, and an academic female at that; one yearns for the protections of another age and status but cannot stand the restrictions and patronizing they imply.

APART from my interest in the people around me in the hospital, I was astonished by the effect that the process of childbearing itself seemed to have on me. I think I now understand the mechanism of what is called the postpartum depression much better. In the first few days after Jenny was born, I suddenly recalled many things which I had not remembered for years and years. I had a very clear and sharp recollection of myself as a small girl; I could recall incidents of my childhood that had not been in my mind since they happened.

I found that I was dreaming strange dreams, some of them extremely beautiful and fanciful, with Paul Klee-like castles and birds and trees and animals of brilliant colors and imaginative shapes, a lovely child’s fairyland. I also had terrifying dreams, in which there were creepy beasts with many legs, black furry things which were threatening me and which crawled out from under something or other. Both were children’s dreams of a kind that I have not had since I have been an adult, since my rational self began to structure dreams in a less fanciful fashion. I noted that for the first few days I invariably used nothing but German endearments on Jenny. I was born a German, and presumably these must have been endearments used on me. I do recall that my mother called me Spatzchen (“baby sparrow”), and I know that I called Jenny that, among other things, for several days.

I believe that in those early days I was reliving a lot of my childhood experience. I also found that my emotions were terribly near the surface; I could cry at almost anything, both good and bad things. When Jenny was brought in to me, I cried because it was so nice, and if someone told me something mildly cheerless, I cried. I think that having a baby may produce, through physiological and partly through psychological means, an effect somewhat similar to that of the psychoanalytic process. It brings back experiences which have been lost for quite a long time. I imagine that women who have a serious postpartum depression find that in the process of this recapitulation, which is, after all, carried on in the absence of a psychiatrist, they come across aspects of their youth with which they cannot deal without help and which, in their extremely vulnerable psychological state, disturb them deeply. I found my condition in those early days after Jenny’s birth rather dreamlike and wonderful, and simultaneously very disturbing.

What surprised me further was that this condition disappeared in the course of perhaps a week without my really noticing it. It suddenly dawned upon me, after I had been home from the hospital a week, that I was no longer dreaming, or if I dreamed, it was only my usual less fanciful dreams, and I was no longer calling Jenny by German endearments. The vulnerability lasted a bit longer; I still found it very easy to cry after a couple of weeks home from the hospital. But in time even that went away.

The “how to have a baby” handbooks all suggest that there may be something unusual in the immediate postpartum experience. They talk about women’s crying easily, about their finding it a particularly emotional time, about how husbands should be kind and considerate and not growl back. But none of the books led me to expect quite so strange and moving a psychological experience.

The memory of the experience itself is beginning to disappear now, as my everyday self reasserts itself in the course of the work that I have to do. When I first resumed my academic activity a week after I came home, I did not know whether I liked it or resented it. On the one hand, the resumption of paper reading and paper grading and lecturing seemed to drive away the curious dreamland in which I had been living, and I resented the fact because the dreamland had been so pretty. On the other hand, my work helped me put my everyday universe back together; it seemed extraordinarily hazardous to be out in the world with so dreamlike a frame of mind. Certainly when I came home from the hospital, I felt as though I were much too young and vulnerable to be able to manage all the responsibilities which the baby and the relentless pressure of my academic work in January imposed on me.

It occurred to me that having a baby wrote finis to whatever remained of my own childhood, that from now on I could no longer permit myself any of the luxury of a childlike frame of mind, which, after all, even adults sometimes resort to. That seemed quite frightening for the moment; I felt a huge additional burden of responsibility descending on my shoulders and heavy days ahead forevermore. Since then I have started feeling lighthearted again, and find that after all I still have cheerful pockets of irresponsibility and a husband and friends to indulge me in them.

I discussed the weighty feeling of this new responsibility with a friend who has five children and who seemed to me the model of natural motherliness. After watching me and Jenny for some hours, she had remarked wistfully that I must be one of those rare women to whom motherhood comes naturally. I protested that this was not true, because I still found in myself corners of panic about the permanent and inescapable quality of this obligation. Surely, I said, she had never felt like that, but had accepted the obligation quite smoothly. No, she said, she had not really given in to the responsibility until her second child was several months old. She remembered the moment vividly: she and her husband had been engaged in a lively conversation with friends when the baby started to cry upstairs. Her husband interrupted himself to tell her that the baby was crying. Since that was obvious, the sentence somehow brought home to her that she, and no one else, carried this responsibility, and she spoke of going upstairs in despair and fury at the inescapableness of the fact. She remembers picking up the child and comforting it even while her resentment continued to smolder. And then, she remembers, the child fell asleep, and her resentment drained from her. It never again returned in the same full force, and she believes it was only then that she became a real mother.

To some extent, the circumstances of enforced independence under which the young mother comes home add to the weightiness of the responsibility. All the books I read made much of the fact that if I had someone in to help at the beginning — either mother or nurse — I should try to get her to do the housework and take charge of baby myself. The literature implied that at this moment above all the advice of the previous generation should be given short shrift, and the virtues of single-generation self-sufficiency practiced. “It’s your baby,” the books advised, as if one did not know it only too well. I suspect that I liked it best that way since I’m enough a child of my generation to take a dim view of the wisdom of the elders. But I wonder whether this particular difficulty, the feeling that one had abruptly and forever given up one’s childhood and the protection and comforts that go with it, afflicted women in the past. The era of the omnipresent grandmother, to say nothing of the joint family household in other societies, must surely have diluted the weightiness of the new obligation. One must have remained daughter even as one became mother, and felt more protected, even though more interfered with.

One final thing occurred to me when I was thinking over the experiences of the hospital in the period shortly after I came home. It seems to me that a pregnant woman may establish a most extraordinary and unique relationship with the man who delivers her baby. My doctor is a very nice man, though not necessarily one with whom I would, in the ordinary course of events, have much in common. His interests and tastes are different from my own, and I feel that we live in very different worlds. I tried to explain to my husband when I came home from my first visit to the doctor why, though I felt him to be so very different, I thought I would have confidence in him as an obstetrician. I recall saying something incoherent about how he made me feel that he and I together could manage this thing very nicely. I do not think I really understood why I put my faith in him as an obstetrician until those rather painful two hours before Jenny was born. As the lady from the next cubicle in the labor room told me sometime later, “I heard him talk to you and encourage you in your labor, and he gave courage to us all” — referring to herself and the other two women in the labor room. I suppose that the relationship between a doctor and his patient at the time of the birth is about as intimate as a relationship between a man and a woman can be if they are not lovers, simply because of the physical processes that are involved. I suppose that when a woman makes a decision about her obstetrician, she makes some kind of assumption that he will be helpful to her at that crucial moment.

I know that not all women feel that their obstetricians served them well, and I should think that a woman would be particularly resentful if one had failed her. Being a good obstetrician seems to require much more than mere technical competence; it also requires a very high sensitivity to the psychological and physiological processes of labor as it reaches the climax.

Now that I am back at work, I look back on the birth of my baby a little bit as I used to look back on summer romances — very sweet and unrecapturable experiences which drew their special quality from the fact that they were exceptional. I wonder if I will feel the same way about my second baby.