June 10, 2010
Are maternity units too noisy?
By: Kimmelin Hull, PA, LCCE | 0 Comments
According to a recent article in the Boston Globe, hospital noise has become problematic and researchers, along with some hospital administrators, are starting to listen.
From The Boston Globe article:
In 2005, a team of researchers at Johns Hopkins University led by the engineers Ilene Busch-Vishniac (now the provost at McMaster University) and James West looked at the best available historical data and found that, since 1960, the average daytime noise level in hospitals had doubled. At night, it was four times louder.
So what's the buzz all about? The numerous studies cited in this article repeatedly point to concerns and, in many cases, concrete evidence that hospitalized patients tend to fare much worse as decibel levels rise. Vitals signs (blood pressure, heart and breathing rates and body temperatures) are less stable. Perceived pain and therefore request for pain medication is higher. Newborns in intensive care nurseries stay longer and can potentially suffer hearing damage. Surgical patients take longer to heal.
For me, this suggests the obvious question about mothers who are supposedly resting up from childbirth - particularly the ~30% of US women who are recovering from cesarean section deliveries - and what type of true 'recovery' they are garnering during their 48 - 72 hour stays.
Some cultures around the world take the postpartum recovery of a woman so seriously, they expect mom to do nothing but remain at home, sleeping, eating and nursing her baby for upwards of forty days. In the United States, our hustle and bustle, noise-filled culture accompanies a woman's postpartum experience.
Typical doctor's orders on a maternity ward dictate a woman's nurse(s) to visit her room no less than once every four hours to perform basic nursing duties - and assuming baby is rooming in with mom, there is often times a completely separate schedule of nursing visits for the newborn. But, following each of my three hospital birth experiences, I seem to recall the door to my room swinging open and shut many more than six times in a twenty-four hour period. Between doctors performing medical rounds, someone from the nutrition department collecting food orders, lactation specialists making their daily visits, hospital photographers stopping in for a quick snapshot of each bundle of joy and occasional hospital volunteer drop-ins, there's actually very little time for a woman to rest following the birth of her baby.
Sleep studies tell us that when a person's sleep is frequently interrupted, they are less likely to slip into non-REM sleep - the mode of rest during which growth and healing is most likely to occur. With overhead pages echoing down the halls, sitcom canned laughter from the neighbors' too-loud television, and, let's face it, the sound of multiple babies crying in poorly insulated quarters, it's no wonder most women leave the hospital more rather than less tired when they entered. (And, if you've recently been pregnant, you'll likely recall how tired you felt by the end of your third trimester.)
But it's not just the postpartum wing where noise is a problem. The L&D room can be a rather cacophonic place as well. With fetal monitors tapping out the baby's twice-per-second heart rhythm, constantly spewing out reams of paper, and bing-bonging an alert every time the baby's heart rate falls outside certain parameters.... with patient controlled analgesia pumps pumping and beeping away... with alarms sounding every time an IV line gets kinked or the bag empties... with a infant warming table blaring when it reaches its preset temperature... with labor and delivery nurses, aides, technicians, nursery nurses, midwives, doctors, PAs and possibly residents and interns floating in and out, a hospital birth room can become as busy as the intensive care department.
We know from observing animals that from an instinctual basis, it's pretty darned hard for childbirth to take place amidst noise and lack of privacy. And, surprise, surprise: human beings are no different. Could the ever-increasing rates of labor augmentations, epidural usage, suction-assisted deliveries, and cesareans for 'failure to progress' be explained, in part, by hospital setting noise? Is it possible that with every 'unnatural' sound we hear, our bodies shut down just a little more - whether during the process of birth, or during the healing, resting, and mother-baby bonding period that is supposed to occur afterward?
Recently, a dear friend of mine delivered her second baby. Having shared a room with another woman in the postpartum wing, my friend initially spoke favorably of her experience being so close to another puerperal woman. 'That's when I realized how much I needed to be with other women following my birth experience,' she confessed.
But our conversation quickly turned to the idea of a postpartum floor lounge - a place specifically designed for mothers and babies...a spa reception-like setting where women could sit in comfortable rocking chairs and heavenly couches, nurse their babies, share stories, exchange words of advice and encouragement amidst quiet music (or no music at all) and dim lighting, drink from the endless supply of healthy teas, water and juices, and languish in an uninterrupted setting for as long as they desired.
'It wasn't exactly ideal sharing a [hospital] room with someone else,' she later told me of her two-day postpartum roommate. 'I could hear all their conversations and she constantly had the TV on. But still, I learned a lot about myself and my needs following my second baby's birth.'
In the United States and many, if not most other developed nations, women do not look forward to a 40-day lying in period following childbirth. So, that cultural practice being what it is, perhapshospitals that are currently looking at their facility-wide noise levels and amelioration plans should also contemplate the overall setting of the labor, delivery and postpartum wing.
This is a guest post by Kimmelin Hull, PA, LCCE. Kimmelin is a Lamaze Certified Childbirth Educator, mother of three, and author of A Dozen Invisible Pieces and Other Confessions of Motherhood. You can visit Kimmelin at her blog site: http://kimmelin.wordpress.com.
Photo by debsilver, used under a Creative Commons license.
TagsPostpartum Sleep Labor/Birth Newborns Babies No Separation