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A look at what could be the future for postpartum care in America

Farida Azizova-Such inside the nursery rocking her son to sleep. "He was 5 weeks when we started coming. It's just my husband and I taking care of him, so I was alone at home. I wanted to find new moms to connect with and a safe space to be able to come and learn about how to take care of a baby, and also my identity shifted when you become a mother."
Ali Lapetina for NPR
Farida Azizova-Such inside the nursery rocking her son to sleep. "He was 5 weeks when we started coming. It's just my husband and I taking care of him, so I was alone at home. I wanted to find new moms to connect with and a safe space to be able to come and learn about how to take care of a baby, and also my identity shifted when you become a mother."

Today, I am the mother of twin 5-year-olds, but back during my postpartum period, also known as the "fourth trimester," I was incredibly overwhelmed and felt so alone. The transition into motherhood brings with it not just joy, but also numerous challenges — mental health struggles, nutritional needs, pelvic floor recovery, and the overarching need for self-care and community. During such a demanding time, when your baby — or in my case, babies — needs so much, who's there to take care of you?

Postpartum care in America is presented as fragmented support services with high costs, leaving most mothers and parents to face this in isolation. During a recent brunch, Sara Hutchins, a mother to a 2-month-old and a 3-year-old, shared her experience about a new postpartum care community she joined in Metro Detroit, known as Fourth Tri Sanctuary. "This place is for mothers to come where they are, come without a shower, take it there. You sit down to breastfeed and someone will approach and ask, 'What do you need?' I thought that, as a second time mom, I don't deserve this because this is a place for first-time moms. It took me a long time to come and explore it — I have found peace when I'm there and I feel at ease. When I come home, I'm a better mom, a better wife, and I'm more patient."

Sara Hutchins becomes emotional during a fireside chat with a mental health professional.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
Sara Hutchins becomes emotional during a fireside chat with a mental health professional.
Sara Hutchins bathing her daughter.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
Sara Hutchins bathing her daughter.
Arielle Weiner, 32, and her 5-month-old daughter (left) participate in a baby-wearing dance class.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
Arielle Weiner, 32, and her 5-month-old daughter (left) participate in a baby-wearing dance class.

Fourth Tri Sanctuary offers up to 18 weeks of support for mothers and their babies from certified postpartum doulas and health professionals in an environment designed for healing, education and bonding, and addresses the critical and often overlooked "fourth trimester" of motherhood. Parents whose babies are beyond 18+ months can also receive mom-only support through their weekly programming and amenities.

Farida Azizova-Such nurses her son. "Seeing other moms and then sharing their stories and finding out that, oh, okay, they have this kind of challenge. I have this kind of challenge. It's very similar or I didn't even think about that and how they dealt with it. I learned from that and having experts here."
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
Farida Azizova-Such nurses her son. "Seeing other moms and then sharing their stories and finding out that, oh, okay, they have this kind of challenge. I have this kind of challenge. It's very similar or I didn't even think about that and how they dealt with it. I learned from that and having experts here."
June Kelly, a certified postpartum doula and yoga teacher, uses a sound bowl to activate a baby's senses.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
June Kelly, a certified postpartum doula and yoga teacher, uses a sound bowl to activate a baby's senses.
Mothers and their babies attend a baby music class facilitated by June Kelly, a postpartum doula and yoga instructor.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
Mothers and their babies attend a baby music class facilitated by June Kelly, a postpartum doula and yoga instructor.

As I walked into the Fourth Tri Sanctuary for the first time, I felt myself holding back tears. What if a space like this existed when I needed it — would I have not faced such overwhelming challenges — from postpartum depression (PPD), to the critical need for self-care and community. Research conducted by Postpartum International Support shows that although perinatal mental health (PMH) disorders affect 800,000 people ayear, only 25% of them receive support. Each year, hundreds of thousands of parents suffer silently because they don't know what they are experiencing is common, or they feel embarrassed to share. Has essential support for new mothers been lost in our increasingly isolated society?

Mothers participate in an expressive art workshop where they are asked, "What do I need? What can I give?"
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
Mothers participate in an expressive art workshop where they are asked, "What do I need? What can I give?"
A mother writes an "I am doing enough" message to herself during an expressive art workshop.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
A mother writes an "I am doing enough" message to herself during an expressive art workshop.
Tiffany Yu pours her breast milk into a bottle after pumping.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
Tiffany Yu pours her breast milk into a bottle after pumping.

Tiffany Yu, a working mother to two children, aged 14 months and 4.5 years, is a mom-only member at Fourth Tri Sanctuary. She enjoys that it is a mom-only workspace, she can pump in the open and it doesn't matter, she can work a bit and then go lay down before she has to return to being a mom. As a 1.5 generation Chinese American, Tiffany observed the traditional Chinese practice of confinement.

"I had three adults, my mother, my father and my grandmother, come take care of me during my postpartum — the level of support is not common in the West. They cooked every meal and sometimes spoon-fed me while I was nursing my baby. That's the kind of support a mother needs to be able to heal herself and then be there for the baby. I think this is going to affect the trajectory of a nation, how well you support the next generation and the current generation. I just hear people my age — I'm a millennial — say 'Absolutely not. I don't want kids. How can we afford it? Who's going to support us? Day care is so expensive. I don't want to give up my career.' And these problems are in place because there's no support. If there was support like that, it would be a non-issue. So for all those reasons, I talk about this place to everybody. Women here [in America] need this support. It shouldn't be a luxury. It really should be the standard of care — women make up over half our population."

While parents participate in a movement class, postpartum doulas care for their newborn babies.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
While parents participate in a movement class, postpartum doulas care for their newborn babies.
Karianne Laurila takes a shower while her child is being cared for by postpartum doulas.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
Karianne Laurila takes a shower while her child is being cared for by postpartum doulas.
Karianne Laurila, a second-time mom, holds her child after taking a shower.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
Karianne Laurila, a second-time mom, holds her child after taking a shower.

Today, postpartum care services in the U.S. can range from $35-$200 or more an hour for an in-home postpartum doula, mental health professionals, lactation consultants among other additional services women and new parents seek. According to a survey conducted by Lansinoh, 88% of moms said they weren't prepared for the postpartum period, and over 95% of moms think new mothers are not sufficiently supported by our society.

The model of Fourth Tri Sanctuary creates a shared environment where mothers who are in the same stage of life can build community rather than just offering brief, isolated or expensive care. Is Fourth Tri Sanctuary a glimpse into the future of postpartum care in America? And if so, how can we ensure it is accessible to everyone? I spent the week exploring the impact of Fourth Tri Sanctuary on postpartum mothers and parents to examine how this community-centric approach could reshape postpartum care across our nation.

A mother bonding with her child.
/ Ali Lapetina for NPR
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Ali Lapetina for NPR
A mother bonding with her child.

If you or someone you know needs help, call or text 833-852-6262 to reach the National Maternal Mental Health Hotline, which is offers free, around-the-clock, confidential services for pregnant and new moms. In the U.S., interpreter services are available in 60 languages.

Ali Lapetina is a photographer based in Detroit.

Copyright 2024 NPR

Ali Lapetina