When Dr. Alicia Robbins had her first two children, she, like almost every woman who has birthed a child before her, felt overwhelmed upon leaving the hospital.
Never mind that she herself is an obstetrician and gynecologist. Both times, having a child “was way harder than I expected,” said Dr. Robbins, 39. “I kept wondering if it was OK that breastfeeding was so difficult or that I felt anxious. I kept asking myself, ‘Is this really my new normal?’”
Her mother traveled from Arizona to help her, “but she kind of froze,” Dr. Robbins said. “I love her, God bless her, but we had fights over things like whether you need to sterilize the breast pump for three hours.”
So when Dr. Robbins, who lives in Greenwich, Conn., had her third child, Otto, on April 5, she welcomed the opportunity to check into a retreat for mothers with means, who have just given birth, and their infants. Until now such retreats were usually private, community-based options not available to the wider public.
“We are there to ease the transition between the hospital and home,” said Boram Nam, who, along with her husband Suk Park, founded Boram Postnatal Retreat, which is located on the ninth floor of the five-star Langham Hotel in New York City and opened Mother’s Day weekend. (They named the retreat Boram because it means “something fruitful after hard work” in Korean, Ms. Nam said.)
For a hefty price tag of between $1,300 and $1,400 per night, a woman who just had a baby gets many of the things she needs (physical and mental care; medical care, however, is the responsibility of the mother and her outside doctor) and even more of the things she most likely wants (sleep; foot rubs on request; banh mi delivered to her room; and a breast pump cleaned between uses.) Most guests stay three, five or seven nights.
‘This is like heaven for postpartum patients.’
Dr. Robbins checked in about one month after Otto’s birth; she had learned about Boram from a colleague. It was her third cesarean section and she found post-operation recovery very difficult — all the more so because she had a 4-year-old and 2-year-old at home.
When she arrived at Boram, she was mentally and physically exhausted, so she delighted in the marble bathtub, rainfall shower, Nespresso machine and Swedish Duxiana bed. Her suite was also equipped with a hospital-grade bassinet and eco-friendly Coterie diapers. Menu items include foods believed to nourish new mothers: seaweed soup, bone marrow and steak.
She checked out the mother’s lounge, a serene space with plants and cozy couches. There were lactation cookies, at least half a dozen types of teas and a refrigerator full of hydrating beverages. The lounge is also where Boram brings in pediatricians, physical therapists and mental health experts offering general seminars on topics including pelvic floor therapy and how to fall asleep more quickly.
Dr. Robbins’s favorite part of the floor, however, was the nursery, helmed by a former Lenox Hill Hospital N.I.C.U. nurse educator and staffed by employees with a background in infant care, to watch the baby whenever the mother wants.
“I sent Otto to the nursery within three minutes of being there,” said Dr. Robbins. “And I went to sleep.”
“I even read a book,” she said, during her three nights there, and her husband stayed for one. (Partners are welcome to stay as well; other children are, understandably, not.) “This is like heaven for postpartum patients,” Dr. Robbins said.
‘A lot of women suffer in silence.’
Even women who have spent nine months preparing to go home with a baby are shocked by how little institutional support they receive once they actually do. Women frequently have to find their own lactation consultants to assist with nursing and therapists to help with postpartum depression, Dr. Robbins said.
“Doctors might give you a number to call, but for the most part you have to coordinate things yourself, and you don’t even know what you need until you go through it,” Dr. Robbins said. Many moms go home from the hospital with little more than a folder full of pamphlets; others rely on Facebook groups for even serious challenges.
Postpartum health is something that largely gets ignored in the United States, said Kristin Sapienza, founder of FemFirstHealth, a New York City clinic that provides services to mothers after they give birth.
The United States has a higher rate of maternal mortality than other developed countries, and women of color are disproportionately affected. Maternal deaths — women who died during pregnancy or shortly after — went up during the pandemic especially in Black and Latino populations, according to a study by the National Center for Health Statistics.
“I think a lot of women suffer in silence or don’t get the resources they need,” she said.
“If we really supported people in raising families like Sweden,” or other parts of western Europe where postpartum home visits, for instance, are part of universal health care, said Catherine Monk, a professor of women’s mental health in obstetrics and gynecology at Columbia University Vagelos College of Physicians and Surgeons, “we wouldn’t even need a facility like this.”
“All new moms talk about the deficit of supportive services for new mothers in the postpartum period,” said Paige Bellenbaum, founding director of the Motherhood Center, a clinical treatment facility in New York City for new and expecting mothers experiencing perinatal mood and anxiety disorders.
Most women don’t see their own doctor until six weeks after giving birth. The pandemic only exacerbated the issue, making women feel more alone, isolated and helpless, she said.
Boram is part of a growing number of companies offering support to new moms when they leave the hospital.
‘Like more of a band-aid for this universal problem.’
Ms. Nam said she was inspired by postnatal retreat centers in South Korea called sanhujori, where “new moms go to after they leave the hospital for 14 days to get pampered.” The average cost for a two-week stay is about $2,000 to $5,000, so while they are still by no means inexpensive, they are slightly more accessible than a place like Boram.
Sanhujori are an ingrained postpartum tradition because the few weeks after a woman gives birth are acknowledged as essential to the health and well-being of mother and child. Baek-il is another tradition, where mothers and infants lie low for the first 100 days after birth. On the 100th day, they celebrate.
Postpartum centers, which emerged about 15 years ago in South Korea, said Ms. Nam, were a natural next step for a culture that prioritized caring for new moms. “It’s understood that you have family and friends who can help you with child care or food and making sure you are not alone.”
After having two babies at hospitals in New York City, in 2010 and 2014, she felt there was a need for this.
“After my first baby, I was in the bathroom looking for ice packs for vaginal soreness while this little crying thing was in my living room,” Ms. Nam said. “I was so traumatized because I didn’t feel like I was well taken care of while all my friends back home got to go to these wonderful places.”
She even considered going back to South Korea to deliver her second child but decided instead to open a postnatal retreat in the city. Eight years later, in May, Boram opened.
Dr. Monk said this type of care or tradition exists in many places around the world in addition to South Korea.
In Latin American cultures, for example, a new mother rests for 40 days, during a time called “la cuarentena” (or “quarantine”), while people in the community do household chores for her and bring her hot, healthy soups to eat.
In China, she said, new mothers have a month of confinement named “zuo yuezi,” — or, in Mandarin, “sitting the month” — where they build up their strength and bond with their baby after childbirth by staying at home.
“I’ve had patients who are part of the Jewish Orthodox community who have gone to this place in Rockland county called a baby hotel,” Dr. Monk said. “They have someone else take care of them and their baby.”
“Many cultures have some form of an acknowledgment that this is a very challenging time and a special time, and a woman needs support for her and her baby,” she added.
Dr. Monk said a place like Boram is what every new mother deserves: “If I could design the ideal, this is what everyone would have postpartum, and they would know they were getting it.”
And yet, with such a steep price tag, Boram is currently available only to people with the means to afford it — and those are people who can likely afford night nurses, nannies, doulas and lactation consultants anyway. “Boram feels like more of a band-aid for this universal problem,” Dr. Monk said.
Boram is aware it has a barrier to entry. “We are in talks with companies so our retreat can be provided as part of benefits to their employees,” Ms. Nam said. “Down the road, we want to work with insurers.”
For now, however, the company insists it needs to charge high prices to maintain its level of service. “We have to charge what we are charging for the service we are providing,” she said.
Jennifer Jolorte Doro, 35, is a clinical nutritionist and postpartum chef who lives in Millbrook, N.Y., a village in the Hudson Valley. After giving birth to her second child, JP, on April 13, she looked for a doula who could help care for her after childbirth, but found there weren’t very many in her area. So she checked into Boram about three and a half weeks after giving birth instead.
She especially loved the hotel’s food.
“The meals are the last thing you think about, but it’s what you need the most,” she added.
Sophia Cho, 33, a graphic designer, checked into Boram a month after giving birth to her daughter, Selah. The hotel was only blocks from her home in Chelsea, but it felt worlds away from the situation in her New York City apartment.
“This is my first baby, and ‘terrified’ is probably the most accurate word for how I’ve been feeling,” she said. “You can read all the books, but there is nothing quite like having to diaper and feed and pay attention to this baby who is crying at the top of her lungs. It’s a little overwhelming.”
During her five-day stay, she found the group sessions, especially one on breastfeeding, the most useful. “There is a lactation consultant on-hand, and I’ve been having trouble nursing my daughter, so getting that expertise was so valuable,” she said.
(Of the ongoing baby formula crisis, Boram has not really been affected: “We have fortunately been able to secure a sufficient supply of Similac RTF formula through Abbott Nutrition,” Ms. Nam said.)
Filling in for ‘the Village’
In fact, Dr. Monk said that forming a community is essential for the mental health of the mother and the physical health of the baby. “We published a paper in 2019 in the National Academy of Sciences where we divided people into three groups: physically stressed, psychologically stressed and healthy,” she said.
“The people in the stressed groups had way lower numbers of supportive people in their lives, people to talk to and social support,” she said. (Having people to run errands was also important.)
“When we have this message that you need to be back at work in six weeks, and we aren’t offering you anything to acknowledge the new demands on you or what you’ve been through, it’s dispiriting,” Dr. Monk said. “This is sending the message that we see what you just did, we see what you’ve been through, and we know this is a huge transition.”
Melina Hope was a patient care associate at Lenox Hill Hospital before becoming a nursing assistant at Boram; she said the entire staff tries to create that kind of support for new moms. “I saw my goal as filling in for the ‘village’ to support moms in the vulnerable postnatal period.”
Ms. Hope, who is 43 and lives in North Bergen, N.J., said when she worked at a hospital mothers would primarily get medical care, and if they had no complications, they would go home after one or two days with a lot of unanswered questions. At Boram she can spend one-on-one time with the moms and really help them.
“The difference between how they came in when they arrived and how rested and confident they were when they went home,” she said, “is remarkable.”