Sunday, May 09, 2010

Dollhouse

It's been clear to me for some time that the Korean maternity experience differs radically from the British one. One important respect in which this difference manifests itself is postnatal care - it isn't uncommon for a new mother to spend two to four weeks at the hospital's 'sanhujoriwon' (산후조리원') postnatal/postpartum clinic recuperating in Korea. By comparison, the National Health Service hospital in one British city states the average length of stay in their postnatal beds in 2009 was 1.2 days.

I went to the Maternity Hospital with my wife for a scheduled ultrasound, and after the scan we went up several floors to look at the postnatal suite. British hospitals tend to comprise of one or more sprawling low-rise buildings in their own grounds, whereas the smaller more specialised Korean hospitals often tend to occupy office buildings, and are easy to miss amidst all the other explosive activity of a typical Korean street. So stepping out of the elevator on the 8th floor, I expected the usual reception area and office-style rows of corridors leading off to various rooms. Instead there was nothing except a separate glass door, through which one could see an image which very much conveyed the message that you were now leaving the clinically sanitised hospital environment for something less dehumanising - beyond was a lounge with a TV on the wall, some couches with refreshments, and a colourful timetable on the wall with cartoon headlines promising treatments, massages, exercises and other activities. A narrow staircase led upwards to some uncertain destination. It was uncomfortably hot - apparently because of the recommended postnatal recovery temperature, otherwise known as 'slow cook'. It's a traditional Korean belief that new mothers should cover themselves with blankets and keep warm in order to protect them from 'loose bones' - failure to do so results in arthritis and rheumatism in older age.

We had to remove our shoes to proceed, emphasising the notion that we were transcending from a public environment to a domestic one. We were led upstairs, to be shown three types of room in which my wife could stay. The first comprised of a bed, a couch, a large LCD television and a desk with an Internet-connected computer, with a door to a separate private bathroom on one side of the room. The slightly cheaper rooms progressively lost the couch and the desk, so that the most economical option potentially had you surfing the Internet from the heated floor. The difference between the cheapest and most expensive rooms was 150,000 won per week (£87/$130), and the most expensive option was 800,000 won per week (£475/$718). I thought it best to go for the most expensive room, given that they were bigger and carried less risk of going stir crazy, especially considering that the view from most rooms extends approximately three feet out to the side of the next building, hence the prevalence of frosted glass. Also, since husbands are expected to stay overnight with their wives, more space is better, and I'd prefer to sleep on the couch rather than the floor.

I noticed something odd though. We'd looked at three rooms with three rather dazed and disconnected looking occupants, but where were the babies? It transpired they were all three floors below us being cared for. This was not what I had expected - to my mind this was supposed to be an important bonding time between mother and child, yet it seemed that the Korean approach involved separating the two for most of their postnatal stay in the hospital. Yes, when the baby needs feeding the mother is called down immediately to do this, but otherwise mother and baby are not together. As my wife sat discussing room options I was left pondering the Korean method and what they knew that I didn't, given that my initial reaction was that the idea was extraordinarily bad. At least it transpired that our 'sanhujoriwon' was not as strict as the one in Seoul whose head said "Mothers are not allowed to touch or hold other babies, we have strict visiting hours and don't even let the grandparents hold the baby."

We went down to see the newborn baby care facilities. This time on stepping out of the elevator we were confronted by a large artificial tree surrounded by a bench, behind which a glass wall separated this small island of faux-nature with a brightly-lit scene which could easily have been straight from a science-fiction movie. Four rows of perspex baby cots were lined up, ten per row, with three nurses moving around changing and checking the slowly stirring occupants. A separate control-room appeared to be situated off to the right. I felt the brightness was hurting my eyes but perhaps you get used to it. I watched a nurse change a baby. It was quick, functional, and not exactly gentle. The baby started crying, which elicited no reaction whatsoever from its carer - she finished and moved on. This did nothing to convince me that separating mother and baby was a good idea, but I understand that the separation may allow time for the mother to recover from childbirth, and it does provide round-the-clock monitoring and care for the babies.

The whole recovery issue though is an interesting one in Korea. Barring a sudden advancement of science or an unexpected alien abduction I'm never likely to experience childbirth, so I'm not really in a position to comment, but the impression seems to be given here that after giving birth a Korean woman's body is 'shattered', bones are fragile, and generally great care must be taken to bring her back from the brink of existence.

In the UK nobody I knew had stayed in hospital for anything like the extended period that appears to be the norm in Korea, and more than that the impression isn't created that women's bodies are completely broken from the experience to the point at which they should be relieved of any involvement in caring for their babies. It crossed my mind that keeping forty women in hospital at 800,000 won per week is probably a pretty good business, although this isn't to say it's necessarily a bad thing. But assuming there are no complications, my cultural background has clearly conditioned me to expect a much reduced recovery time to the one which my wife was envisaging.

This issue is a potential cultural battle which any sensible Western husband is going to carefully avoid with their Korean wife - so I told my wife it's entirely her decision how long she stays in hospital for. She has to weigh up the advantages of the rest and postnatal care versus the potential loss of immediate bonding, actual quality of care and the formal complaints which have been raised.

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