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INTRODUCTION

When I got home from the hospital, my wife and I felt like we had been dropped on a desert island. The first few days everyone was really excited to see the baby and brought food and company, but after that initial rush, we were alone. Neither of us had babysat much, so we were awkward even holding the kid for a while. I was afraid all the time. I would just sit up staring at her, so terrified that she would stop breathing in her sleep. I didn’t have enough of a milk supply and after two weeks of crying…usually all of us crying together…we finally caved and just went to formula. I felt like the worst mother on the planet. I couldn’t even figure out how to feed my baby. I wished there was someone who could help, but I didn’t even have the energy to look and, even if I did, I wouldn’t have known where to start. It got better in its own time, I think mainly just from the baby getting older and us gaining some experience, but I think I missed out on something…that sort of new mothering bliss I always imagined I would have. I hardly even remember what my daughter was like as a newborn, I was so stressed and sleep deprived. I was probably a bit depressed too, though I was never diagnosed or anything. I would definitely do a lot of things differently if I knew then what I know now.

E. L., new mother

In medicine, mommy blogs, and most pregnancy books, including this one, much time and energy is spent on improving the labor and delivery process and outcomes. For the most part, the postpartum period is an afterthought and there is little planning for this time or support for the mothers navigating an entirely new set of challenges, while still physically recuperating from pregnancy and delivery. Most parents spend more time on their baby registry than on preparing for the actual realities of new parenthood. While some would argue that no book or class can adequately prepare expectant mothers and fathers for what is to come, most new parents express the desire for more than just on-the-job training and feel they would benefit from more parenting information prior to delivery and increased help after the baby arrives.1

With increasing awareness about the importance of breastfeeding and the resultant public health campaign to expand breastfeeding in the United States and throughout the world, some positive developments have occurred in postpartum care, but most of those improvements have been limited to the hospital, with little to no continuity with care providers following discharge. In the traditional postpartum care model, mothers who have an in-hospital vaginal delivery spend 1 to 2 days in the hospital after the birth of their child and do not see their obstetrician or midwife until well after delivery. ...

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