There’s a New Way for Moms in the U.S. to Recover After Childbirth. Most Can’t Afford It

Mercedes Forrest first heard about postnatal retreats when one of her favorite Peloton instructors, Becs Gentry, posted on Instagram about her stay at Boram Postnatal Retreat, the first such center in the U.S. Forrest watched Gentry and her husband celebrate their newborn by checking into a luxury hotel, sipping champagne, and munching on protein-rich meals of salmon and seasonal salads. In the caption, Gentry wrote that during her stay she attended classes on infant CPR and met with a lactation consultant to check that her baby was properly latching. Forrest wasn’t even pregnant yet. “But I knew if I ever had a baby, that’s where I was going,” she says.

Eventually, she did. After considering hiring a doula or night nurse who would help feed and care for the baby overnight, Forrest decided a stay at Boram would be akin to hiring a doula, lactation consultant, personal chef, and cleaning person in one space for a fraction of the price, albeit still a significant sum. And while she did indulge in daily foot baths during her five-night stay in August, what Forrest most appreciated was the ability to call a nurse anytime day or night to whisk away her baby to a nursery for a few hours and offer Forrest and her husband some much-needed sleep.

Read More: Why Maternity Care Is Underpaid

Postnatal retreats have been popular in Korea, where they are known as sanhujoriwon, since the 1990s; there, eight out of 10 new mothers check into one, though not all are quite as posh as Boram. In recent years, they’ve gained popularity across Asia and Europe and are just beginning to gain traction in the U.S., thanks in part to Instagram posts about how much support new moms receive abroad. “You have momfluencers from other countries, and you see how postpartum is for them,” says Forrest. “And you realize treatment of mothers in America is so underwhelming.”

It’s the same understanding Boram co-founder and namesake Boram Nam came to more than a decade ago when she was pregnant with her first child and deciding whether she should have the baby in New York City or her native Korea. “I created an Excel chart with pros and cons because all my friends were checking themselves into these postpartum retreats in Korea,” she says. Ultimately, she and her husband decided they couldn’t afford to travel. “How is it possible we live in one of the most amazing cities in the world and have nothing like this?” she asks.

In May 2022, the couple opened Boram, which translates from Korean to “fruit of one’s labor,” inside the Thompson Central Park Hotel in New York City. It has since served more than 700 families, who, on average, stay six nights, usually with a partner, though at least one guest stretched her visit to 42 days. The Village Postnatal Retreat Center opened at the Fairmont Hotel in San Francisco last July. A retreat called Sanu opened in McLean, Va., in December. The Ahma & Co. retreat debuted in Orange County in March. Retreats are also popping up in Washington, D.C., Seattle, and San Diego. “My feed is full of the luxe mom movement,” Forrest says. “The older generation would say, ‘Well, I did it by myself, and my husband worked all day.’ And I think now more moms are not ashamed. They’re like, ‘If I have the means to get help, I’m going to do it.’”

It’s hardly surprising that there’s a market for these retreats in the U.S. The federal government has an abysmal track record when it comes to support for new mothers and infants. The U.S. is the only developed country without a federal policy of paid family leave and rates first in maternal and infant mortality among that same group. Up to 20% of mothers in the U.S. experience postpartum depression. And in the U.S. postpartum care for mothers is often limited to a single checkup about six weeks after the baby’s delivery, an appointment nearly 40% of new moms miss.

But while these retreats can be a haven for new parents, the experience comes at a cost: Depending on length of stay, Boram costs about $995 per night. And unlike some of their foreign counterparts—the Korean government offers subsidies and discounts on postpartum care—the American retreats are not subsidized by the government and few of their offerings are covered by even the most expensive insurance plans. This means this level of care is out of reach for the vast majority of people who give birth in the U.S., leading some women’s advocates to question whether they are solving a problem or simply offering cover to a government unwilling to tackle maternal and infant health issues.

Jennifer Darwin, founder of The Village Postnatal Retreat Center, worked for 11 years as a labor-and-delivery and pediatric nurse and witnessed firsthand how little support mothers got after giving birth. “We had to discharge families because of insurance, but they weren’t ready,” she says. “The looks on their faces, they were shocked they had to go home with this human and didn’t know what to do.”

The minimal coaching parents did receive was often short and contradictory. “I’d see nurses say, ‘This is how you’re supposed to breastfeed: Do 15 minutes on this side, then 15 minutes on this side.’ That nurse would clock out,” Darwin says. “And the next nurse comes in and says, ‘You’re doing it wrong. You only breastfeed on one side.’ Then I would show up for my shift, and people are almost in tears. Their anxiety is through the roof because they feel they’re doing everything wrong.” Darwin eventually left nursing to become a birth doula because she thought she could help more parents that way. But when she realized even then she couldn’t meet her clients’ needs—she’d require a whole team of nurses and doulas for that—she began thinking about starting a postnatal retreat.

Sanu founder Julia Kim arrived at the same conclusion based on her experiences as a parent. “I took all the courses on how to change a diaper and what to do if they’re choking. I read all the books. I scoured the Internet. I was 110% ready,” she remembers. “Then I had my baby and was so lost. I couldn’t swaddle the baby. I just thought, we need to better prepare mothers, especially when it’s hard for them to walk or go to the bathroom as they’re leaving the hospital.”

Many countries have figured out how to mitigate feelings of stress and isolation for new parents. In China, a postpartum parent rests for a month while a family member or “confinement nanny” attends to housework, older children, and other tasks. In many parts of Latin America, female relatives take on domestic duties for a 40-day period called la cuarentena. In Japan, new mothers often return to their own parents’ homes while still pregnant and stay after the birth to be cared for while they heal. In the Netherlands, the government sends a maternity nurse to new parents’ homes after they’re discharged from the hospital. In Sweden, nurses and midwives make home visits after delivery. In the U.S., meanwhile, one in four women returns to work within two weeks of childbirth.

Erin Erenberg, CEO of Chamber of Mothers, a national nonprofit that advocates for paid family leave and affordable childcare, agrees with the founders of these retreats that new mothers are in desperate need of medical attention and psychiatric support in the months after their baby is born. “We need to look at this as an emergency,” she says. But she and others who lobby for postpartum support to be enshrined in law worry about the impact of relying on private solutions amid a public crisis. “When you offer a private service, it further widens the gap between the haves and the have-nots in this country,” she says.

Many of the people who can afford to book these retreats can also afford support of some kind. All the women who spoke to TIME about their stays at retreats said they had considered some combination of night nurses, lactation consultants, and postpartum doulas before booking a room. Erenberg argues that it’s the women who have no parental leave or access to affordable childcare who are in most desperate need of care. “In a country where women battling poverty say, ‘I don’t know that I can afford to have children,’ a private solution is a flawed one,” she says.

The hefty fee for these retreats–typically between $700 and $1,400 per night–helps cover the salaries of lactation consultants, therapists who screen for postpartum depression, and other experts, in addition to equipment like bassinets and nursing pillows, but the founders acknowledge the price tag is prohibitively expensive for most people. “We’re trying to figure out how to do this without sacrificing the level of care,” says Kim of Sanu. Boram, meanwhile, has tried to make its services more accessible by launching an online subscription for $40 per month called “Boram Anywhere,” which includes recorded classes on everything from babywearing to bottle feeding. For an extra $200 parents can receive three one-on-one coaching sessions.

The founders of these retreats speak of a future in which every mom can access at least some version of the support services. Esther Park, founder of Ahma & Co., argues they will be a “proof of concept” for insurance companies. “We’re starting with the market that can pay out of pocket because we want to establish the service as something that is needed,” she says. Boram has launched pilot programs with private companies that may be willing to offer postnatal retreats as a perk to lure and retain employees. The founders point to the culture shift around fertility treatment as a model: 46% of companies with more than 500 employees now provide some sort of coverage for IVF, according to a survey from Mercer. And New York passed a law in 2020 that mandates large group insurance plans to cover IVF. They’re convinced the benefits of postpartum support will eventually become apparent to lawmakers, who will in turn find ways to subsidize support, at least in some states. “The government says, ‘Wow this is actually much better for the general population,’” says Park.

If you’ve followed the debates over family leave and childcare in recent years as legislation has stalled, it may be hard to imagine this vision becoming a reality anytime soon. Erenberg expresses skepticism at the notion that Congress will ever find the funds to support low-income mothers seeking to stay at postpartum retreats when it can’t even pass a bill on universal childcare. Instead, she thinks there’s a simple explanation for why postpartum retreats are gaining steam in the U.S. “Capitalism, honestly,” she says. “We see these models abroad, and it’s very American to say, ‘That’s a good business idea,’ instead of saying, ‘There is a serious systemic support gap for American mothers that needs to be addressed.’”

In fact, even the private sector may not yet be sold on the idea of postnatal retreats. Several of the founders of these retreats say they had trouble convincing U.S. investors of the value of the business model. “There still isn’t an understanding of postpartum care as essential care here,” says Suk Park, Boram Nam’s husband and co-founder of Boram. “It was easier to present this idea to Korean venture capitalists than it was to American ones.”

The majority of the first guests to sign up for Boram were Asian or Asian American couples already familiar with the concept, though that pattern has begun to change. Kim and Darwin observed something similar with their retreats, Sanu and The Village respectively, noting that their early guests hailed from cultural backgrounds where postpartum support is the norm.

That was true for Linda Wen, who checked into The Village when her husband expressed concern that hiring a confinement nanny who would live in their home would afford them little privacy. “I’m Chinese, and in Chinese culture something like this or a confinement nanny is not unheard of. There’s a lot of emphasis in the culture on recovery of the mother,” she says. “I knew something like this existed. I just didn’t know how luxurious it could be.”

Wen found that she valued the mental-health support as much as the physical support. She would wander out of her room to the mothers’ lounge where Darwin and other staffers would offer snacks and empathy. “Nobody tells you giving birth is trauma. Your whole body is in pain, not just your pelvic floor but your breasts and your nipples,” says Wen. “Your hormones are fluctuating and you’re crying about everything. It was great to have the Village retreat women there be like, ‘Yeah that’s normal.’”

Darwin says her ultimate goal is for postnatal retreats to become as mainstream as doulas. “The idea of having a doula, that really blew up in the last decade,” she says. “I want people to feel like this is also something they deserve. Fifteen years ago there was no such thing as a babymoon, but now people take that vacation. That’s what I want to do with postnatal retreats because it kickstarts your recovery.”

For now, stays at these high-end retreats remain options for only a privileged few. But Forrest looks back at her time at Boram and refuses to feel guilty for seeking help. The way American mothers are asked to function at home after childbirth is unsustainable, she says. “You can’t get into a routine because you’re in survival mode of when to eat, when to shower, when to feed,” she says. “The retreat takes you out of survival mode.”