Hannah Oh

Professor Althoff

WRTG 150

15 November 2019

Before Sunrise: Sleep Fragmentation in Postpartum Women

Introduction

In Disney’s The Lion King, a young cub named Simba wakes early one morning to

excitedly pounce on his father, Mufasa, to wake him up. His mother, Sarabi, mumbles sleepily to

her mate, “Your son is awake.” In response, Mufasa quips, “Before sunrise, he’s your son.” (The

Lion King, Minkoff).

This light-hearted scene is funny because it’s relatable. Most mothers watching The Lion

King smile and role their eyes, and maybe turn to their husband with a quick, “Ain’t that the

truth?” Yet, most viewers fail to question Mufasa’s assumption that all nightly duties should fall

on Sarabi. Those roles are so securely ingrained into our culture that we don’t even question their

validity.

Today, let us begin questioning: Why are mothers expected to wake up several times a

night to care for children while their partners are allowed to roll over in ignorant bliss?

All too often, the fathers in our society believe that only the mothers have the ability or

the responsibility to care for children during nighttime wakings. For this reason, mothers,

particularly those with infants, are disproportionately prone to fragmented sleep patterns.

There have been many arguments aiming to explain why new mothers are more

vulnerable to sleep fragmentation than fathers, ranging from natural maternal resources to time

availability, but the data points to society as the most probable cause (Burgard). Society has
placed unreasonable expectations on mothers that require those mothers to sacrifice their own

health in order to provide 24/7 on-call care to their newborns with very little, if any, help from

their partners.

These gendered expectations have far-reaching effects. Fragmented sleep patterns have

been shown to have adverse psychological, physiological, and social effects. Society is

essentially torturing new mothers by denying them restorative sleep.

Many in our society would argue that it is a natural experience for new mothers and that

women who have chosen to be mothers have also chosen to lose sleep over it. What these people

are ignoring is that new fathers made the same decision when they helped to conceive a child,

and that they bear equal responsibility in caring for that child.

Societal expectations of mothers cause postpartum women to be more vulnerable to

fragmented sleep patterns, adversely affecting their overall health and well-being, but we can

improve postpartum women’s health by moving toward more egalitarian expectations of

mothers’ and fathers’ roles as infant caregivers.

Background

Sleep Fragmentation in New Mothers

Sleep fragmentation refers to repeated, short sleep interruptions during a sleeping period

(Bertha).

In a study about the sleep quality of postpartum women, participants reported waking up

an average of three times per night for forty-five minutes each time (Lewis). It should be noted

that sleep wakings vary in frequency and duration with every child. For example, I know women

whose children, only weeks after delivery, only wake once every night to feed. Meanwhile, my

first child woke up an average of six times until she was two and my youngest, at just shy of one
year, wakes a decent average of three or four times per night. My oldest nursed for forty minutes

at a time, while my youngest nurses for approximately fifteen.

Current Studies on Sleep Fragmentation in Postpartum Women

While there is a plethora of studies on sleep quality, insomnia, and general sleep

deprivation, studies on sleep fragmentation are limited, and those which focus on postpartum

women are more so. Many studies that include sleep fragmentation in relation to postpartum

women group it with other sleep quality issues rather than isolating it as a risk factor. This is

problematic in that it limits our understanding of the specific effects of fragmentation on new

mothers and reduces distribution of the findings that do exist.

While the effects of postpartum sleep fragmentation haven’t been researched

significantly, there is a more significant amount of sociological research to support the idea that

postpartum women are more likely to experience fragmented sleeping patterns than their

partners. Research shows that American mothers, regardless of other social roles, are more likely

to take the night shift of childcare than fathers or other partners (Burgard). This is supported by

another study in which fifty mothers were asked, in addition to other sleep quality questions,

who was responsible for nighttime caregiving. Forty-five of the fifty mothers reported that they

were the sole nighttime caregivers. Only one mother reported that the father took the nighttime

caregiving role, while four reported shared responsibility (Carroll, et al).

The question remains, then, of why women are so much more likely to sacrifice sleep,

when it would seem that mothers and fathers should be equally responsible for their child.

Postpartum Women and the Nightshift

 There are varying hypotheses as to why new mothers are more vulnerable to disrupted

sleep patterns than new fathers. Four of these hypotheses were tested against each other in a

study which used data from the American Time Use Surveys conducted between 2003 and 2007.

Theory #1: Time Availability

The Time Availability theory suggests that women are more likely to take the night shift

of caregiving because men spend more time in paid work, and thus have less time to do

caregiving (Burgard, 1192). This assumes that domestic responsibilities are less time-consuming

and demanding than paid work.

Among participants in Burgard’s study who were employed and had an unemployed

partner, 3.2 percent of women took the night shift, as compared with 0.9 percent of men

(Burgard). While this does show that employment does seem to somewhat affect who takes the

nightshift, the gap between employed men and women is still significant. In addition, people

who were in dual-earner homes showed a significantly greater gap between men and women,

with only 11% men reporting sleep interruption, while 32% of women reported the same.

Returning to Simba’s family, As Mufasa’s brother later points out to his hyenas, “It’s the

lionesses’ job to do the hunting” (The Lion King, Minkoff). If the lionesses (which, presumably,

includes Sarabi) are responsible for hunting, a time-consuming career to be sure, we must

assume that time availability due to occupation is not a viable explanation for Mufasa’s refusal to

fulfill nighttime parenting duties, and we must turn to other hypotheses.

Theory #2: Specialization

The Specialization theory attributes women’s nighttime caregiving to their specialized

resources, specifically breastmilk. Burgard’s research shows that mothers were more likely than

their partners to waken regardless of the particular need of the child. In fact, the decision of who
would care for the child’s needs seemed to occur when one parent reacted to the cue (such as a

cry) by waking up and the other did not, before the needs were determined (Burgard).

Cotrell and Karraker’s study of fifty mothers lends further evidence against the

specialization hypothesis. In the study, twenty mothers reported exclusively breastfeeding,

eighteen reported exclusively formula-feeding, and thirteen reported a combination of the two.

Under the specialization hypothesis, one would expect that approximately twenty participants

would also report being the primary caregiver at night, about equal to the number of

breastfeeding participants. Yet, as previously mentioned, forty-five of the participants reported

being the sole caregiver at night (Cotrell & Karakker, p. 210).

In the case of our lion family, Simba’s wakeup call is specifically aimed at his dad, so

breastmilk is clearly not his motive for waking. Despite this, his father still rolls over and refuses

to wake, directing Simba’s mother to take responsibility (The Lion King, Minkoff)

Clearly, there are other factors involved in the disproportionate role women have in

nighttime caregiving.

Theory #3: Resources

The Resources theory suggests that the person who has the most resources has the power

to assign undesirable tasks to one that has less resources. This primarily refers to the idea that

men are more likely to provide more money for the family and are therefore able to assign

nighttime duties to the women, who contribute to the family through service.

This theory can be falsified for the same reasons the Time Availability theory was

eliminated: even working women are more likely to be assigned the night shift, regardless of

their household contributions (Burgard).

Theory #4: Gendered Expectations

 The Gendered Expectations theory suggests that new mothers are more likely to

experience fragmented sleep because society expects women to fill the role of nighttime

caregiver, just as society expects a woman to fill other domestic responsibilities. This theory

calls the night shift “the third shift”. This refers to the idea that a working woman will come

home to care for spouse and children in an unpaid second shift followed by a third shift during

the night.

This theory is the one most heavily supported by Burgard’s study and by what I found in

Cotrell and Karaker’s study (Cotrell & Karakker, p. 210, both of which showed that women

external factors had little effect on their likelihood to take the nightshift. Through falsification

methods, it can be determined that societal expectations are the most likely cause of new

mothers’ vulnerability to sleep fragmentation.

Under this theory, we can conclude that Mufasa expected Sarabi, regardless of her own

exhaustion and her contributions to the pride and irrespective of the purpose for Simba’s waking,

to take care of Simba at night due to his society’s traditional understandings of lionesses as the

primary caregivers of their cubs. In other words, society told him that Simba was Sarabi’s son,

and that he could go back to sleep.

Now the question is, what is society doing to mothers?

Effects of Fragmented Sleep

Studies have shown that sleep fragmentation is more detrimental to subjective sleep

quality in postpartum women than the amount of time they are awake during the night (Gress, et

al., p. 384), as well as to the development of postpartum moods (Park, et al., p 8). Poor sleeping

patterns may result in, “exhaustion, impatience, lower ability to concentrate, and a poor quality

of life, which can all lead to an increased risk for postpartum depression” (Lewis, et al., p. 1).
Postpartum depression is deeply troubling for mothers, like myself, who want badly to bond with

a new child but find themselves either apathetic or irritable. While medications are available, the

risk of affecting the newborn through breastmilk is a common deterrent, resulting in an

abundance of untreated cases. In extreme cases, sleep fragmentation can lead to postpartum

psychosis, a dangerous state that requires hospitalization (Sharma and Mazmanian, p 98).

In addition to increased risk of psychological disorders, testing has shown its negative

effect on memory and psychomotor skills (Swain, et al, Abstract) and on growth and healing due

inability to reach slow wave (deep) sleep, the primary restorative sleeping stage (Burgard).

Research has also shown that the postpartum period has a negative effect on marital

satisfaction due to spousal perceptions of one another’s sleeping patterns (Ensana, et al.). In one

study, new mothers reported more sleep fragmentation than their male counterparts, but both

mothers and fathers reported equal fatigue in the weeks after delivery. Additionally, women were

more likely to sleep during the daytime than men (Gay, et al.). When women believe their

husbands are getting better sleep than they are because they are not waking in the middle of the

night to help, and men believe their wives are just taking naps all day while they themselves are

working tirelessly at work, there is a lot of room for misunderstanding and negative perceptions.

Improving Postpartum Sleep Quality

Postpartum women are in a difficult and dangerous position. With proper solutions, new

mothers will no longer feel that they must choose between caring for their child or caring for

their health.

There are several recommendations for how to solve this issue.

Some specialists recommend being more selective in choosing when to respond to infant

distress at night. Rather than rushing to every beck and call, one should determine if the cry is
one of hunger and need, or if the child has merely woken unexpectedly and will shortly fall back

asleep (Gress, et al.). Unfortunately, this recommendation doesn’t account for the many children

who need more frequent feedings or cannot put themselves back to sleep because of innate

personality.

Napping is, perhaps, the most recommended solution to the effects of sleep

fragmentation. Unfortunately, opportunities for naps are not easy to find. Other priorities, such as

housework, homework, careers, older children, and others, often prevent mothers from taking the

time to lie down and restore themselves (Cotrell & Karakker, p. 210).

The solution must go beyond simple restoration and go to the source of the issue: fathers

should share the mothers’ nighttime responsibilities in order to decrease the frequency of

fragmentation. As has been discussed, there is little reason why fathers cannot take on some of

the nighttime caregiving responsibilities. While they cannot breastfeed, they can bottle-feed if

possible, change wet diapers, and sooth fussy babies. Paired as necessary with discretionary

response to wakings and with napping, shared responsibility for nighttime childcare would

greatly reduce the adverse effects women experience from sleep fragmentation in the postpartum

period.

Conclusion

Sleep fragmentation is a harsh reality of early motherhood. It has far-reaching effects on

many aspects of postpartum women’s lives, including their mental, physical, and social health.

When we consider everything that a mother must do to care for a child, including producing

milk, holding, transporting, and teaching, in addition to her other daily responsibilities, it is

baffling that society expects her to sacrifice her sleep. A mother cannot successfully fulfill all of

these duties and perform well without necessary restorative sleep. Not only does sleep
fragmentation affect her, but it affects the child that depends on her. Society depends on a

mother’s nurturing, which allows children to grow and develop and become the world’s new

leaders. How can we expect women to provide the best care for the world’s future leaders if they

are themselves at their worst?

Fathers or other partners should take equal responsibility in caring for a new child,

including sharing more equally in nighttime caregiving. In addition to the aid it would give

mothers, more involvement would allow for better father-child bonding in the first year. While

father involvement would mean that two parents will suffer from sleep fragmentation, sharing

the nightshift would significantly cut down the fragmentation frequency, and may also improve

marital relations through increased understanding. Therefore, father or partner involvement in

nightshift duties is the most desirable solution to the postpartum sleep fragmentation crisis,
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