The postnatal retreat in Northern Virginia, which offers services inspired by practices in South Korea, is one of only a few to have opened in the United States.
After hours upon hours of labor, an unplanned C-section, an impossibly long walk to the car and a jittery drive away from the hospital, Charlotte Campbell felt like most new moms: Overwhelmed. Exhausted. Anxious.
Then she and her husband pulled up to a sleek Northern Virginia hotel, took the elevator to the 19th floor and entered Sanu Postnatal Retreat.
As the Arlington couple checked in this month for a week-long stay, doulas stood ready to whisk away their newborn daughter, Audrey, to a round-the-clock nursery. Staff encouraged Campbell to sit down and take off her shoes. Before long, the first-time mother, 36, was sipping a cup of tea and soaking her feet in a lavender salt bath.
"From that moment on, I just felt like this was the best decision I ever made," Campbell, a partner at a D.C. law firm, said five days into her stay.
With her husband, Josh, an orthopedic surgeon, sitting beside her, she cradled their dozing, eight-day-old baby, who had been freshly changed and swaddled by a Sanu care manager. Campbell, radiant after another full night of rest, gazed with wonder at her "little nugget."
The idyllic scene was a far cry from the sleepless, harried period that greets most Americans who give birth and have to perform the balancing act of recovering while caring for a newborn. Nationwide, there are only a few places like Sanu -- which opened this year inside the Watermark Hotel in Tysons, Virginia -- that offer pampering and rest and a temporary village for those who may be far from family. But stays there don't come cheap. Some can cost as much as $1,500 a night. Sanu's nightly rate tops out at $880.
Sometimes called the "fourth trimester," the postpartum period is mostly an afterthought in the United States, despite the physical and mental challenges that accompany the life-altering experience of having a baby. Among industrialized nations, the United States stands out both for lacking guaranteed paid parental leave at the national level and for having the highest maternal mortality rate, with about half of those deaths occurring after the baby's birth.
Enter postpartum care centers. Standard in South Korea, the model has only recently made its way across the Pacific Ocean to the United States, where at least six such facilities have cropped up in high-end, big-city hotels over the past three years.
Word about them has spread in part through TikTok and Instagram. Videos showing off tidy hotel suites, in-room meals, massages and classes on infant CPR rack up comments like, "Every new mom needs this." But also: "Who can afford this?"
Julia Kim, Sanu's founder and chief executive, started the retreat out of a conviction that the United States needs to do better by new moms and babies. The barrier created by the costs, she said, "really keeps me up at night."
"I want to do everything possible to make this more accessible," she said.
In South Korea, more than 80 percent of mothers check into a postnatal retreat after being discharged from the hospital. Government funding aimed at addressing the nation's fertility rate -- the lowest in the world -- helps defray costs; some of the centers are even publicly run. Called sanhujoriwon, they sprang from the Korean tradition of a 21-day healing phase for mothers after childbirth, one that emphasizes rest and restoration.
In the United States, after nine months of regular doctor's office visits, formal postpartum care typically comes down to one checkup six weeks after delivery.
"One of the problems I saw was that after you have a baby, unlike when you're pregnant, all the attention and focus gets shifted from the mother to the baby," Kim said. "What about the mother?"
'Where every postpartum need is lovingly cared for'
When she was pregnant with the first of her two children, Kim did her homework. She read the books, took the classes, dropped by multiple pediatricians' offices near her home. She was, she said, "that crazy mom-to-be."
"I felt like I was super prepared," recalled Kim, who worked as chief of staff to a Virginia state senator. "Then I had my son, and there was just this moment where the nurses, they wheeled me into this recovery room, and then they just left. And I was like, 'Oh my gosh, where are you going?'"
Things didn't get easier at home. She was wracked with worry over how to meet her new baby's needs, and, on top of it, she was suffering from a condition that causes depression and anxiety during breastfeeding, called D-MERS, or Dysphoric Milk Ejection Reflex. At the time, she hadn't even heard of it.
Kim was still thinking about that period two years later in 2020, as she pursued an MBA at Georgetown University and contemplated having a second child. Its effects, she said, "had never quite left me."
A couple of her friends with family in South Korea, where her parents were also born, had made the trip there late in pregnancy to stay in postnatal retreats. Maybe, she thought, something similar could be a solution here.
And so Sanu was born. It debuted on Jan. 2, joining newly opened retreats including Boram in New York City and the Village in San Francisco. Sanu has five suites inside the Watermark available to "parenting teams," all featuring kitchenettes, living spaces and huge windows overlooking the highway and trees below. Family members, including dogs, are welcome to stay with the moms and babies.
The rooms resemble those in any other modern, upscale hotel, except for a few telltale signs: A bassinet waits near the bed, with wheels to allow easy transport to the nursery, and the dresser is topped with a changing pad. A whale-shaped baby bathtub stands next to the sink, where a note says parents need not worry about washing or sanitizing bottles or pump parts, adding, "we will do it for you." The bathroom is stocked with perineal care products -- peri bottles, ice pads, sitz baths.
A thick binder lays out complimentary services (among them breast massages, aromatherapy and classes on newborn soothing, bathing and burping) and meal options (including harvest salad, seared salmon and mushroom-crusted pork chops). Other pages detail add-ons such as lymphatic drainage massage, postpartum movement sessions and IV therapy. A schedule notes morning and evening doula check-ins.
"Welcome to Sanu!" says a sign on a nightstand. "Where every postpartum need is lovingly cared for, and every new beginning is celebrated!"
'Shouldn't be a luxury'
Iesha Vincent, a 32-year-old travel and lifestyle influencer from the Philadelphia area, remembers feeling like a stranger to herself in the days that followed the birth of her first son. So after she gave birth to her second child this fall, and Sanu invited her to stay for free and share her experience, she happily accepted.
During the two nights she spent at the retreat, she said, "It was literally like I didn't have to lift a finger at all unless I wanted to." With her first child, she was overprotective, a self-described "Velcro mom." With her second child, when a Sanu employee offered to take her baby down the hall to the nursery, which is staffed by doulas and nursery assistants and equipped with cameras, she was quick to answer: "Yes, please."
As a mother, Vincent said, it's not often the opportunity comes up to focus on your own well-being while someone else helps out. She has pregnant friends who would love to stay at a postnatal retreat.
"But the biggest holdup for them is the price," Vincent said. "At the end of the day in America, it's a luxury to go to one of these."
The way she sees it, that's a shame. In a country that prides itself as a global leader, she said, new mothers being cared for "shouldn't be a luxury."
That someone is paying attention to what new mothers go through and trying to do something about it is exciting to Tina Sherman, national director for the Maternal Justice Campaign at MomsRising, a nonprofit focused on economic security for families. Postnatal retreats "sound like a phenomenal idea" to her -- if they could only be more equitable. She noted that disparities are endemic in pregnancy and birth, including in maternal deaths.
The maternal mortality rate was about 22 deaths per 100,000 births in 2022, the most recent year for which data was available, according to the Centers for Disease Control and Prevention. Among Black women, the rate was significantly higher: 49 deaths per 100,000 births. In D.C., the disparity has been especially stark. A Maternal Mortality Review Committee report found that Black people made up 90 percent of birth-related deaths.
"If something like this is available for some moms and not all moms," Sherman said, "are we exacerbating the inequities?"
Kim, Sanu's founder, said she has talked to operators of some of the other retreats in the United States and looked at insurance plans to see what might be covered (the answer: not much). "It is heartbreaking, and it makes me think, okay, what is it going to take?" she said.
Her background in politics has given her some ideas. If the companies band together through an industry association, she thinks, they could advocate for insurers to cover the care, possibly through legislation. In a recent win, Kim said, Sanu should soon be able to arrange for parents to be able to use their Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) for doula care. (Doulas are trained professionals who provide support to families before, during and after births. There are no mandatory licensure requirements for them to practice in the U.S., but they can seek certification from states and organizations).
As it stands now, Sanu is not making a profit, Kim said, noting that its rate breaks down to a cost of $36 an hour for round the clock care. Sanu has six full-time employees and a dozen more who work part-time or as needed. Kim said losing money the first year was expected, but the business needs to get off the ground before it can push change.
As of early November, just shy of a year in, the facility had hosted 85 parenting teams for an average of five to seven nights. (Two couples stayed for three weeks and one for a month.)
People make reservations months before their babies arrive. Several women who have booked stays at Sanu, Kim said, did so while still in their first trimesters.
'I couldn't be the mom she deserves'
South Korea is not alone in observing a period of recuperation and support for postpartum mothers. Many cultures prioritize rest for a span of time that ranges from 21 days to five weeks, according to one study that examined different rituals, with extended family members or others taking over household chores.
In Japan, through the practice of Satogaeri bunben, women return to their family homes late in pregnancy to be attended to by their mothers until about eight weeks after birth. In Mexico, a 40-day rest period is called la cuarenta. In Thailand, yu duan lasts 30 days. Nigerian, Jordanian and Eastern Indian cultures also recognize an extended support phase.
"For a very short, tightly circumscribed period," the researchers wrote, "the mothers are mothered in order to value and protect their future capacity for mothering."
In Western culture, postpartum practices generally do not extend beyond the first few days. Yet some European countries have standardized support in the form of at-home visits: In Belgium, Sweden and the Netherlands, for instance, a health care worker visits a new mother in the first few days after birth. And among the 36 countries of the Organization for Economic Cooperation and Development, 33 offered an average of 16 weeks paid maternity leave as of 2020. The United States was one of just eight countries worldwide with no such protection.
Most American women are left to navigate the postpartum period alone until the traditional six-week appointment, a committee of the American College of Obstetricians and Gynecologists wrote. The group noted the "lack of attention to maternal health needs" as a particular concern, stressing the fourth trimester as a critical time for women and babies.
Holly Mason's first days of being a mother to her daughter, Iris, didn't go the way she had imagined. She knew it would be hard, but after two days of labor ended in a C-section last year, the Fairfax County poet and academic was drained physically, emotionally and mentally. The baby wouldn't sleep in her bassinet. Mason and her wife took turns sitting awake in bed, holding Iris, getting little rest themselves. Mason was full of guilt and self-doubt, feeling like "I just couldn't do it" -- like "I couldn't be the mom she deserved."
"In those early days, every decision feels like it's the decision, you know? It's like, okay, if I exhale now, I'm going to ruin her everything -- like, her whole life," said Mason, 35. "Everything feels so big."
At a breaking point about two weeks in, she remembered stumbling across the concept of postnatal retreats on social media, and started Googling for one nearby. That led her to Fourth Trimester, which had launched that month in the Watergate Hotel. It was more than the couple could afford on their artists' salaries. But, Mason said, the owner worked with them, waiving the three-night minimum and offering to discount their stay if they agreed to be photographed for promotional materials. They decided to go for it.
They didn't end up sending Iris to the nursery. But that first night, the baby had her longest stretch of sleep yet -- and so did her parents. The couple also met with a therapist and learned baby wrapping and breastfeeding tactics they brought home with them.
Looking back, Mason isn't sure postpartum retreats are the answer; she noted government or insurance backing of other options, like home visits or doulas, could also offer much-needed support.
"It didn't magically erase the exhaustion and everything, of course," Mason said of her time at Fourth Trimester, which has since been sold to a new owner and decamped to Chicago. "But I left better than I entered."
'Baby boot camp'
Even before she found out she was pregnant, Charlotte Campbell knew she would come somewhere like this.
She was familiar with postnatal retreats from friends who'd traveled to their native countries to stay at them, and after a positive pregnancy test, she and Josh (who correctly guessed it was a girl) took a tour of Sanu. They did the math of hiring a nighttime doula, taking classes, staying in a hotel and having three meals prepared every day and found the rate reasonable.
It seemed like a good bridge into parenthood. The owners of two rescue dogs, they'd considered themselves more dog people than baby people and had never changed a diaper before their daughter's birth. And Josh had less than three weeks off from work.
"We treated this like our baby boot camp," Campbell said. "Like, we're coming here. We're going to learn everything, take every single advantage, while we're here, to ask all the questions."
The whirlwind five days at the hospital, following a C-section that limited Campbell's ability to move, left the couple even more relieved that they'd have support.
"There's no other surgery that we're going to send somebody home and ask them to care for an infant," Josh Campbell said. "It's like, you just had major abdominal surgery -- now go care for this very needy thing."
While at Sanu, the couple learned infant CPR, changed a blowout diaper under supervision and took a course on nighttime feeding routines. He got in a workout; she had two massages. They had a date at the Japanese restaurant inside the hotel.
Before their stay was up, Charlotte Campbell texted her pregnant friends urging them to reserve rooms. She found so much comfort in knowing that someone was just down the hall if she needed help, and the time to rest seemed to speed up her recovery.
"By day three, I just felt like myself again," she said.
And that, she felt sure, would only make her a better mother.