Monday, 4 January 2016

When attachment and bonding isn’t spontaneous.

In an ideal world, as a baby is born, it is held by its mother, and that mother-baby connection is swathed in happy hormones and instinctive behaviours. Bonding and attachment are evident and the room will be filled with ahhs and awws. I’ve just described a perfect scenario, just like this in my previous Blog. As a midwife with a very deep interest in normalising birth I can recount many other wonderful experiences that meet these expectations for greeting a new baby. It’s the image every film, where childbirth has been part of the story, has presented us with since we were tots ourselves.

It seems natural then to assume in pregnancy that there will be a rush of recognition and love by its mother immediately as baby is born. If this is a wanted baby then lots of recognition of behaviours of the developing baby are already a part of the Mother baby bond. She will be noting sleep and activity patterns, rubbing the tummy and talking to the bump, recognising hiccups, taking an interest in growth charts and scans. The mother who has been waiting for him or her for 9 months anticipates instant recognition and love. Even if there is an understanding prior to birth that not all women experience an immediate attachment at birth, the expectation is then (of course) that this distancing will normalise soon. For most women in this situation this will be true. 

For many others however this is not the case.

Later, for some, instead of remembering a rush of delight and love, a woman looks back at her baby’s birth, she feels little recognition, or memory, and no happiness. When this is a person’s real experience it can be bewildering, scary, and leave a new mummy feeling guilty, bad or sad.

We are story tellers, and in pregnancy and after childbirth, particularly so. When poor attachment has occurred, how does a new Mum explain that lack of immediate connection with her baby to herself? How can she say this out loud and who does she talk to?

I remember my first awareness of the impact natural hormones have on a woman’s body during labour. A woman’s ability to access this wonderful cocktail depends on so many personal and environmental factors. When it all comes together though this exceptional experience creates the exceptional stories. Labour is easier. Birth is easier. Attachment is easier.

What I have recognised in the counselling room is that the protective capacity of these hormones on a woman’s emotions and memory during her labour and birth also carry into the postnatal period. The opposite is also true.

Birth trauma; the psychological disruption to a person’s sense of safety, disrupts the ability of the body to maintain the protective cocktail in labour, at birth, or in the immediate period after birth. Fear enters the equation. A woman feels frightened, responds to a perceived threat to herself or her baby with fear. Then stress hormones visit instead. Again in the counselling room the effect of these events are very real and painful. What is wonderful is that they are most often easy to normalise very quickly. What is sad it that it may have been years since this fear response began.

There are so many reasons why it can take a while longer for those feelings of attachment and connection to happen either during pregnancy or at birth. Some require a little processing because they are so hard to think about. Talking about a lack of emotion for a new baby can seem impossible. It would be very natural to feel afraid that people wouldn’t understand. Starting that conversation with the baby’s dad, a midwife or health visitor, GP, Mum or a friend can reduce the feelings of guilt or confusion.

Talking means a woman’s own mind starts to explore those feelings. She may remember that the labour was very long and think about how impossibly tired she was. Or she may realise how many other things she was worried about. Complications may have meant she was depleted in emotional and physical energy.

Midwives and Health Visitors are placing a much greater emphasis on attachment behaviours. During antenatal care and through to the rest of a child's life, the importance of talking, touch, eye-contact and connection with little ones is spoken of again and again. Babies have learnt to hear their parents’ voices while growing inside the uterus. The baby knows its parents at birth. They are immediately curious and hard wired to connect.

When it is hard to bond
Best advice. First Aid. Actively pretending is the best thing a woman can do. Going through the motions as though she really feels them will help to safeguard the baby’s bonding, and start their journey towards emotional security early. Remembering to look into baby’s eyes and smile, provide touch and cuddles. If a baby cries and Mum responds with provision and care it orientates the baby into security. They learn in the centre that they are ok. The mother is growing the connective pathways, so that when her mind settles and she is emotionally able to bridge that gap, her little one already knows how loved and important s/he is. Their security-centre has been filling up with every connection since they were born. Consider talking. If anxiety symptoms are present it is wise to talk about these things too.

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