Tuesday, June 19, 2007

Mother-infant bonding, and maternal instincts

God has made the mother wonderfully able, not just to give all that’s needed for a new baby, but to want to give. God has made babies able to recognise and want their own mothers. In a day when women aspire to work in many occupations alongside men as equals, this is one occupation in which gender does matter. Giving birth, breastfeeding, and nurturing very young infants are quintessentially and exclusively women’s work. When a couple come to me and say “We want a natural birth”, or “We are planning to breastfeed”, I seek an opportunity to remind them, gently of course, that only the woman can give birth; only the woman can breastfeed. Only a mother has maternal instinct to guide her response to her own baby.

I think my father understood this fact. Many times I heard him advise fathers, and he would always say “The best thing you can do for your little children is to love their mother.”

The establishment of strong attachment or bond between a mother and her newborn is one of the miracles that happens after birth, and is enhanced by close contact. Bonding is supported by all the mother’s senses, and we know that oxytocin, the love hormone, surges in the mother’s blood as she feels, smells, hears, and sees her new baby and experiences the baby seeking her breast. Mothers who have given birth spontaneously, without drugs, experience a natural surge of oxytocin within minutes of the baby being born, often as the baby seeks the breast. This is a potentially significant moment in establishing a strong mother-baby attachment. This hormonal surge also has an important role in separating the placenta from the wall of the uterus, and minimising blood loss.

A natural or physiological Third Stage (birthing of the placenta or ‘after-birth’) is the usual practice of midwives attending birth at home, and in some birth centres, even though we have the synthetic oxytocics, and will use them if needed. Hospital maternity services usually have a protocol for medically managed Third Stage, in which a synthetic form of oxytocin is injected into the mother’s blood or muscle, resulting in strong contraction of the uterus. The synthetic hormone overrides the mother’s body’s natural processes, and although the synthetic oxytocin acts on her uterus, it does not cross the blood-brain barrier in the way that her naturally produced hormone does. This is an important area of physiology in which midwives and doctors who attend birth need to constantly update our knowledge with the findings of research.

I wonder if a woman who has not experienced spontaneous, unmedicated birth, is likely to wonder, if what I have written is true, she may have harmed her relationship with her child. Are mothers and babies able to bond well when the natural processes in birth are interfered with?

If we consider for a moment the release by the mother’s pituitary gland of natural oxytocin, the love hormone, and its impact on mother-baby bonding, the importance of early skin to skin contact and initiation of breastfeeding, regardless of the mother’s experiences in birth, cannot be overstated. Oxytocin is released into the mother’s blood stream when her baby seeks the breast, and suckles. Breastfeeding is not a technologically driven event – it involves the senses of touch, sight, taste, smell and hearing of both mother and baby. The surge of oxytocin in the mother causes contraction of muscles around the milk producing cells in the breast, leading to ejection or squirting of milk. Once the milk supply is established, the baby needs to work strongly to coordinate sucking and swallowing at this time, and if he releases the breast, the milk may squirt strongly for a few moments and spray anything nearby.

At the same time, as a result of the oxytocin surge, the mother’s uterine muscles also contract, and these contractions are often painful immediately after birth. This phenomenon, known as ‘after pains’ is stronger in mothers who have had several babies than it is after the first baby.

It is clear from everyday human experience that oxytocin has an important role in the lives of mothers and their new babies. This observation has been backed up by scientific studies on behavioural patterns in animals when their oxytocin and other normal hormonal patterns are manipulated and interfered with. A logical question is, how much oxytocin-based activity is essential for mother-baby bonding, or, putting the question in another way, how much interference is too much? I cannot answer this question, but I do strongly suspect that there is a point in the early postnatal period at which the individual mother-baby bonding can be seriously compromised. The basic philosophy of non-interference in the birthing continuum, without a good reason, protects mothers, babies, and society in ways that we do not fully understand.

Instinct is an internally driven provision that God has made for the protection and preservation of life and wellness.

Biological scientists and anthropologists seek to understand and describe mothering behaviours. Laboratory animals have been manipulated and experimented with in an effort to understand intricate relationships between environment, genetics, hormones, and other factors. Experiments in the 1960s which have outraged many people and fueled the animal rights movement had baby monkeys removed from their mothers, and deprived all natural contact. Yet many young human babies today are left alone to cry, and some exhibit detachment behaviours, showing that they have given up trying to call for their mother’s attention.

We live in a society in which approximately 30% of babies in Australia are born surgically (caesarean births), and most of the rest are born in highly medicalised settings. The natural process in birth and early parenting is virtually forgotten, and few practitioners in birth understand or apply physiological principles to birthing.

“Can a woman forget her nursing child, or show no compassion for the child of her womb? Even these may forget, yet will I not forget you.” (Isaiah 49:15). The love of a mother for her suckling child is given as a model of God’s love for his children, the very best example of human self-sacrificing love. Yet the distinction is drawn, that even the mother’s love is limited, and imperfect, while the heavenly Father’s love is absolute and unending.

No comments: