Academic journal article Journal of Prenatal & Perinatal Psychology & Health

SHARING SPACE: Obstetrics and Attachment

Academic journal article Journal of Prenatal & Perinatal Psychology & Health

SHARING SPACE: Obstetrics and Attachment

Article excerpt

ABSTRACT: In the last 30 years there has been an increasing amount of psychological investigation into attachment. At the same time there appears in this literature to be a gap in the discussion of what may be the origins of early detachment of the child from his/her caretakers. This article suggests that the beginning lies in obstetrical care in today's highly interventional and technocratic management of pregnancy and childbirth. Specifically, what drives this situation is the attempt of obstetricians and medical professionals to avoid the highly litigious system. The result of the effort to reduce risk at all personal cost, creates a stressful situation for the mother and decreases the emotional satisfaction of the family. In short, the power of birth has moved to the professional and remains causal in dis-attachment of child to parent.

KEY WORDS: Attachment, obstetrics, prenatal, pregnancy


All attachment begins in the womb.

We consider the time of postpartum as crucial for attachment. It is natural then that we examine how interventional obstetrics might affect the attachment process. For example, medical/technological interventions such as epidurals, inductions and C-sections may carry a much higher implication than previously thought. When a therapist is considering attachment disorder, especially when "... that attachment is a measure if a child's experience... ." Daniel Siegel, M.D. also has said, if"... .the parent creat[es] a state of alarm in a child [or fetus, author's insertion], the child is presented with a "biological paradox': its brain motivates it to move toward the caregiver for soothing ..." on the one hand, but if the caregiver is the source of the state of alarm, the attachment is an intrauterine "Catch 22."

Going to the labor room is informative to make this point, but going into the doctor's office is even more illuminating.

Karen [Karen will represent every young woman in her first time pregnancy] comes into the examining room excited about being pregnant. This, her first contact with the medical birth assistant, was a time for conformation, for encouragement and for education, as Karen wants to do everything she can for her developing baby.

And then first shock comes. The visit is all about her risk factors. In detail the nurse goes through a listing of every concern in her history, that of the father of the baby, drug and alcohol use, her family history of genetic conditions, and on and on. Toward the end of the interview she asks if she is to see the doctor and receives the disappointing news that she will not see him until her next visit. "After all," nurse says, "Doctor needs to have the ultrasound work and the laboratory testing so he can evaluate the pregnancy. You understand?"

Karen did not understand, but being afraid to argue accepted the explanation and made her next appointment, a whole month away. When she got home her excited husband was disappointed, too. He wanted to know that she was all right and that their baby was okay. When he realized how long before they could have conformation, another month, and meaning she would be almost 17 weeks according to their calculations, he thought maybe something was wrong with her and did not hesitate to question her. That brought on all kinds of worries, as she related what had transpired in the office, especially, the digging into their history. "Do you suppose something is wrong with us and the baby is not normal?" they wondered.

Instead of attachment to their growing child there was fear, deep fear, and doubt about their ability to have a normal child. Now too, the couple was becoming dependent on the medical profession for reassurance and care, willing to accept anything so that their baby will be "Okay!"

Thus it begins.

Karen goes to the laboratory (blood and urine tests) and the sonographer. She asks for the results but is told they aren't allowed to give out results and she will have to get her information from her doctor. …

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