Closeness after birth

A Finnish study exploring parent-infant closeness and separation has thrown more light on how hospital practices both promote closeness and cause separation in the first couple of hours after birth. And it’s kind of paradoxical, because the researchers discovered that, while staff aimed for mother-infant and father-infant closeness and promoted this through promoting practices such as skin-to-skin, many of the hospital routines caused parents to be separated from their child (Niela-Vilen et al 2017).

This isn’t a new finding. I remember listening to medical sociologists and social scientists talking about how hospital practices cause separation two or more decades ago. But the results of this study are important because they show that, even though staff are trying to promote closeness, the structures of the system itself (which often prioritise routine measurement and collection of data) are preventing that from happening, or at least reducing the time in which it can happen.

If we want things to change, it’s the structures that we need to address.

 

Niela-Vilen H, Feeley N and Aexlin A (2017). Hospital routines promote parent–infant closeness and cause separation in the birthing unit in the first 2 hours after birth: A pilot study. Birth: Issues in Perinatal Care. DOI: 10.1111/birt.12279

 

The Research

Background: Despite the evidence of multiple benefits of early skin-to-skin contact, it does not always happen and infants are separated from their parents because of different hospital practices. The aim of this study was to explore parent–infant closeness and separation, and which factors promote closeness or result in separation in the birthing unit in the first 2 hours after birth from the point of view of staff members.

Methods: This qualitative descriptive pilot study was conducted in one university hospital in Finland in December 2014. Midwives and auxiliary nurses working in the birthing unit were eligible for the study. The data were collected with a new application downloaded on a smartphone. The participants were asked to record all the closeness and separation events they observed between the infants and parents using the application.

Results: The application was used during 20 work shifts by 14 midwives or auxiliary nurses. The participants described more closeness than separation events. Our findings indicated that the staff of the birthing unit aimed for mother–infant closeness, and father–infant closeness was a secondary goal. Closeness was mostly skin-to-skin contact and justified as a normal routine care practice. Infants were separated from their parents for routine measurements and because of infants’ compromised health.

Conclusion: Routines and normal care practices both promoted parent–infant closeness and caused separation. Parent–infant closeness and separation were controlled by staff members of the birthing unit.

photo credit: Alex-de-Haas Brand new parents. via photopin (license)

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