maternal-infant bonding

Jolie, BSN · Apr 2, 2006

Is this a school project?

Perhaps you could Google your questions and find some relevant articles. Or perhaps you could state your theories and ask posters to support or refute them with examples of their own patient care experiences.

rn/writer, RN · Apr 4, 2006

Speaking both as a mother and a postpartum nurse, I'd have to say that while the effects of an episiotomy can certainly influence maternal-child bonding, it is only one of many factors. The baby's health, maternal blood loss, support of the father, external stressors, pain management, sleep deprivation, chronic heath concerns, financial worries, and many more are all considerations that need to be taken into account.

Proper pain management--meds, ice, topical spray--can facilitate mother-child bonding even after a complicated repair.

SmilingBluEyes · Apr 4, 2006

I think mother-baby bonding is a wee bit more complicated (or simple, really!) than that. IF the fact an epis was a real factor, what about csection moms? I really bonded w/my daughter much sooner after my "c" than I did w/my lady partsl delivery w/my son because he was in a NICU after birth (being preemie, in an isolette on oxygen and IVs......conversely, dd was term/healthy and put to breast in the first hour after birth. Bonding w/her was so natural, fluid and easy cause she was healthy and did not have health problems that complicated my son's first 3 months of life.

Truly, I believe, in the long run, bonding is really up to the individual family. Both my babies were very well-bonded to both my dh and myself in the infancy stage of life, and beyond.

Truth be told: My dh seemed to bond sooner w/my son as he was first shown kangaroo care w/him, whereas I was spending all my time struggling with and trying to nurse him (preemies are tough) and not kangaroo'ing him. I noticed my baby was much calmer when my dh was holding him than when I was.

At first that bugged me, but I realized what a gift it was soon enough....

At home, we both did skin-to-skin with both our babies, and bonding went very well........

You see, really, bonding is a long-term thing, not just a first-day deal! And an epis or other such procedures should NOT get in the way of that.

Also I believe firmly that nurses are in a unique, honored and wonderful position to facilitate family-newborn bonding,whether it be in the NICU, post-partum or immediately after delivery in the labor suite. We definately can get them off the a good start, with some effort and consideration. And that can overcome almost anything that happened during the labor/delivery course. So no, sorry I am not buying this one!

Jolie, BSN · Apr 4, 2006

Thanks for clarifying. I hate to think I'm doing someone's homework for them :).

Helping patients to avoid unnecessary medical interventions during childbirth is an important nursing function. Episiotomies, like C-sections, should never be routine, but there are circumstances in which they are beneficial and necessary to ensure mother's and baby's health. My oldest daughter delivered with a complex presentation (hands up to face). Without an episiotomy, it is likely that her delivery would have been difficult and delayed, possibly placing her at risk for injury and/or asphyxia. My second daughter had an occult prolapsed cord. She needed to be delivered quickly, facilitated by an episiotomy. Thankfully, I understood the urgency of these situations, and accepted these interventions as necessary. I don't believe that having episiotomies with my deliveries in any way impaired my desire or ability to bond with my babies.

I encourage you to read articles with a skeptical and critical mind. It is possible to find "evidence" to "prove" virtually any theory through poorly designed research. I suspect that an article advancing the theory that an episiotomy is the determining factor of the success or failure of maternal-infant bonding was probably written by someone with an agenda. Perhaps someone with a "militant" anti-intervention attitude toward childbirth. These authors, child birth consultants, etc. seem determined to convince their clients that the healthcare establishment exists to ruin their birth experience, not to facilitate a healthy delivery. Anyone who has worked in L&D knows what I mean.

As far as prematurity impacting bonding, yes, I agree with that. Mothers and babies who are ill, are separated from each other, are unable to enjoy cuddling, feeding and other closeness are certainly at risk for impaired bonding. But even that is not a given. As SBE stated, bonding is a life-long phenomenon. Having a preemie may delay the onset of such behaviors, but does not necessarily doom the process. Some preemie parents feel overwhelmingly attached to their infants, while parents of some healthy, term babies may need time for such feelings to "grow". It is a very complex process which we can only hope to facilitate.

cammy429 · Apr 5, 2006

when i had my daughter (i wasn't in nursing school as yet), i was given demerol because i decided that i didn't want an epi. i changed my mind last minute but i was too dilated. well, needless to say, demerol crosses the placenta barrier (sorry if it's not the correct term l&d nurses;) ). after she was born, i was out of it. i didn't want to hold her out of the fear that i might drop her and she was very sleepy as well. i think she slept for two days straight:lol2: .

i said all that to say that the medication in my opinion did inhibit our bonding.

hello,
i read an article that indicated the mothers health following an episiotomy was the determining factor in maternal infant bonding. an additional article i read pertaining to the same subject suggested that mothers of premature infants have to work harder to initiate and maintain the bond. how do nurses facilitate bonding between mother and infant? please feel free to give thoughts, theories, or experiences regarding episiotomies or premature birth in relation to maternal-infant bonding.
thank you for your time.