When Rebecca Levy was born in June 1988, she was tiny-a 2-pound, 2-ounce preemie. Her mother, Judy Levy, remembers cradling her in her arms for just a few seconds before a medical team whisked Rebecca away to a neonatal intensive care unit at St. Louis Children’s Hospital.
There Rebecca spent the first nine weeks of life in an isolette. Though her parents had 24-hour access to her, at first Rebecca couldn’t be held for more than a few minutes at a time, since it was hard to maintain her body temperature. Because Rebecca was unable to suck, she was fed by syringe, with the help of a thin tube that snaked down her throat. She required many blood transfusions, and she experienced precipitous drops in her heart rate.
Throughout the ordeal, Judy Levy tried to focus on a positive result-a normal, healthy baby. That she got.
What she didn’t get-and still regrets missing-was a positive postpartum experience.
“When Rebecca finally came home and I realized how much I could hold her, and how much I had missed, I felt sad,” Levy says. “I still think about what it would have been like to bond with Rebecca and nurse her.”
Ever since 1972, when pediatricians John Kennell and Marshall Klaus published a study in the New England Journal of Medicine asserting that mothers who had contact with their infants right after birth showed better mothering skills and had better-developed babies, bonding has been considered the glue that helps get children off to a great start in life.
Spurred by the growth of feminism and its belief in a more “natural” childbirth experience, hospitals quickly institutionalized the notion, providing special rooms for bonding. And before long, child experts began citing “failure to bond” as a cause of child abuse and juvenile delinquency.
But there were some inherent problems with jumping so quickly on the bonding bandwagon.
First, a large number of mothers simply couldn’t. Mothers like Judy Levy, whose infants needed special, immediate care. Mothers who had Caesarean sections. Mothers who adopted babies. Even mothers who had normal birth experiences but were simply exhausted afterward. For them, the notion of bonding became a mother lode of guilt.
And second, according to Philadelphia psychologist Diane E. Eyer, the entire idea of bonding became a popular myth based on shoddy scientific evidence. And it’s that faulty research that Eyer seeks to expose in “Mother-Infant Bonding: A Scienific Fiction” (Yale University Press, $25).
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“Kennell and Klaus originally were concerned about babies who survived because of heroic measures taken in neonatal intensive care units only to experience higher-than-usual incidences of neglect, and perhaps abuse, once they were reunited with their parents,” says Eyer, 49, who holds a doctorate in psychology from the University of Pennsylvania.
Puzzled by this neglect, Klaus read the work of animal researcher P. Klopfer, who had observed the postpartum behavior of goats. Klopfer found that if female goats were separated after birth from their offspring for as little as five minutes, they rejected their young by butting them away and failing to feed them.
Intrigued, he and Kennell wondered whether placing infants in neonatal intensive care units somehow interrupted a human instinctual process as well.
The pair studied 28 first-time mothers with normal-birth-weight babies. Fourteen of the women were given 16 extra hours of contact with their babies immediately after birth; the others followed regular hospital routines. Kennell and Klaus concluded that the “bonded” mothers had better relationships and the babies’ superior developmental scores based on what Eyer says were “a few highly subjective” measures such as whether the mother stood close to the child during a pediatric exam, whether she exhibited “soothing” behavior, and whether she left her baby with another caregiver within a month of birth.
That study, which Eyer says is poorly constructed, led to a model of motherhood that survives to this day, despite the fact that most professionals had dismissed it by the early 1980s.
Why? One reason, says Eyer, is that it is both politically and socially convenient.
Hospitals, fearful of losing obstetrics patients to home births and midwifery, are happy to embrace ideas of bonding and birthing rooms for economic reasons. Growing numbers of working mothers, fearful of the effects of day care on their children, see bonding as a “quick fix” to the dilemma of briefcases versus babies. Even psychologists, social workers and pediatricians who dismissed the original study “were reluctant to criticize something that humanizes childbirth and leads to hospital reforms,” Eyer says.
In addition, she says, there is great confusion over what constitutes bonding as opposed to attachment.
“The kind of bonding I’m talking about simply refers to the postpartum period in the human mother when she is supposedly hormonally primed to accepting or rejecting her baby,” Eyer explains.
Attachment, on the other hand, refers to a developmental period in the young during which the baby forms a relationship with his or her primary caretaker, usually the mother. Some experts consider the crucial period of attachment to be one year; others, the first three years of life.
“No one-Dr. T. Berry Brazelton, Penelope Leach, Dr. Benjamin Spock-would disagree that a strong relationship between a parent and young child is extremely beneficial to that child’s well-being,” Eyer says. “The problem is in terminology.”
Nor is she suggesting that there was a conspiracy of experts trying to somehow control the postpartum experience for the benefit of society.
“Every society has its beliefs, but beliefs are different from scientific fact. In this case, bonding became almost a superstitious belief, like throwing salt over your shoulder to ward off evil,” Eyer says. “And while there is no reason to consider the notion of bonding bad, it is harmful to those who cannot participate in it for a variety of reasons and feel varying degrees of remorse as a result.”
In fact, Eyer’s exploration of bonding stemmed from her interest in a much larger issue, the entire history of child development research.
“In the 1920s, mothers were told that infants should be rigorously scheduled,” she said. “Picking them up if they cried was considered negative behavior; they might then be conditioned to cry in order to be held.
“By the late 1940s and 1950s, when Spock became influential, mothers were told the reverse, that they would do damage to their children’s psyches if they didn’t pick them up.”