Earlier in the course we looked at the very first physical attachment to your mother as the small bundle of cells known as a blastocyst first implanted into the uterus. You spent around 9 months living in the womb, securely attached physically to your mother.
Now you are moving through your next transition where, with the cord cut and you born, you are now physically separate from your mother.
But not emotionally and energetically. You are forging a new bond that leads to secure attachment and a place in your new world.
Our natural biology, evolved over millennia, has a wonderful system that promotes bonding of mother and child so that she will want to take care of her child. The process is again driven by multiple hormones and designed to create an intense emotional connection that will ensure the survival of the newborn baby. The hormones change brain chemistry, promote nurturing behaviors, and enable mutual recognition through scent and touch. Much of the motherly behaviour - cooing, cuddling, stroking, is biologically regulated; meaning that it is instinctive and a mutual sensory experience between the newborn and mother.
When this goes smoothly, this step of your transition to an independent being will be gentle. You will emerge secure, stable and emotionally regulated. Studies show that children who are well bonded to their mother (and/or other primary caregivers) are usually physically healthier and emotionally more stable than others without this strong bond.
It is quite amazing what happens between the mother and baby on a physical level that is quite unconscious during this time of proximity just after birth (and continuing as the relationship and the baby grow). Let's take a closer look at the bonding process from the physiological perspective and then how this can be disturbed by modern birthing practices and/or traumatic birth experiences.
Biological Bonding.
During Labour - Setting up for a successful bonding experience.
In an undisturbed birth, the labour itself sets up the perfect conditions with a massive hormonal surge.
For the mother:
- Oxytocin. Our friend, popularly termed 'the love or bonding hormone' as we saw previously is released in high pulses during labour supporting the uterus to contract. After birth the high levels of this hormone in the mother induce a state of euphoria, contentment and a strong urge to care for your baby.
- Beta-Endorphins (the body's natural pain killers) These rise during labour to help manage pain and after birth they support the mother to feel alert, blissful and close to her baby.
- Adrenaline- This provides an energy surge for the final pushing stage of labour. It also helps the mother to be alert right after birth which means she is able to interact.
For the baby:
On the babies side, immediately after birth they have extremely high levels of catecholamines, (epinephrine/adrenaline, norepinephrine, and dopamine) up to 20 times higher than adult levels. these high levels are temporary but a crucial part of the transition to life outside the womb. The role these hormones play includes:
- Management of the stress of labour. The hormonal surge is similar to a fight and flight response designed to support the baby with the energy needed to manage the stress of being born
- Initiation of breathing. Adrenaline stimulates the absorption of lung fluid which is needed in the transition to breathe air.
- Cardiovascular support. The hormones help redistribute blood flow to essential organs like the brain and heart which is particularly important in the initial moments of hypoxia ( low oxygen) immediately after birth.
- Arousal. They help ensure the baby is alert and able to interact with the mother straight away.
- Energy Regulation. The hormones help raise blood sugar levels as the baby needs energy at this time.
In addition, the baby also has high levels of oxytocin, sometimes even higher than the mother's levels, with similar effects on the baby as on their mother.
After birth- continued bonding and the oxytocin feedback loop.
In an undisturbed birth the baby will either be placed or will move themselves towards the breast. The new born baby is hardwired to be drawn to their mother specifically and displays many instinctive reflexes to support them to get to the breast. These include the rooting reflex and the stepping reflex which aids in the breast crawl which is a miraculous process in which the baby can unaided propel themselves up their mother to reach the breast. (Click to watch the breast crawl in action)
Once at the breast the time spent skin to skin is incredibly important, with a number of processes taking place that are beneficial to both the baby's health in the short and long term and to the establishment of the strong bond. These include:
- Sensory Stimulus. Studies have repeatedly shown that the baby is wired to know and prefer the scent of her own mother and the colostrum ('first milk') and the sound of his mother’s voice. The mother is also drawn to the scent of her newborn baby who will be covered in vernix and smell of the “womb” – the amniotic fluid. The baby smells familiar to the mother as they smell of her own body. As the baby lies at her breast this is the perfect distance and place for her to smell the newborn head and to see into their eyes. The sensory stimulus of the physical contact and proximity sparks further hormones ( particularly oxytocin) to be released that encourage behaviours that are supportive of bonding such as cuddling and cooing. The sound of the heart beat in particular signals safety to the newborn.
- Further hormonal surges This continued release of oxytocin on both sides reduces stress and anxiety and promotes a feeling of euphoria. Suckling further stimulates the release of oxytocin in the mother to support with the contracting of the uterus, releasing the milk and also reducing stress and enhancing wellbeing including a sense of security. This helps the newborn's nervous system transfer from the high stress state to a calm state. Oxytocin continues to be produced by both the baby and mother when stimulated by physical closeness that happens with skin to skin, breastfeeding and cuddles. This creates a continuing feedback loop of oxytocin production that promotes attachment and strong bonding. Oxytocin is crucial for bonding. Studies on mice showed that once injected with oxytocin, mice who had not given birth and who would usually have no interest in responding to newborn mouse cries would quickly go to the rescue of stranded baby mice. ( Read more here)
- Thermal Synchrony The mother's body temperature naturally adjusts to warm a cold infant or cool an overly warm one in a process called thermal synchrony. I have personal experience of this where I started sweating like a furnace from an internal boiler in order to heat up my baby who had got cold during birth. It stopped as soon as he was warm again.
- Cardiorespiratory Stability: Skin to skin straight after birth regulates the newborn's autonomic system. It fosters a steady heart rate, normalise breathing patterns, lowers blood pressure, and improves oxygen saturation.
- Microbial Transfer and Immune Development The process of seeding the microbiome of the newborn that started with the passage through the vagina continues. The microbial transfer from the mother promotes healthy gut flora and boosts the immune system with long term health benefits for the baby.
- Neurological benefits. Studies of the brain show increased white matter volume in areas crucial for emotional regulation, memory, and cognitive function. The touch and sensory feedback reinforces neural pathways linked to attachment,
What does the bonding process feel like
This description is based on the mother describing her experience. Although we cannot remember as babies I would imagine it is a similar experience.
During labour and immediately after the mother who has experienced an undisturbed birth will often feel a rush of ecstatic joy and euphoria. This has been compared to orgasm and given rise to terms such as ecstatic birth. At the same time the mother will experience a strong primal desire to protect her child and keep her close to her body. Many mothers describe a sense of coming home or recognition as if they have known their baby forever. The mother often feels empowered with a sense of I can do anything. Even intense pain fades away with the floods of oxytocin to be replaced with calm, peace and general well being.
I can attest to all of the above with the births of my three children. There was an intense feeling of joy and achievement and euphoria is a great word for it. And there was no way you would have got me to let anyone take my baby out of my sight. With my first they dressed him a couple of metres away and even that produced a mild agitation that was relieved only when he was back in my arms.
The 'Golden hour' and the time sensitive period for bonding.
A study by Dr John Kennel established that the greatest impact for this process of strong bonding is well within the first 12 hours and that delaying the initial close contact can interrupt the process severely. Farmers know this well. They understand that if a ewe is separated from her newborn lamb then reuinited she will likely reject the lamb, unable to recognise and claim it as hers. Mothers who have experienced such separation often struggle on a long term basis to bond with their babies and usually feel great guilt and shame. They often blame themselves when it is not their fault and there is nothing wrong with them. With time and effort a bond can be created and healing work such as this can restore the severed energetic connection and the lost benefits of a strong bond.
Understanding of the importance of the first moments with your new baby has led to most places in the UK promoting skin to skin and aiming to honour the' Golden Hour'. This is concept that is well known world wide and in particular in Northern Europe and the USA.
The Golden Hour
Despite its name this is not a strictly 60 minute time frame. However, the first 1 to 2 hours has been identified as a critical period for initiating the bonding process. This is the time in which mothers and babies should be left undisturbed in peace, quiet and relative dark to adjust and connect with each other.
Where hospital protocols are in place to honour and facilitate skin to skin in the first hour, some checks are delayed to allow this connection to take place. However despite that being a common protocol, the delay does not always happen.
As we have seen above, the time of uninterrupted skin to skin contact is crucially important in the bonding process. In summary, keeping mother and baby together skin to skin after birth:
- supports the baby to process the birth experience.
- aids the newborn to stabilise by regulating their nervous system, body temperature and heart rate as they settle into breathing air.
- supports establishing breastfeeding which further cements the bond and promotes hormone production.
- helps the newborn to feel safe, calm and secure.
- results in a strong bond that contributes to long term physical, mental and emotional health.
Modern Birth Practices and interruptions to the bonding process
Any separation of the baby from their mother at this stage has a profound impact on both. In an emergency it may not be avoidable, but crash out, full on emergencies are rare and usually babies needs could be accommodated to a degree but often aren't. Modern birth systems especially in hospitals, as we have seen in previous lessons, do much to disrupt the natural process and hormonal flow even without any emergency.
Assessments
Of course there are assessments to check on how a baby is and they have their place and use. A traditional midwife would assess the baby, but in an unhurried manner and starting with her eyes and senses without disturbing the dyad. But in a centralised, and often strained and under resourced system to boot, these assessments can also become part of an accumulating trauma. A lack of awareness of babies experience of birth and needs can lead to insensitivity in timing and application of any checks, for example weighing the baby. Everything is done quickly to a time schedule that is not shared by the baby. With some thought and understanding of the perspective of the newborn experience, procedures such as weighing can be done in a more gentle and timely manner. With the example of weighing, the scales can be set to zero with a warm blanket that smells of mother already in place and then placing the newborn prone onto the blanket. Instead it is common to place them supine on the cold surface and they often cry at this.
Procedures and protocols vary over time , from country to country and in different establishments within the same country. Possible experiences you may have undergone that impact the process of bonding are: suctioning the mouth, antibiotic eye drops, circumcision, being washed, rubbed, slapped, moved around with limbs dangling, dressed, weighed naked on a cold surface, and general experience of bright lights, cold, strangers and the words being spoken generally or to or about you.
An additional factor is how many people are present in the room. Sometimes there are many people present, each with their own job, energy field and impact on the birthing environment and ease of bonding.
Many of the initial assessments include a period of separation from your mother at a critical time. In some cases you will have been separated many times for longer periods as you would have lived in a dedicated nursery for babies whilst your mother recovered from birth. You may only have been brought to her for feeding.
Of course if you were premature or had other difficulties at birth you would have spent time in an incubator and possibly with respiratory assistance. Kangaroo care, where you stay with your mother has wonderful outcomes but is not standard in most places. You may then have been given to your mother for a varying amount of time and you may have been separated into a nursery with other babies for many hours at a time.
Hormonal Interference and imbalance- Synthetic versus natural oxytocin.
Synthetic oxytocin is commonly used to speed up labour and also is generally used in the injection to birth the placenta in a managed third stage. Although it is chemically identical to natural oxytocin there are some important differences.
Firstly the natural oxytocin is produced in our brain in pulses. This means there are natural peaks and valleys rather than a continuous high rate as with the IV drip. It also means the brain receives oxytocin where it has calming and pain relieving effects. The higher levels seen with the drip come without the calming benefits and cause stronger, longer contractions without pause for the uterus and mother to rest. The concentration of Synthetic oxytocin in the bloodstream, delivered via IV can lead to an overloading of the body’s own system of oxytocin production. It binds to the body’s oxytocin receptors in the uterus leading to a process called desensitisation, meaning the body is less responsive to both synthetic and natural oxytocin. So now you need more for the same effects and these higher levels further compound the extra stress on the mother's body as contractions continue relentlessly. This can be exhausting.
With an induction there is a need to constantly monitor due to higher risk of foetal distress and lack of oxygen during these stronger contractions. With the exhaustion and greater pain levels come a greater need for pain relief. When that comes in the form of an epidural , this reduces the natural levels of oxytocin as without the sensory input from the contractions the positive feedback loop that tells the brain to release more oxytocin is no longer working. After birth a ‘fatigued uterus’ may not be able to strongly contract after the birth of the baby which can lead to an increased risk of post partum haemorrhage and therefore necessitating the injection of oxytocin to stimulate the contractions needed to birth the placenta and reduce risk of bleeding.
The disruption of the delicate hormonal balance in these circumstances is well underway before the baby is born. In these circumstances the mother and baby emerge more exhausted with potentially less of the natural oxytocin flowing. As previously noted, natural oxytocin positively impacts mood and lessens sensations of pain and is a fundamental part of the bonding process. Synthetic oxytocin does have these benefits.
In addition high levels of synthetic oxytocin can cause a delay in the initiation of breastfeeding. Studies have shown reduced levels of newborn reflexes such as rooting and licking behaviour. Natural oxytocin is important in the milk ejection reflex, lower levels can also impeded successful breastfeeding. the A mother and baby dyad who has experienced synthetic oxytocin will have to work harder to bond and it can sometimes take more time for that bond to establish.
Of course the good news is that the work we are doing, even many years later can heal this early trauma and the energetic bond can be reestablished and experienced.
( Link to a good post on the subject of syntocin with referenced articles by Sarah Buckley here.)
Note on bias in reporting statistics and facts:
Before we go to reflection I would like to take a moment to highlight a subtle but insidious way facts are often reported that documents the changes from an intervention as if they were the baseline and comparing those changes to the physiological norm This skews the information so much. I have likely done this myself in the course of these lessons as it is quite ubiquitous ,particularly in areas such as breastfeeding versus formula feeding.
Here is an example of what I mean to illustrate the point.
“Immediate Skin to skin decreases post partum bleeding, increases breastfeeding success and decreases depression”
This should read, "Not having skin to skin increases post partum bleeding, decreases breastfeeding success and increases depression".
The biological norm is the baseline from which studies should operate. Skin to skin and undisturbed time with the mother is the biological norm that the baby expects at an evolutionary level. Whatever measurements are noted when that has occurred are the base line that should be used to measure against. Once you see this you can't unsee it! It is everywhere.
In our work in this course, we we are healing the impact of any deviations from the evolutionary expectations and norms the baby expected and deserved as well as other trauma that as experienced and not resolved.
The Breast Crawl and other reflexes
Babies are a lot more capable than we realise. They are innately programmed with everything they need for survival. They have reflexes at birth that include the rooting and sucking reflex so that they can feed. The breast crawl is particularly fascinating - left to their own devices a baby on a mother’s chest will make their way to the breast and latch on by themselves. They have the stepping reflex that will cause their legs to make stepping actions and arms to move until they get to the breast. They will usually find a good latch by themselves. Compare this to several tales I have read or heard of babies heads being pushed onto the breast by health care providers to initiate feeding so they can tick the box off, even if baby or mother is not yet ready.
Reflection Questions:
1. What occurred during the first few hours after you were born? For example, Did you receive skin to skin straight away, was your mother able to hold you and what was her response to your arrival?
2. Was there a gap between what you expected from an evolutionary perspective and what actually happened?
3. How easily did your mother bond with you?
4. What is the impact of those first few hours of your life on your sense of self in the world?
5. How does this experience map onto your life now?
6. What is the impact of your initial bonding experience on your relationships later in life?