Care of the newborn infant during maternal-infant separation

Abstract

The overall aim of the thesis was to describe care of the newborn infant immediately after birth, during maternal-infant separation; the father as primary caregiver and the mother's experiences of separation and later reunion with the infant, in order to enhance development of care for the newborn infant during maternal-infant separation.

In study I, II and III a phenomenological approach was used to gain access to mothers' and fathers' lived experiences (I, III) and lifeworld (II). Six interviews with mothers with experiences of separation and later reunion with their infants (study I) and interviews with 15 fathers taking care of their infants as primary caregivers during maternal-infant separation (study III) were included in the analyses. Study II was an observation study through videotape recording of 15 fathers taking care of their infants during the first two hours after birth. For the purpose of study IV and V, a quantitative design with naturalistic observations, audiotape recordings and respiratory monitoring was used. The infants in study IV and V were randomly assigned two groups: being cared for skin-to-skin with their father who was seated comfortably in an armchair or being placed in a cot, with their father seated beside them. Data was collected from 29 (study IV) and 13 infants (study V) respectively.

The essence of the mothers experiences (study I) was their strong desire to be close to their babies during maternal-infant separation. Mothers wanted to be close to their babies whatever the circumstances, and to be kept fully informed at all times. It was the mothers' experience that the organization, staff and other circumstances prolonged the separation. The essence of fathers lived experiences while taking care of their infant while mother and child were apart (study III) yielded a meaning of alterability towards togetherness between father and child. This movement meant immediate and gradual alterability within the father himself that made him gradually undertake the responsibility, as he got to know his child.

The essence of the father's observed lifeworld in study II yields the very first experience of the father coming increasingly closer to the newborn infant and revealing an ebb and flow variation in the father's involvement with the child. There was an ebb and flow between becoming a father and a physical withdrawal, rather than immediately taking the practical approach of becoming a resource for the infant.

In study IV the infants in the skin-to-skin group cried less than the infants in the cot group (p<0.001). Rooting activity was more frequent in the cot group than in the skin-to-skin group (p<0.01), as were sucking activities (p≤0.001). The pattern for wakefulness showed a lower level for the skin-to-skin group when compared with the cot group (p<0.01). The infants in the skin-to-skin group of study V showed higher inspiratory and expiratory air flows, larger breath volume (all (p<0.001) and minute ventilation when compared with the cot group. A caregiving model, where fathers hold their infants skin-to-skin in an upright position on their chest, seemed to have a positive impact on the infant's wellbeing. At the same time, the father took the child to himself. The mothers, separated from their child, had a strong desire to be close to the baby.