Monday, 14 February 2011

Attachment Parenting Series: Birth Bonding

Welcome to our first installment of the Attachment Parenting Series - Birth Bonding!

What is it?

Birth bonding is the beginning of the formation of a close personal relationship between parents and their newborn child. More accurately, it is a continuation of the relationship that began while the child was in the womb, as evidenced by the emotional trauma experienced after a miscarriage or abortion.

How can we encourage it?

There are a number of things parents can do to give their relationship with their child a strong head start, both during labour and delivery and immediately afterwards. This foundation will continue to be built on in the days, weeks, and years to come.

Labour and delivery

During labour and delivery, gentle birth practices will provide a two-fold benefit to birth bonding: bonding will be enhanced immediately postpartum, and, on the other side of the coin, there is a significantly greater chance that actions that may interfere with bonding will be avoided.

Gentle birth practices can include, as far as circumstances allow, the following:
  • the use of non-pharmacological means of pain relief
  • external fetal monitoring (preferably intermittent) rather than internal
  • natural rather than augmented progression of labour
  • avoidance of forceps or vacuum extraction
  • instinctive/spontaneous pushing
  • a peaceful birth environment - quiet and warm with low lighting
  • skin-to-skin contact and access to the breast immediately after birth
  • delayed or declined routine postpartum procedures
  • leaving a male infant's penis intact

These practices can help enhance postpartum bonding. The lack of pharmacological drugs in both mother and baby will provide greater clarity of mind and responsiveness between the two. Baby will feel calm and alert.

These practices can also decrease the likelihood of a number of interventions that may interfere
with postpartum bonding. By labouring as naturally as possible, the mother has a far greater chance of avoiding the common L&D cycle of pain medication --> stalled labour --> labour augmentation --> decreased fetal heart rate --> emergency c-section.

To provide the most natural, gentle and peaceful birth for the infant, with the lowest opportunity for unnecessary medical intervention, expecting mothers with low-risk pregnancies may wish to give serious consideration to choosing a midwife-attended homebirth and/or waterbirth.

Immediately postpartum

Once the baby is born, there is widely thought to be a "sensitive period" of 30 to 90 minutes in which the newborn baby is most alert and able to form a strong bond with his or her mother. Parents can take advantage of this window of time by insisting on (as far as circumstances allow) a chance to hold, stroke, kiss, breastfeed, smile at, and talk to their baby before routine postpartum procedures (weighing, cleaning, eye drops, vitamin K shot, and so on) are performed. Immediate medical interference disrupts this period of strongest bonding instinct and may also impair the infant's rooting reflex. It is particularly helpful if the parents can be alone with their new child during this time.

For infants born in a hospital and staying for a couple days before being taken home, the best place for the child is with the parents in the mother's hospital room. The hours and days following the birth should be sensory-rich for both parent and child. Look at the child, gazing into her eyes and examining her hands and toes. Hold the child, providing as much skin-to-skin contact as possible. Smell the child, breathing in his intoxicating newborn scent. Listen to the child, the little coughs and tinny wails and precious sneezes. Likewise for the infant, allow him to see, hear, touch, smell, and taste (nurse) as often as possible, encouraging the deepest bond between child and parent.

Breastfeeding plays a noteworthy role in mother/baby bonding. Oxytocin is released during breastfeeding, reducing the stress hormone cortisol and facilitating bonding. (More about breastfeeding later on in the Attachment Parenting Series.)

What if it doesn't happen?

There are times when this opportunity for early bonding is disrupted or does not happen. Sometimes this is due to extenuating circumstances such as medical complication or adoption. Other times, the mother simply does not feel that instant bond with her child. Fortunately, birth bonding is not the be all and end all of a parent/child relationship, but rather a head start in the long series of bonding opportunities.

Extenuating circumstances

Circumstances may arise which prevent early bonding between parent and child, whether by chance (emergency medical situation) or by design (adoption). It is important in either case that parents not feel as though they have missed an essential element in the parent/child relationship. "Catch-up bonding" should begin at the earliest opportunity. In the case of an infant, this bonding should look similar to the birth bonding described above, with a particular emphasis on the senses (touching, gazing, talking, smelling, nursing). A method of parenting which promotes attachment can compensate for this loss of early bonding.

Not "love at first sight"

There are times, however, when even in the best circumstances, a parent does not feel an instant bond with the newborn child. This is something we don't tend talk about in our society, and so there is a significant sense of shame and pressure in parents who don't feel that "love at first sight" when handed their child.

This feeling (or lack thereof) is well within the variation of normal. Postpartum feelings are widely varied and individual, with no one reaction being the "correct" one. Parents should not fear that this feeling will last; the baby is uniquely designed to draw the parents into a lasting relationship (his or her survival depends on it!).

Sometimes a mother may need some time to rest and recover after the birth before she feels ready to turn her attention to the task of mothering and bonding with her child. It is important in the meantime that the baby be allowed to bond with the father, or even a grandparent if need be, rather than left lying alone in a bassinet.

Other times, the feeling of a lack of connection with the baby may linger for the first days and weeks. In this case, as in the case of extenuating circumstances, the opportunities for bonding should be frequent and sensorial.

If a lack of interest in or negative feelings towards the baby persist beyond the first month, postpartum depression may be a concern and should be discussed with a doctor.

Our experiences

My older son was born in a hospital, without pharmaceutical pain relief or medical intervention. We were left alone to focus on the labour other than the occasional fetal monitoring or internal check. When he was born, the doctor expressed some concern over his colour and began to take him to the other side of the room. Our nurse stopped him, noted that his colour was improving, and told him to give the baby to his mother. The doctor acquiesced and handed me my son. I was given the opportunity to hold him, talk to him, and nurse him before he was taken, accompanied by his father, to the other side of the room for routine postnatal procedures.

When I first looked at my son, I had the strangest sense that I was looking at a stranger. I didn't feel like this was the same baby I had carried in my womb for the past nine months. Even though I knew in my head that of course he was mine, of course he was the same baby, my heart actually mourned the "loss" of this "other" baby. It is a difficult sensation to describe.

I used the rest of our two-day hospital stay to get to know this new little one. We nursed steadily to bring in my milk. He slept snuggled close to my side at night, tucked in the crook of my arm. I spent the rest of my time exploring this strange creature - his perfect lips, his tiny fingernails, his wrinkled feet, his grey eyes, his full head of hair, his birthmarks, his sweet newborn smell, his mews and wails, his button nose, everything.

And despite all of that - our natural birth, the immediate chance to hold and nurse him, the steady sensorial exploration of my new little boy - it took me the first four weeks of his life to feel as though I truly knew him.

While I have no regrets over the labour and delivery and while it was ultimately a positive experience, there are some things I would choose to do differently if I were to have a hospital birth again.

But with our younger son, I chose not to have a hospital birth at all. We decided, for a number of reasons, to have a homebirth instead.

Although his birth was fast and furious and nothing at all like I had envisioned, I did not have the same sense of holding a stranger when I first picked him up. He was born into the trembling hands of my mother-in-law and laid on a towel, while I, shocked and exhausted, leaned against the edge of the tub for a few much-needed deep breaths. Having caught my breath and refocused my thoughts, I peeked back to see that I had a son. My mother-in-law handed him to me and, gazing down at him, I immediately thought oh! There you are! There was that instant connection that I hadn't felt with my older boy.

We moved from our bathroom where he was born to our own bedroom where we snuggled down for the night. His transition into our lives felt very natural and smooth, lacking the marked split between "before" and "after" that I had experienced after our hospital birth with our firstborn. Our first days were spent in the same way - nursing, exploring, and snuggling together at night - but without the same sense of him being a stranger rather than the same baby I had carried in my womb. Whether/to what extent our homebirth played a role in that difference, I can only speculate.


Birth bonding should be considered a head start rather than an essential element in the parent/child relationship. Because it does have a number of benefits, however, we should seek to encourage birth bonding as much as possible. This can be achieved through gentle birth choices and through an immediate postpartum opportunity to bond that takes advantage of the infant's "sensitive period" of quiet alertness.

This immediate bonding does not always happen, however. Extenuating circumstances may temporarily prohibit such an opportunity, in which case bonding should begin or resume as soon as circumstances allow. It is also within the range of normal for a parent to not feel an immediate attachment to the child, in which case actions that encourage bonding should be continued as the relationship slowly develops.

Birth bonding allows the natural attachment-promoting behaviors of the infant to join with the intuitive caregiving qualities of the parent. It allows the parent and child to get off to the right start at a time when the pair is most primed for such an attachment. Ultimately, however, we must remain mindful that early bonding with a newborn is only one factor in the complex relationship between parent and child.

Recommended Reading:
What Your Pediatrician Doesn’t Know Can Harm Your Child by Susan Markel, MD
Bonding: Building the foundations of of secure attachment and independence by Marshall Klaus, MD
Bonding with Your Newborn by Dr. Sears
Bonding Period by Robbie Davis-Floyd, PhD

Now it's your turn! Add your link using the Mister Linky below to share your thoughts, experiences, resources, or struggles as they relate to birth bonding. I look forward to reading them! See you next Monday for our second installment - Breastfeeding!


  1. My birthing and bonding experiences sound very similar to yours, although both of my children were born at home. My first labor was calm and gentle - about six hours. As he emerged and was immediately placed on my chest, I had the same sensation you described - like meeting a stranger. It was so strong, in fact, that I said "is this mine?", even as he was still attached to me. It took me a week or two to start feeling like he belonged.
    My daughter was born after a crazy 90 min labor. As she was placed in my arms, I recognized her and said "Well, hello there!". (this bonding was much quicker and stronger the second time despite a wicked case of PPD that hit on day 4). Perhaps I was more comfortable because she looked just like her brother. Or perhaps I knew better what to expect and do the second time around. Regardless, I can't say the difference I experienced in bonding had to do with location of birth (same midwife, home, bed, etc).

  2. That's very interesting, Victoria. Thank you so much for sharing that experience!

  3. When my first was born (at home, after a "textbook" 12hr labour), the first words out of my mouth were, "It's a baby!"

    Well, duh! Of course it's a baby. But it was hard for me to reconcile this actual baby with the imaginary baby I had created in my mind while she was growing inside me. Hard to explain, but I had less of that OMG BABY the second time around. Probably because I knew more of what to expect.

  4. It's so encouraging to hear these similar stories. Thank you too, Michelle, for sharing your experience.

  5. Have you seen the Breast Crawl video? I think this is a fascinating look at how babies initiate attachment - which I think goes beyond the physical meaning of latching onto a breast.

    One thing I did recommend as an LLL & IBCLC is when moms are ambivalent about bf'ing or their babies or when bf'ing is not going too well, is to take a bath WITH the baby. Comfortably warm room, comfortably warm bath. Helper assists mom into tub who reclines. Helper places baby on mom's chest so arms & head are well above water line, baby's butt & legs are below water. Often baby will float about. Place warm damp facecloth on baby's back to prevent evaporation & cooling. This is a deep rebonding experience for many moms & babies. Babies will often latch on very well on their own. Either way, it's a relaxing & pleasurable way to get skin to skin between mom & infant.

  6. Looking forward to more installments on this series! We had our second 5 weeks ago today. With both babies, much to my disappointment, we had medically necessary inductions. I was able to deliver without using pain medication for both of my children, but had very different experiences. Both were born in hospitals, but my first was with an OB who was not at all encouraging, made me lie down on my back to push, and threatened c-section as my daughter was crowning. My second was with a midwife at a hospital that allowed water births. The atmosphere was much more peaceful despite the fact that I was strapped to an IV of pitocin and had constant external monitoring. I left feeling so happy about my birth experience with my second child and not at all upset about the induction. The OB with my first said she supported natural childbirth, but her actions during my labor did not indicate that. Having a midwife made all the difference.

  7. Hornblower, I have seen that video - so amazing!

    What an excellent suggestion for mother/baby bonding. I loved taking baths with my older son when he was a baby. I've had fewer opportunities with my second, unfortunately. I recall them being wonderful, peaceful moments of bonding.

    This Is Us, you make a great point about a common difference between OBs and midwives. I didn't touch on it too much in my post because I didn't want to get too far off track, but the nurse who was with us through the labour and delivery made such a huge difference in our hospital birth experience. As I mentioned, she was the one to stop the doctor from whisking my newborn son away instead of handing him to me. Similarly, she stopped him from unnecessarily intervening at a couple other points during the labour. She acted in many ways very much like a doula, and I am certain our experience would have been far poorer without her. Because of that, if I ever had to give birth in a hospital again, I would not even consider doing it without a doula at the minimum, and preferably with a midwife as well. Thank you for sharing your experiences.

  8. This is such a great first entry for the series! I was very excited to read it :) I'm reading The Baby Book by Dr. Sears right now and find the information in it invaluable! I'm excited and pray often that my birth will be a gentle birth that will allow my daughter to arrive the way I know God intended her to.

    It's funny. I grew up in a 'hippie' town (if you will) and midwives and doula's were readily available. My Mom had a midwife with my sister, she birthed at a hospital but they had tubs that women are encouraged to use (that was 11 years ago!).

    Now I'm seeing the same midwife group, and depending on what happens with my husbands work, I might give birth there and will be able to have the water birth I so deeply desire. It wasn't until I moved from home and went to college that I realized so many women aren't offered that opportunity.

  9. That is wonderful, Korey! It's great that you grew up with that as the norm, and I wish you all the best with your upcoming birth. :)

  10. Unfortunately in the US home births can be cost prohibitive for many families. Insurance companies often won't pay for a birth outside of a hospital. I've been wondering,how is payment for a home birth handled in Canada?

  11. That must be so frustrating.

    Our midwife was covered by our provincial health insurance. We had to buy our homebirth supplies ourselves (minimal expense), and because we ended up having to call 911 (midwife's orders, since the baby was going to arrive before she would), we had a $50 ambulance fee as well. The ambulance fee would have been higher if they had transported us. Aside from that, we had/would have had no other out-of-pocket expenses.