Medicalising motherhood

“I sighed deeply, exhausted and defeated by the realisation that feeding my child, the most primal and natural role that a mother can try to fulfil for her baby, would, of course, be yet another clinical event.”

Excerpt from Chapter 34 of my upcoming memoir

One of the things I found hardest about the time my youngest daughter spent in hospital was the, often unavoidable, medicalisation of my role as a mother. What would normally be private, intimate acts of love and care between mother and child had to be performed in front of one or more nurses or clinicians. Most of these acts required a high degree of input from the medical team, and the way they were sometimes handled served to diminish my autonomy and my confidence as a mother.

For many months the simple act of picking up my premature baby to cuddle her took upwards of ten minutes to perform and required the input of at least two nurses. The whole event was framed by trailing wires, tubes being taped to my shoulder and plastic valves digging into my side.

Weeks later when my daughter had progressed from intensive care to high dependency (HDU), I gave her a first bath. Under the watchful eye of several nurses it was yet another medical event, requiring careful handling of the oxygen tube and nasogastric tube. The billowing plastic covering over the bath made the whole process feel as unnatural as bathing her in a bin liner.

Naively, when it came to the breastfeeding stage a few weeks later, I assumed that it would be over to me. Finally I’d be able to do something normal and natural for my baby. But of course it wasn’t, and couldn’t be, that way. Breastfeeding had to be measured and monitored and recorded on charts. It needed to be scrutinised and moulded and controlled by nurses, registrars, consultants, breastfeeding specialists, speech and language therapists and dieticians. It was just one more medical event that didn’t belong to a mother and her baby, but to a multidisciplinary clinical team.

Almost all the nurses and medics I came across during my daughter’s stay in neonatal care tried to uphold the value of the mother role as much as possible. But crazily busy and high pressure shifts often meant little time for emotional intelligence and holistic care. Often a nurse would change my baby’s nappy themselves rather than asking if I’d like to do it. I would need actively to request to get involved unless I wanted to be left to sit and watch on the sidelines. Frequently I’d arrive at the unit to find my baby had just been bottle-fed, despite me having called to say I was on my way and would breast feed her upon arrival.

Of course, for the best part, the medicalisation of my maternal role was absolutely necessary for the wellbeing of my tiny baby. Every wire, every tube and bit of plastic she was hooked up to was essential for her survival, especially in the early days of her 5 month hospital stay. The monitoring of her milk intake was fundamental for such a tiny baby who needed all the nourishment she could get. Failing to involve me in ‘cares’ or forgetting I was going to try breastfeeding held little importance against the backdrop of my baby’s lengthy hospital stay and complex medical needs.

But the impact this all had on my mental health and emotional stability cut more deeply than many members of the clinical team probably appreciated. My sense of self-worth and self-esteem took a swift nosedive and I struggled daily with intrusive thoughts. For a long time I could barely do anything for my baby. I sat and watched nurses check her, change her bedding, administer her medications. It was hard to believe I held any more importance in her life than the chair next to her incubator. In time I was able to perform more of her ‘cares’ – changing her nappy, checking her temperature, swapping probes from one foot to the other. But well-meaning nurses were always nearby, the beeping of a thousand monitors was relentless and the stench of heavy duty antibacterial spray was ever present.

Many mums I spoke to during my daughter’s hospital stay felt similarly about the medicalisation of their maternal role. For the most part it’s simply a sad, yet unavoidable, element of neonatal care. But I wonder if more could be done to minimise the negative impact it has on maternal mental health. Perhaps more open dialogue between parents and clinicians about the potential effect of the medical setting on emotional well-being and mental health would be a good place to start. It would normalise difficult emotions for mothers and would help nurses and doctors to understand how best to support mothers during their time on the ward.

I’ve written much more about the effects the medical setting had on my maternal mental health in my upcoming memoir. My hope is that it raises awareness of these important issues and helps other mums struggling in similar ways. Has your baby stayed on a neonatal unit? How did you feel as a mum? Or a dad?… It’s a well known fact that many dads really struggle to forge a role for themselves whilst their baby is in neonatal care.

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