Giving birth to a premature infant can bring on grief for a new mom similar to having a child with a chronic illness, according to researchers, but the faster a mother can overcome that grief, the better the chances of forging secure attachment between baby and mother.
According to Prachi E. Shah, M.D., assistant professor in the Department of Pediatrics and Communicable Diseases at the University of Michigan C. S. Mott Children’s Hospital, “Mothers with resolved grief following a preterm birth are three times as likely to have securely attached infants, compared with mothers with unresolved grief.”
Successfully getting over grief may require the mother to redirect her expectations and hopes for her child during uncertain circumstances, and mourn the “hoped-for child” as she still embraces the child she has, she said.
Shah is co-author of a a new study by the University of Michigan Health System and the University of Wisconsin that explored mothers’ feelings about premature infants. It suggests the mother’s ability to adapt after a preterm birth influences her baby’s future social-emotional development, and that maternal resolution of grief may be a subject pediatricians should explore during neonatal follow-up visits.
For the study, researchers observed 74 premature babies (born at 36 weeks or less) and their mothers, who were also part of a larger study of high-risk infants led by Julie Poehlmann, Ph.D., professor of Human Development and Family Studies at the University of Wisconsin.
The researchers wanted to determine whether a mother’s unresolved grief might affect the baby. To do this, they factored in the following aspects: an evaluation of neonatal and socioeconomic risks when the baby was discharged from the neonatal intensive care unit; an analysis of maternal depression and verbal abilities, an interview that focused on the mother’s reaction to her preterm birth, parenting quality at 9 months; and mother-baby attachment at 16 months.
Previous research has focused on resolution of grief and mother-baby bonding in cases of chronic illness and disability. However, this is the first study to hone in on grief resolution after a preterm birth, Shah added.
“When a baby is born prematurely, the developmental prognosis is often not known for many years — it evolves over time,” Shah said. “How the parent adapts to the birth of a preterm infant has implications for the infant’s attachment security, which can influence social-emotional development over time.”
Shah said grief resolution was not predicted by maternal age, socioeconomic status, education, marital status, depression, verbal ability, the child’s gender or race, whether it was a multiple birth, or length of hospitalization.
The researchers also discovered that the extent of prematurity or even the infant’s health was not a predictor of a mother’s resolution of grief.
“Whether the infant was born very preterm versus slightly preterm, or whether the infant had many medical complications or was relatively healthy did not predict which mothers resolved their grief,” Shah says.
“Because mothers of healthy preterms were just as likely to have unresolved feelings of grief after preterm birth as mothers of sicker preterms, it suggests that the experience of trauma and grief following a preterm birth is very individual, and difficult to predict,” Shah said.
“The good news is that for mothers who are able to resolve their feelings of grief following a preterm birth, those infants are three times more likely to develop a secure attachment. In addition, mothers who demonstrated more positive interactions with their infants were also more likely to have securely attached infants.”
The study appears in the January 17 online edition of the journal Pediatrics.