If
you have never heard Dr. Nils Bergman speak in person, you need to make every
effort to do so. This mild-mannered
physician who was born in Sweden and raised in Zimbabwe works as a Senior
Medical Superintendent of Mowbray Maternity Hospital in Cape Town – overseeing 18,000
births per year.
Dr.
Bergman was in my community recently. I
did hear him speak. And here is part of
what I learned:
During
pregnancy, a baby begins to get to know the mother. Her voice, her smell. And immediately after birth, putting a baby
skin-to-skin….mother to baby with no interference from hats, blankets or
any
other clothing…babies will begin to establish the external womb, a safe and
inviting place in which to thrive. Blood
sugar, respirations, blood pressure, and neuromuscular control stabilizes
because the baby knows that he is safe.
Skin to skin contact immediately between mother and baby allows the baby
to be colonized by the same bacteria as the mother.
When
other mammals are studied, those babies who are taken out of their natural
habitat – the external womb – show all of the physiologic signs of being under
significant stress. Cortisol rises (a
stress hormone) and thwarts the baby’s system, decreasing stabilization. Additionally, normal baby behaviors such as
rooting and searching the breast, breathing normally, staying warm…all of these
behaviors take a tragic turn for the worse.
There
is no reason why most babies cannot spend a significant amount of time in
skin-to-skin contact with the mother – even cesarean born babies. And what better to help the mother and father
relax and establish this amazing environment that with the presence of a doula.
Unfortunately,
Dr. Bergman’s highly praising comments regarding doulas were met with “crickets”.
This
amazing and safe environment allows the baby to begin its life outside the womb
with a feeling of calm and safety. Yes,
there is a lot of emphasis on safety.
Early experiences establish brain function and the loving mother is key
for neurodevelopment. Studies show that
what happens in early life may facilitate a risk for developing severe
psychopathologies at later states in life.
Therefore, separation of the mother/baby dyad by required stays in a
nursery or the baby taken away for “tests” interrupts needed neural process and
becomes opposite of skin-to-skin.
Basically, maternal absence to a baby is considered toxic stress.
For
the mother, when oxytocin is released in the brain, its effects are to reduce
fearfulness and initiate “mothering” behaviors but also enhances a tendency
toward aggression and protective force toward anyone bothering the baby.
These
tremendous links between behavior and hormones are called neuro-endocrine
behaviors.
Therefore,
it truly matters how we are born and also how we are nurtured after the
birth. We are defined by our
relationships early on. And separation
of mother and baby is a violation of an innate agenda.
To
add to my notes and thoughts of hearing Dr. Bergman, the following is excerpted
from Dr. Bergman’s website www.kangaroomothercare.com
~
One of the most basic abilities, and
that appears early in development, is to determine whether a sensation (or even
constellation of such) is safe, dangerous or life threatening. This is seen in
early fetal life, and is fully competent from 28 weeks. All the sensations in
the uterus tell the fetus it is SAFE. At birth the baby is highly stressed, and
this birthing stress is necessary to activate the systems that make for
breathing air and coping with “life outside”. But once outside, the need for
being SAFE is primary, and essentially it is only mother’s presence providing
familiar sensations that achieve this. The chest of the mother is to the
newborn its PLACE of care. Care means the three basic biological needs are met:
mother skin-to-skin contact ensures warmth, her breasts provide nutrition,
and her arms cover baby for protection. The baby is wired to
respond to this place in many different ways, the two we can easily see we call
self-attachment and breastfeeding. After feeding, sleep cycling is essential to
establish the pathways that were fired.
When mother is absent, the newborn
brain feels unsafe, it perceives danger and threat to life, and its basic needs
are not provided. The brain kicks in a powerful defence reaction, which first
makes a short burst of crying before shutting that down and lowering heart rate
and temperature, and then shuts down all activity, reverting to the
immobilization defence, similar to that of frogs and reptiles. This looks like
sleep! But it is not, and it is maintained by high levels of cortisol, which
make the “wear and tear” which is the primary first cause of all subsequent
problems preterm infants suffer from. This is not actually sleep, so the
pathways are not established. Instead, when stress is prolonged, the cortisol
disrupts brain architecture, unless there is “buffering protection of adult
support”.
All of our routines that are just that….routines, and not
evidence-based…do more harm to our society’s future than we realize.