The experience of premature infancy within the mother- infant dyad in neo-natal high care unit: A psychoanalytic exploration

Abstract

The experience of prematurity is disruptive and traumatic for both mother and infant, potentially placing the parent-infant relationship at risk. Given the risks involved as well as the prevalence of premature births, this is an area that requires engagement and research. In an attempt to address the paucity of psychoanalytically oriented research endeavours into the topic of prematurity, this study explored the experience of premature birth for mothers and infants in a neonatal high care ward through the lens of psychoanalytic theory. A psychoanalytically oriented ethnographic approach was utilised integrating object relations and intersubjective psychoanalytic theory with developmental psychology. This implied a focus on the influence of the mothers’ previous relational traumas on her experience of premature birth and use of dissociative defences. Maternal narratives from interviews as well as observational material from three premature mother-baby dyads allowed for in-depth exploration of maternal states of mind, intersubjectivity within mother-premature infant dyads, and infant responsivity. The study design required high levels of researcher reflexivity and the impact of the researcher’s subjectivity was explored. Insights were also offered into the process of conducting psychoanalytically oriented research within this sensitive context. Key findings included the fact that the trauma of engaging with a premature infant appears to reactivate dissociated self-states associated with childhood experiences of loss and absence for mothers. The study suggested that although the vulnerability of the infant is relevant, maternal states of mind play a bigger role in either supporting or derailing the development of the parent-infant relationship. The study also demonstrated the premature infant’s capacity, when appropriately supported, for communication and engagement.