A Sober Look At Neonatal Care: Foundations of Violence?

With barbeque grills across the country barely cooled off from Father’s Day, I’m reflecting on the pre-release screening I attended last week of Janel Mirendah’s film The Other Side of the Glass — a birth film for and about fathers. Its chilling glimpse of hospital neonatal care protocols has important implications for the idea of raising a generation of peacemakers.

The U.S. mentality for every problem is to go to war: the war on poverty, the war on cancer, the war on drugs, the war on child abuse, the war on terror, begins with the experience of birth imprinted in our neural system. –Janel Mirenda, filmmaker

The famed child psychologist Erik Erikson taught us that the first psychosocial lesson a child learns — in infancy, and in my book I make a case for extending this into the womb — is trust versus mistrust. An infant whose cries of distress are met in a timely, attuned way that meets his needs learns over time that he can trust the world, that his word has influence on his world, that people can be counted on when he is in need. Trust. A child who is left to cry, or worse, learns in the most primal, pre-verbal, implicit way the opposite of trust. She learns that he has to fend for herself and sort of protectively bind herself up from others, which is a terrible existential bind, for she still perceives himself as one with his mother. (This is a whole other blog post!) And it certainly is the opposite of the healthy interdependence that distinguishes the peacemaker.

Neonatal Care & Fresh New Senses

I’m speaking there of infancy. But what of the first moments of a baby’s life, newly arrived from the silky, cocooned embrace of the womb? When he is, as late poet John O’Donohue put it, “fresh from the eternal”? Is trust fostered or shredded by the invasive, distressing, painful procedures that are routinely performed on newborns in our country? Rubbing briskly with towels that would feel like sandpaper compared to velvety amnion? Early cord-clamping, which deprives the baby of up to one-third of his rightful blood volume? A nasal bulb inserted into his nose to suction? Or worse, a gastro-nasal tube threaded into his nose and down his throat? Fingers inserted into his mouth, up and over and around his gums? Circumcision? And aside from all of that, the fundamental trauma of being separated from his mother?

Mirendah’s film shows the birth and postnatal ministrations on her own grandson, a healthy full-term baby upon whom all of these procedures were performed (while her daughter shot video — a brilliant use of the unthreatening “invisibility” of a youth). These procedures were done roughly, and some of them repeatedly. Audio of the nurse’s sardonic comments to the screaming baby heighten the horror: “You can get away from the doctor but you can’t get away from me.” All while the baby’s father and grandmother stand by futilely expressing their concern, and the wish for the baby to be returned to his mother.

One RN who is filmed watching that footage says that “Ninety-five percent of what was being done to that baby was medically unnecessary, and I have no problem saying that.” (It is only afterward, in a poignant moment while the RN is still on camera having just made that statement, that the filmmaker behind the camera tearfully reveals that it was her grandson in the video.)

At least three years ago evidence-based recommendations regarding neonatal resuscitation and management of meconium were issued by one of the leading obstetrical professional societies saying that not only is suctioning not necessary, it carries many risks. One nurse interviewed by Mirendah refers to it, along with other invasive, painful newborn procedures that are protocol in most hospitals as “normative abuse.”

One of the poignant overarching themes in Mirendah’s film is the deep and insidious double-bind in which this puts fathers, who only a nano-second ago in human history were (grudgingly) allowed into the delivery room and expected to function comfortably and expertly. His deepest and most powerful instinct is to stand in the way of anyone who would hurt his partner or his baby, but he is unable to do so without violating layers of institutional and cultural conditioning, thus possibly putting them at further risk for reprisals by angry medical personnel. Examples of such situations abound in the film.

Fathers and partners cannot be trained or educated enough to go to the hospital to be able to “protect” their partner/wife and baby. The fact that they are expected to, or that women feel they need to be protected, is a serious unaddressed issue in our society. –Janel Mirenda, filmmaker

Newborn Care & The Fate of Humanity?

Childbirth and the first postpartum hour are decisive moments in development, a brief window of time when critical systems in the brain and body of both mother and baby organize in ways that will affect them lifelong. Of fundamental importance, as we consider birthing a generation of peacemakers, is the circuitry for oxytocin, the hormone of love, connection and — according to neuroeconomist Paul Zak — moral behavior. Biochemical cascades triggered during an unimpeded mammalian labor, birth and postpartum period establish in the baby enduring set points for his brain’s self-regulating and social functions. These thresholds will to a great extent forecast how able this individual will be to respond to later influences — including parental, educational, and spiritual guidance — aimed at cultivating socially conscious attitudes and behaviors. How we birth matters for peace at many levels.

Primal birth researcher and obstetrician Michel Odent suggests that up until now in our human history, it has been evolutionarily advantageous to develop the capacity for aggression. How best to do that? Make birth more difficult! He points out that this was well known in such warrior cultures as Sparta, where they made it a point to disturb the natural birth and postpartum process, knowing it would result in more aggression later in life. Given the violent demands of their world, they deliberately cultivated in their new citizens an “impaired capacity to love.”

But today’s world poses very different demands: its sophisticated complexities call for a robust capacity to love. Whatever evolutionary survival advantages difficult birth might have conferred in the past are not only no longer useful, they may be our undoing. The challenges faced by coming generations will require a level of cooperative interdependence never yet seen on a large population scale in human history. Just as the paleontologist and priest Teilhard de Chardin predicted last century about our current techno-united world, now is the moment when we need to cultivate and harness the energies of love. The lasting first impressions at birth — including the lessons of trust or mistrust — play a fundamental part in that cultivation.

Within the overflowing Labor & Birth shelves at the bookstore, the baby’s experience of birth is mostly overlooked, with one notable exception — Birth Without Violence, which Utne Reader called “one of the twenty books that changed the world.” (Their pronouncement has proved sadly optimistic, or at the least, premature, for it has not changed the world yet.) Referring to the first impressions left by our birth experience, author and obstetrician Frederick Leboyer wrote, “What futility to believe that so great a cataclysm will not leave its mark. Its traces are everywhere — in the skin, in the bones, in the stomach, in the back. In our human folly. In our madness, our tortures, our prisons.”



Portions adapted from Parenting for Peace:  Raising the Next Generation of Peacemakers

One thought on “A Sober Look At Neonatal Care: Foundations of Violence?”

  1. See also the work of John Bowlby and James Prescott the latter looked at the Origins of Violence violence.de/

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