My life explorations as an adopted person and my studies of the foundations of human wellbeing have consistently turned up a key element of health: the experience of and capacity for connection.

Birth presents us a momentous opportunity to foster connection. It is also important to understand the costs of not staying connected after birth - whether it is due to adoption, NICU confinement, health issues in the mother, or other circumstances preventing mother-newborn connectedness.

This is not about guilt or blame, but the empowerment that comes with understanding what happens with neonatal separation.

Chemicals of Connection

During and immediately after birth, a complex hormonal cocktail orchestrates biochemical exchanges between a mother and her newborn, offering never-to-be-repeated opportunities to set the stage for optimally healthy psychosocial development. Levels of oxytocin -- our hormone of love, connection, peace and healing -- peak during this time. This paves the way for important brain circuitry to wire up in the baby's social and emotional centers. It also nurtures the mother's urge toward maternal behavior.

Oxytocin is a primary peacemaker hormone in the body: it elicits a relaxation and growth response, which in turn reduces activity in the stress (fight, flight or freeze) system. We're all familiar with the idea that love conquers fear, and thanks primarily to oxytocin, it's not just a worthy ideal, it's a basic feature of our physiological design! Along with its ability to moderate a person's tendency to switch into stress-response mode, oxytocin is involved in such basic peacemaker capacities as empathy, adaptation, tolerance, cognition, and interdependence. Impairment of the oxytocin system has been implicated in autism, as well as schizophrenia, drug addiction and even cardiovascular disease.

Understanding the Trauma of Separation

Throughout generations of routine obstetrical, hospital, and adoption practice in this country, the attitude has been, "Why would the separation from its mother affect a newborn baby?" But with the advent in the last thirty years of prenatal and perinatal research, we have astounding findings about what a fetus experiences in the womb.

We now know what a strong connection a baby has with its mother long before birth, and how intelligent, aware and remembering a newborn is. Researchers currently feel the more appropriate question to be, "Why wouldn't separation from the mother to whom he or she was connected for nine months affect an infant in fundamental ways?"

As Nancy Verrier wrote in her landmark 1993 book, The Primal Wound Understanding the Adopted Child,
Many doctors and psychologists now understand that bonding doesn't begin at birth, but is a continuum of physiological, psychological, and spiritual events which begin in utero and continue throughout the postnatal bonding period. When this natural evolution is interrupted by a postnatal separation from the biological mother, the resultant experience of abandonment and loss is indelibly imprinted upon the unconscious minds of these children, causing that which I call the "primal wound."
Verrier's book is well-known in the adoption world, but her insights are critically important for any circumstance in which there is prolonged or chronic neonatal separation. So as I go on to describe the implications of not staying connected after birth in terms of adoption, they can apply to other separation circumstances as well, including NICU stays.

Over my years of counseling and coaching, I have seen so-called "classic adoption issues" (e.g., trust, intimacy, persecution complex) show up in those who were separated by NICU confinement. This can be a difficult line of exploration, because none of this is ever done maliciously or with anything but the best intentions. How painful it can be to discover that even our best intentions don't trump biology! The good news is, there is always healing possible -- but only once we recognize the truth of what our child experienced.

Rather than deeply question whether the experience of separation in adoption is traumatic, we as a society tend to believe that enough love and care can make everything right. But psychologists have taught us that the first stage of psychological growth includes the development of trust, as a foundation for secure relationships with others, and ourselves. Babies who are separated from the only connection they've ever known -- their primordial biological and psychological matrix -- have had their nascent sense of trust deeply violated.

Adoptees may unconsciously feel that it's too dangerous to love and be loved authentically and deeply; all of the love and care parents give them sometimes has a hard time "getting in" past the child's defenses against the hurt and abandonment that they are internally "hardwired" to expect. As Verrier says of her own relationship to her adopted daughter, "I discovered that it was easier for us to give her love than it was for her to accept it."

Again, varying degrees of deep distress can occur for newborns under circumstances other than adoption, such as NICU stays for premature or ill babies -- in which case the trauma of separation may be compounded by painful medical procedures, isolation, and harsh, invasive surroundings.

My Own Challenge Staying Connected After Birth

border bs:0 bc:#000000 ps:0 pc:#eeeeee es:0 ec:#000000 ck:500d02a4f1f1d7497340cc586896bf11Separation wounds can also happen in the most "normal" of birth and postpartum circumstances. Like so many modern American moms giving birth to healthy, full-term babies in hospitals... and despite my best intentions (and the admonition of my very progressive pediatrician, to "not let them take your baby away from you!")... I found myself overpowered by the momentum of standard hospital protocols (and perhaps my own remembered / reenacted newborn experience) of separation.

Not only did this have its effect on our son's developing trust, it also interrupted the unfolding of my own maternal instincts and identity, which was a dangerous thing given my risk profile for postpartum depression.

An Unrepeatable Moment in Time

Would I have held on tighter to Ian had I known this next piece of sobering research about the importance of staying together in the first hours following birth?? (Granted, this study didn't come down the pike for another twenty years -- but now YOU get to know about it!)

Researchers at the Karolinska Institute studying the long-term effects of hospital delivery and maternity practices on mother-infant interaction found that close contact (skin-to-skin and suckling) during the first two hours after birth, led to increased levels of maternal sensitivity, infant self-regulation, and "dyadic mutuality and reciprocity" one year after birth... as compared with mothers and infants who had been separated during their first two hours.

The most striking aspect of their findings was that the negative effect of a two-hour separation after birth was not compensated for by the practice of rooming-in.[ii] There is something unique and irreplaceable about those first hours following birth -- and we want to use them to their fullest peaceable potential!

The Trauma & The Healing

The trauma of newborn separation is registered largely on the physical level, leaving the nervous system predisposed to getting stuck in survival mode: fight or flight, or freeze. In babies, these powerful feelings are thus expressed physically, through
  • inconsolable crying (or the other extreme, virtually no crying at all)
  • extreme startle responses
  • arching or stiffening at being held
  • "spacing out" or sleeping all the time
  • severe colic
  • other illness (e.g., I contracted pneumonia at 6 months of age)
The primal sense of loss, abandonment and rage that results from the trauma of separation is overwhelming to a newborn, who hasn't yet developed an ego, much less ego defense mechanisms. Left unacknowledged and unaddressed, these unresolved nervous system patterns can permeate the psychological, neurological and personality realms.

They can manifest in such ways as hyper-controlling behavior ("the little tyrant") and intense emotional volatility (adoptees often pick up the diagnosis of borderline personality disorder or bipolar, which are indeed marked by such volatility). They can be reflected in disordered nervous system circuitry and/or sensory integration processes, which may present as a variety of "disorders," such as ADHD, SPD, ODD and others. Or these patterns can show themselves in the opposite way -- a superficially cheerful adaptiveness ("the pleaser").

Children often split themselves off from the injured parts of their psyche, and develop a functional, acceptable, "false self." This concept of the false self is often the explanation behind what seems like "wonderful adjustment" on the part of an adoptee, or traumatized child who has responded to the deep fear of further abandonment or trauma by becoming compliant and adaptive to the needs and expectations of the parents or caregivers. But their grief and anger is simply buried in the unconsious, curdling their social and emotional lives.

However, all is not lost. Parents needn't feel hopeless in the face of these revelations. On the contrary, when faced with an inexplicably unsoothable baby... or, one who kind of "tunes out" and won't engage... a parent without these insights could understandably feel hopeless and helpless!

When parents are provided this understanding about the impact these early experiences may have had upon their child, it can be very liberating (after the initial shock and grief passes). It frees them to reach beyond themselves and not take the child's behavior personally ("He doesn't like me!"). This can empower a parent to make herself truly available as a loving, healing presence for her baby. How?

Staying Connected After Birth with Healing Words

One of the most powerful healing forces is available to every parent, free of charge: empathy. Empathy allows a person, even a tiny baby, to feel her feelings, rather than repress them, so they can be released. Babies who have lost their original mothers, permanently or even temporarily... and babies who have suffered other painful or traumatic experiences... need to express their feelings of grief and loss.

They need our help to do this, and this help needs to take the form of active empathy... saying the words, out loud, that let the baby know that what he or she is feeling makes sense and is allowed. (I'm reminded of what a therapist once said to me: "It's knowing what really happened to us that makes us sane.")

So instead of the very common dismissive mantra chanted to upset babies, "It's okay, you're okay, you don't need to cry..." the thoughtful and knowledgeable adoptive parent can gently croon to her baby in distress:

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"You miss your mother. You miss your connection. You've lost something very important, and I understand. I'm not the mom you expected, I don't smell like her, I don't sound like her. I'm a different mom and I am here for you... always... when you feel sad, and when you feel joyful..."

Or the mother (or father) of a baby in or recently out of the NICU might say:

"I really see you, and that you're in distress... I understand... You had some scary and painful things happen to you while I wasn't with you, I wasn't there to protect you, and I'm very sorry..."

These may be difficult words to say, words that prod at our own losses and hurts... infertility; the death, miscarriage, or stillbirth of a previous child; other deep pain suffered on the road to adoption; or the pain and fears involved in having an ill or premature child. But I can think of no greater gift we can give our precious new children than the freedom to be exactly who they are, with everything they feel, so they don't have to bear the leaden emotional baggage of banished feelings throughout their lifetimes.

And in return, we are blessed with a secure, trusting, and joyous relationship with our children... the gift of true intimacy. The gift of staying connected after birth…and forever.

E.g. Maté, Gabor. In the Realm of Hungry Ghosts: Close Encounters with Addiction. Berkeley, CA: North Atlantic Books, 2010; Odent, Michel. The Scientification of Love. London: Free Association Books, 1999; Ornish, Dean. Love & Survival: The Scientific Basis for the Healing Power of Intimacy. New York: HarperCollins, 1997.

Bystrova, Ksenia et al. "Early Contact Versus Separation: Effects on Mother-Infant Interaction One Year Later." Birth 36, no. 2 (2009): 97-109.

Images (in order):
footloosiety, Flickr | Creative Commons
John Axness
N8tr0n under a Creative Commons license