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The Elusive, Ephemeral Moment

by ACNM Guest Blogger, Kimla McDonald, CNM

“Please turn off that spotlight,” I asked the labor tech in the birth room as the baby’s head was crowning. I tend to do without the bright light, because my hands are really my eyes as the baby’s head emerges from the mother’s body. That gentle pressure we apply to ease the head out, gradually, is a kinetic act, not a visual one. It’s very much the same as popping the cork from a champagne bottle, as I learned recently helping out with my sister-in-law’s wedding. (I love when work skills come in handy at partiesso rare when you’re a midwife.)

The baby’s head slid out slowly, gently stretching everything, following quickly by her shoulders, chest, and then the rest of her tiny body. She had good color, great tone, and was starting to cry, so I gently placed her on her mom’s chest so she could be held by the woman who had just brought her into the world. It is at this “fragile moment,” described by Dr. Frederick Leboyer’s 1974 classic Birth Without Violence, that

“The baby is between two worlds. On a threshold. Hesitating.

Do not hurry. Do not press. Allow this child to enter….

An elusive, ephemeral moment.

Leave this child. Alone.

Because this child is free—and frightened.

Don’t intrude: stay back. Let time pass.

Grant this moment its slowness, and its gravity.”

Hospital routines push back against this moment. Nurses are busy. They need to weigh and measure, give shots and drops, move things along. As midwives, we can weigh the options, encourage a gentle transition, help baby find the breast. Just because the baby is out doesn’t mean our job is done.

And here is another fragile moment. As we help the new mother to breastfeed, how many of us are thinking that this might be an act that sets the course for the child’s future development as an individual, ultimately influencing not only his own mental health, but that of his community?

Wow. Really?

So said Donald Winnicott, a British pediatrician and psychoanalyst who famously broke with Sigmund Freud over his theory of human nature in the 1950s. Winnicott observed that for a baby, finding his mother’s nipple is his first relationship with another being, and the way this relationship is entered into creates the expectations a child develops regarding others, and therefore his ability to form relationships for the rest of his life.

Dr. Winnicott recognized “the need for the infant to be the creator of the nipple of the breast of the mother.” In allowing the baby to find the nipple, rather than being the passive recipient of his mother’s breast, the baby learns that he has the ability to contribute to the most important relationship there is. He seeks and finds his object of desire, and with the help of his mother, enters into a relationship that creates a new individual.

As midwives, we can guard this precious time for mothers and babies, giving them time and opportunity to let this first relationship unfold, to help these newborns “create the world.”

Dr. Winnicott died in 1971, leaving behind important works on the “good-enough mother,” object relations theory, and play. Frederick Leboyer is 93 now, and a new edition of Birth Without Violence was published last summer. If you haven’t read it, you should. In this world of technical jargon and ever-increasing electronic tasks, he reminds us to disappear,

“So that only the baby remains. We must look at this baby. Or better yet, be absorbed into its very being. Without complication. Without prejudice. In all innocence. All newness. Become…this new person.”

P.S. Check out for a great tutorial on letting babies find the nipple and “create the world,” thanks to Dr. Suzanne Colson.

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Posted 12/8/2011 3:39:09 PM



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