‘They’ve forgotten that I’m the mum’: constructing and practising motherhood in special care nurseries

Abstract

Little sociological research has sought to investigate the ways in which women with hospitalized newborn infants construct and practice motherhood. This article seeks to address this lacuna, using data from a qualitative research project based in two Australian neonatal nurseries. Thirty-one mothers of hospitalized newborns and 20 neonatal nurses were interviewed, and other data were obtained via observations of the nurseries, tape-recorded verbal interactions between parents and nursery staff and casual conversations with mothers and nurses. The data revealed that while the mothers’ and nurses’ discourses on what makes a ‘good mother’ in the context of the neonatal nursery converged to some extent, there were important differences. The mothers particularly emphasized the importance of physical contact with their infants and breastfeeding, while the nurses privileged presence in the nursery and willingness to learn about the infant's condition and treatment. There was evidence of power struggles between the mothers and nurses over the handling and treatment of the infants, which had implications for how the mothers constructed and practised motherhood. The mothers attempted to construct themselves as ‘real mothers’, which involved establishing connection with their infants and normalizing them. In time, many of the mothers sought to position themselves as the ‘experts’ on their infants. For their part, the nurses attempted to position themselves as ‘teachers and monitors of the parents’, ‘protectors of the infants’ and ‘experts’ by virtue of their medical training and experience. Differences in defining the situation resulted in frustration, resentment and anger on the part of the mothers and disciplinary and surveillance actions on the part of many of the nurses, both covert and overt. The nurses’ attitude to and treatment of the mothers was integral in the development of the mothers’ relationship with their infants in the nurseries, and this influence extended beyond discharge of the infants.

Introduction

There is a substantial sociological literature exploring the experiences of mothers for newborns, the transition to motherhood of new mothers and the ways in which ‘good mothers’ are defined, both by women themselves and by experts and texts on parenting. Previous research into motherhood has shown how certain dominant discourses pervade notions of what is considered to be a ‘good mother’ (see, for example, Woollett & Phoenix, 1991; Marshall, 1991; Crouch & Manderson, 1993; Brown, Lumley, Small, & Astbury, 1994; McMahon, 1995; Hays, 1996; Lupton, 2000). These include the qualities of patience, unconditional love and kindness concerning how women relate to their children. ‘Good’ mothers are expected to ‘be there’ for their children and to develop a strong ‘bond’ with them. Specifically in relation to infants, ‘good mothers’ are expected to place their infant's needs above their own and deal cheerfully and patiently with the loss of sleep and time for oneself and other privations that caring for a baby entails. The practice of breastfeeding is also associated with the ‘good mother’ ideal, as dominant discourses on infant feeding insist that ‘breast is best’ for infants’ physical and emotional wellbeing.

These perspectives on ‘good motherhood’ invariably tend to refer to the construction and practice of motherhood on the part of women whose infants are born in good health and without disability. Thus far, few sociologists have turned their attention to the experiences of women whose infants are hospitalized immediately following birth. In such a situation, women are forced to practice motherhood within a setting in which there are significant constraints upon how they can interact with their newborn. Their infant's hospitalization has major implications for how women see themselves as mothers and how they construct and relate to notions of the ‘good mother’.

In this article, we address the question of how women who have given birth to infants requiring care in neonatal nurseries practise motherhood and construct themselves as mothers. Drawing on an empirical study, we focus specifically upon how such women, as well as the nursing staff who care for their infants, construct notions of motherhood. The latter were included in the study because they play a significant role in structuring and shaping women's experiences of being ‘nursery mothers’. Most women in western societies get to know their newborn infants and learn about the practice of motherhood in the highly privatized setting of their home, having spent only a few days in a hospital setting following the birth. In contrast, the mothers of hospitalized newborns must practice motherhood in an extremely public arena over a period of days, weeks or even months under the watchful eyes of the nursing staff in the nurseries to which their infants are admitted.

Our approach is interested in the power dynamics inherent in the experiences of ‘nursery mothers’. We adopt a Foucauldian approach to power in acknowledging that power is not necessarily always repressive but also productive, bringing into being forms of knowledge, subjectivity and social relations (Armstrong, 1997; Lupton, 1997). We were interested both in the material practices and technologies (such as the nursery rules and regulations, the practices around caring for the infants, the layout of the nurseries) and the discursive practices shaping women's experiences and their sense of self as a mother in the nursery.

According to the Foucauldian perspective, power relations are dynamic, produced and reproduced through the everyday activities and social encounters in the nursery. The material conditions of the nursery are important in reproducing and structuring these activities and encounters, but so too are the words (grouped in certain specific discourses) that are used to describe and give meaning to them. Discourses are generated and reproduced in a material context that shapes these discourses and privilege some over others. It is via these discourses, as well as others that they bring to the setting, that the mothers seek to make sense of their experiences and perform mothering actions in the context of the nursery. Nursing staff, for their part, draw on a limited range of discourses in their communication with the mothers when discussing the infants, their care and appropriate behavior on the part of mothers, and when interacting with and caring for the infants themselves. They also use certain discourses in making judgements about the mothers and their behavior. These may, in turn, have implications for the mothers’ experiences within the nursery and the meanings that they give to their mothering. Discourses, thus, are interrelated with practices, and both contribute to the construction of meaning.