Bonding Experiences in a South African Community Hospital: Kangaroo Mother Care Ward

This paper explores the relationship between a Winnicottian holding environment and the beginnings of Bowlby's attachment within the context of a Kangaroo Mother Care (KMC) ward. KMC entails the strapping of premature infants to their mothers' chests to facilitate temperature regulation, breast feeding, and better bonding between mothers and their babies. It is endorsed by the World Health Organization and, over the past decade, has slowly been implemented in South African public hospitals. This study aimed to explore these mothers' experiences. An interpretive thematic analysis of eight interviews with mothers on a KMC ward was done. The study found that the women experienced bonding as an intense psychosomatic identification with their infants. Narratives of loss and trauma emerged, and within this context the separations between mother and infant in the ICU ward were experienced as persecutory, while the KMC ward was experienced as holding and facilitative of the growing bond between mother and infant, fulfilling Winnicott's total environmental provision. This paper suggests that a temporary regression in the mother to paranoid-schizoid functioning allows for healthy splitting and identification with the surviving baby, thereby permitting the mother to risk bonding with her baby under challenging circumstances and creating an internal psychological space that is facilitative of attachment.