The Most Fragile Humans on the Planet
When I went to Rome in 2010 one of my goals was to observe newborns. The 30 hours of observations required by my AMI Assistants to Infancy training did not leave me feeling like I understood the newborn, as many of these hours I had watched a sleeping baby.
The students
attending the original Montessori Assistants to Infancy School in
Rome went to the orphanage, the maternity hospital, the private birthing clinics or
attended home births for the experiential learning part of the newborn training - the practical part was every morning - and the theoretical lessons were in the
afternoons. The course lasted two years and a vast amount of experience was gathered in that time.
After my A to I training, I wanted to go to Rome to "finish" my training: learn RAT, respiratory autogenic training for birthing, and observe newborns in the hospital. I hoped I would be able to do newborn observations in
the hospitals under the guidance of Dr. Montanaro, like her students from the first AMI course in 1980. But in 2010, this
was no longer possible.
Seven
years later, after four trips to Italy totaling 8 months, I was
finally able set up an internship so I would be able to study the
newborn and the delicate first days of life when the mother and child
come back together after being separated by a birth. I have observed
over 100 newborns over the last 7 months, watching them come into the
light, live through their first hours, their first doctors visits,
and find the breast for the first time. I feel like the most
fortunate person on Earth, spending so much time with the purest,
most unconditioned humans.
One
of the amazing things to see is the first alert state right after
birth - with eyes wide open - taking everything in. They usually have
an hour with their mother and then they spend an hour in the
incubator. I watch them until they fall asleep, charting how long it
takes from the moment of birth and I often find them staring at me
from the incubator, as there is little to focus on within their sight
range. I've read about the “golden hour,” a term used to describe
the very alert state of the infant right after birth, when he does
his first bonding with his mother. The protocols where I observe must
be set up based on this idea of the golden hour. But it is a golden
two hours as far as I can tell based on how many times a newborn has
a stare down with me from his incubator.
I've
never had an official diagnosis but I'm pretty sure I fall into the
category of being a highly sensitive person. I have an
uncontrollable urge to empathize with another's pain. For example,
when I watch movies I feel intense emotions, sometimes sobbing
uncontrollably, as I did at the 28th International Montessori Congress in Prague during Srikumar Rao's talk. He
showed the film about Ghandi's protest that won out in the end to
free India from British rule, but as the non-violent protesters were
beaten one at a time, each stepping forward in defiant disobedience,
each clubbed and bloody, sobs rose in my chest and at last I fled the
Congress Hall.
This
internship has offered me a wide spectrum of emotional experiences.
One of the very first days I observed in the NICU, the neonatal
intensive care unit, and I was struck deeply in my heart by the
inherent challenges of surviving a premature birth. At home that
night I cried for those babies I saw. After months of observations
the reality has sunk in and I'm no longer moved to tears each time I
enter the NICU. It is apparent that lives are being saved and modern
medicine has worked a miracle on the lives of thousands and thousands
of infants who would not have survived in the past.
That
first day in the NICU my eyes first fell on a tiny being who was but
a few weeks old, born months premature, weighing only a hair over a
kilogram. She looked like a tiny baby skeleton, her rib cage being
most prominent. She wore an oxygen mask and had an intravenous food
tube. The wires attached to her heart and oxygen saturation monitor
were wrapped around her two feet like a rope binding a prisoner. She
slept and I gawked at her, never having seen anything like her in my
life. After a bit, something stimulated her and she woke up and as
she began to squirm, she spoke first with her movements. Her arms and
legs thrust outwards and back towards her body reflexively, and the
more she moved the more agitated she became. She began to cry.
This
would have been a normal situation, a baby waking up and beginning to
squirm and fuss, (perhaps she was hungry, perhaps a noise brought her
out of her sleep state) but in this situation she was being attacked
and her protests were those of wanting the attack to stop. She wore
the wrist band every newborn in the hospital wore, to keep her
identity safe. The extra length of the band strapped to the wrist of
a premature baby is even more accentuated than for a newborn born at
3-4 kilograms, and the extra length was pointed towards her delicate
head. It ended in a sharpish point, a design feature for the adults
to be able to easily insert the strap into the slot when putting it on the
newborn. This baby was stabbing herself each time her
right arm moved away and towards her body.
“Education from Birth, the experience of the Montessori Birth Center”
This excerpt is from a chapter on the Assistants to Infancy School.
“The
very few but precious indications relative to the needs of the
newborn that we had to go by we found in the pages of 'The Child in
the Family.' They gave us a clear indication of how and what to look
for in our observations. We carefully read and re-read them, leaving
behind our preconceptions.
They
were pure in their expression and might even be construed as
mystical, containing above all a starting point for a series of
concrete investigations:
- the need to do whatever possible to offer a gradual adaptation to the extra-uterine environment
- to be attentive to suffering due to the delicate sensibilities of the newborn
- to see how the newborn is sensitive to every movement: the way he is held, touched and carried around
- to recognize the importance of his continual contact with his mother
- to see how his protests, expressed mostly with his body, communicate a distaste for every sudden change
- seeing clearly the gradual progression of his development in the first year
- and recognizing the value of the sensitive periods of this age
And
these were our working guidelines that years later under the direct
supervision of Adele Costa Gnocchi I was able to put into concrete
terms when I wrote “the Newborn, with Love,” a guide for parents,
an account of our 20 plus years of work.
At
the very beginning of our work we had already realized to what extent
medical practices for children were truly rigid and reductive. The
care that children were offered excluded any emotional and
psychological aspect and this style was endorsed by doctors and
schools preparing nurses and early childcare providers.
Montessorians,
on the other hand, were able to unite sanitary and didactic aspects
with a sensitivity to mental phenomena and individual behavior, the
key term being psycho-somatic, always keeping in mind the
interdependency of the mind and the body, two aspects traditionally
separated in common practice.
We
worked with families with newborns in their home, helping parents
find a balanced relationship with their child, and how to understand
his or her reactions. Above all, after helping them through the
birth, we would assist them through the transition of the first week
of life.
Montessori
herself confirmed the significance of our work at a brief meeting we
had with her at the Sanremo Congress in 1949 where the theme was “the
formation of the child in world reconstruction.” What she said to
us in that meeting can be summarized by the last statement she made:
Make
yourselves ambassadors to the newborn because that is where we must
begin in order to make a new world.
Not
an easy thing to accomplish. From the very beginning, in our
internships at the orphanage, in the hospitals and in the families,
we were in direct contact with the wall of defensive prejudices
regarding children.” GHF
Italian copies of this 'out of print' journal can be ordered from the Montessori Birth Center in Rome.
Who
but the premature infant needs to feel heard, needs to feel held, if
not physically due to the incubator and tubes she's attached to, then
emotionally by a voice, the touch of a kind nurse's hand?
The
other day I was observing a full-term newborn in an incubator who had
been born an hour before. Hospital protocol requires an hour of so of
“warming up” time in the plexiglass box, along with the
electronic monitoring of his heart rate and his oxygen levels before
he is given back to his mother. This baby was causing concern with
the nurses and doctors as his breathing was not normal yet and they
decided to send him to the NICU. The next day I saw this baby in the
NICU hooked up to a respirator. Without it he possibly would not have
lived. Five days later he was off the respirator and moved out of the
incubator into a regular bed, dressed in clothes, and moved into the
room where his mother could come hold him during the day and nurse
him.
Why
is it, I have to ask myself, that these babies are changed and fed
but not comforted when they cry, these babies who are the most
fragile form of human life on the planet? If a person cares about the
other person, she can “feel” his or her pain through an act of
empathy and there is a response to the other's cry for help. If a
nurse is offering medical services to a patient and concerned with
physical symptoms and not necessarily noting psychological symptoms, the delivery
of “care” is done without attention to the psychosomatic unity, without truly understanding the experience of
the other human. I remember a Montessori quote we were given in our AMI training: give the best to the youngest. And the premature infant is definitely the youngest, and most deserving of the best care we can possibly offer, medical as well as psychological.
Who
but the premature infants of the world need our compassion and love,
and the mothers and fathers of these unfortunates, who must endure the
life saving procedures before being able to hug and be hugged, to
hold and behold the miracle of human life?
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