“I thought he was ugly”: Mothers of extremely premature children narrate their experiences as troubled subjects

Introduction

This article sets out to explore how mothers of extremely premature ¹ children make sense of their negative feelings towards their newborn child and their strategies for performing “proper motherhood”. Although there has been a remarkable increase in the survival of extremely preterm infants during the last two decades (Håkansson, Farooqi, Holmgren, Serenius, & Högberg, 2004; Martin et al., 2008), these children are at greater risk for a range of neurodevelopmental and neurobehavioral impairments (e.g. cerebral palsy, blindness, deafness, cognitive deficits, learning disabilities, or emotional–behavioural problems) (Anderson & Doyle, 2008; Serenius et al., 2013). Researchers have argued that parenting style, and especially a good mother–child relationship, is a central factor that influences the growth and development of the preterm infant (Assel et al., 2002; Beckwith & Rodning, 1996; Feldman & Eidelman, 2007). The ambition to promote the parent–child relationship, based on Bowlby’s attachment theory, has, therefore, been one important factor in directing the nursing of premature infants towards a more family-oriented form of care that involves the parents as equal partners (Fegran, Helseth, & Slettebo, 2006).

However, concepts such as attachment and bonding, and the way that they have become cornerstones in dominant discourses of “good motherhood” have, for a long time, been questioned by feminist scholars. For example, Birns (1999) has discussed the unreasonable responsibility for a child’s well-being and future life that is expected of mothers according to the basic premise underpinning attachment theory that:

… due to biological programing of both mother and infant to behave in certain ways, the infant develops a monotropic relationship to the mother. Her/his secure or insecure attachment becomes the essential basis for all future development. (p. 12, emphasis in original)

Following the tradition of attachment theory, Kennell and Klaus studied mother–infant bonding, which they described as mothers’ biological/hormonal need (i.e. instinct) to be with their children right after birth in order to secure a healthy relationship and the child’s future well-being (Eyer, 1992). If the “right bond” was not accomplished, and a mother rejected her infant, the child might suffer from abuse or neglect, risk failure in school, and turn into a juvenile delinquent. The concept of bonding became an institutionalized idea in the 1970s American context and gained its legitimacy from describing natural behaviour, since it was largely inspired by animal research (Eyer, 1992).

According to Eyer (1992), the concept of bonding was taken up by a feminist move that claimed women’s control over delivery. This movement was partly the cause of substantial reformation of hospital childbirth, which – for example – meant that a mother could have her newborn child with her after delivery and that the care became more family oriented and the setting more homelike. For professionals in neonatal intensive care units, the idea of parent–child bonding became especially important as a means to encourage parents of premature and sick children to become engaged with and care for their infants. In this sense, the notion of bonding was also taken up by medical professionals as a way to remain in control over child birth and “proper” child care (Eyer, 1992).

In spite of the general scientific critique and feminist debate, theories of attachment and mother–infant bonding are still a part of a western, dominant discourse of good motherhood that positions the mother as the main parent responsible for loving and caring for the child and securing her/his proper development (see, for example, Birns, 1999; Bliwise, 1999; Eyer, 1992; Franzblau, 1999a, 1999b; Knaak, 2010). Elvin-Nowak (1999) has argued that the significance of mothers’ “accessibility and closeness to the child”, as proclaimed by developmental psychological theories, has also turned into a motherhood ideal in the Swedish context that has been taken up by mothers (p. 5). Further, Forsberg (2009) has argued that the Swedish contemporary norm “involved parenthood”, meaning that parents should be with their children as much as possible and “try to develop close relations to them”, is still mainly a mother’s responsibility (p. 11).

Unfortunately, as Eyer (1992) has argued, the “imperative to bond” leaves the parents of premature children especially “overwhelmed with regret and guilt” for not being able to be with their child (p. 3). This is the case, in spite of the significant challenges that make the bonding ideal more or less impossible. For example, there is often an uncertainty with regard to the survival (i.e. at very early gestational ages) and the severe complications that might strike these children. Further, for some mothers, the premature birth means having a traumatic and stressful experience (Hansen, 2010), which might lead to depression and other post-traumatic symptoms (Goutaudier, Lopez, Séjourné, Denis, & Chabrol, 2011; Karatzias, Chouliara, Maxton, Freer, & Power, 2007; Lau & Morse, 2003). Complications such as preeclampsia or various infections, or the delivery itself (e.g. via caesarean section), might also affect the mother’s overall health, strength, and ability to parent, which means that the father may be the first parent to meet and care for the child (Hansen, 2010). Moreover, the technical medical equipment needed, for example, the humidicrib or continuous positive airway pressure, makes it hard for parents and children to be physically close (see, for example, Bolch, Davis, Umstad, & Fisher, 2012). Additionally, since premature children often express themselves with cues of lower intensity, it becomes hard for parents to figure out their needs, which – in turn – impinges on the interplay between parent and child (see Goldstein, 2013).

Previous research

This section deals with the previous research, mainly within medicine and nursing, that focuses on mothers’ experiences ² of premature birth and which, in some cases, relates to notions of attachment and mother–child bonding. Several studies have reported how mothers describe the birth in terms of chaos. These mothers experienced negative feelings of fear, stress, worry, helplessness/powerlessness, and guilt (Bolch et al., 2012; Fegran, Helseth, & Fagermoen, 2008; Goutaudier et al., 2011; Hall, 2005; Hansen, 2010). For some mothers, it was a shock to see the child for the first time, and these women expressed difficulties in attaching to the child and identifying themselves as mothers. Fegran et al. (2008) reported that, although some mothers really wanted to attach to the child, their worry for the child’s health and their fear of touching the child aggravated this process. The fear of losing the child made it hard for some mothers to be with their baby, while others found it hard to leave her/him (Erlandsson & Fagerberg, 2005; Jackson, Ternestedt, & Schollin, 2003; Swartz, 2005).

In a meta-analysis of 14 qualitative studies, mothers’ sense of becoming parents has been described as moving from uncertainty, fear, and ambivalence to feeling more self-secure, daring to bond to the child, and starting to take control over the care for the child (Aagaard & Hall, 2008). However, there are, as mentioned above, different hindrances in this process. For one thing, mothers have experienced the feeling that their child seemed to belong to the hospital during the first period after birth (Hall, Brinchmann, & Aagaard, 2012), and some mothers expressed a fear that the child would be closer to the nursing staff than to themselves (Goutaudier et al., 2011). Parents have also reported how they must adjust to routines and directions that were defined and ruled by the nursing staff, which made some parents feel monitored by the personnel (Aagaard & Hall, 2008). It has also been noted that different opinions about “good motherhood” can lead to a power struggle between mothers and nurses. Lupton and Fenwick (2001) reported how the nurses expected the mother to be present and engaged in the care of the child, while the mothers highlighted the importance of being close to the child to caress, cuddle, and breastfeed her or him if possible.

Methodological and theoretical starting points

The theoretical framework of this analysis is based in discursive psychology and the notion of the individual as “partly subject to pre-existing discursive resources, but endlessly mobilizing and reworking these” (Wetherell, 2005, p. 70). This means that our interest lies in investigating how the mothers creatively use linguistic resources when they try to make sense of the self, their experiences, and emotions when they talk (see Potter & Wetherell, 2001). According to Davies and Harré (2001), these resources can be “particular images, metaphors, story lines, and concepts which are made relevant within the particular discursive practice” (p. 262). Since people mostly have alternative discourses to which they can relate, they often construct meanings that are fragmented, fluid, and sometimes expressed in terms of “a dilemma of stake or interest” (Potter, Edwards, & Wetherell, 1993, p. 389). The empirical material chosen for this analysis consists of the difficulties expressed by mothers around negative feelings towards their extremely premature child. Given the dominant discourse of mothers’ responsibilities for attachment and bonding, the mothers clearly describe their negative feelings towards their child as a dilemma and use various linguistic resources to manage this. At stake is their credibility as “acceptable mothers”.

When people try to manage different dilemmas, or defend their interests in some issue, they use different linguistic tools. For example, factual reports and descriptions work as seemingly neutral and true facts that downplay the speaker’s own interests (Potter et al., 1993, pp. 389, 393). An extreme case formulation can work to justify or defend ideas, opinions, and actions, for example by referring to what (supposedly) everyone knows to be true (Pomerantz, 1986). In many cases, speakers’ references to their own free will and choice is a way to use what Reynolds, Wetherell, and Taylor (2007) described as a cultural resource to make sense of being in a problematic position.

Further, when people use different discourses, they also construct various identities or subject positions (Reynolds, Wetherell, & Taylor, 2007) that can be analysed as including/excluding categories and how people relate to them (Davies & Harré, 2001). For example, you can think of yourself as part of a certain group of people if you recognize yourself as having the same characteristics as the members of the group (Davies & Harré, 2001, p. 263). In this case, there is a dominant discourse that defines good motherhood as being loving, caring, and attentive to the child and its needs. A woman’s failure to perform good mothering – for example, what is labelled as her inability to attach to and bond with her child – is, according to the logic of the discourse, an exception from the norm that is often explained as sickness (almost madness) and labelled as postpartum psychosis or postnatal or breastfeeding depression (see, for example Murray & Finn, 2012).

In this analysis, it will, therefore, be helpful to understand how specific subject positions are talked about as questioned, criticized, and troubled, while untroubled positions are talked about as normal and righteous (Wetherell, 1998). Staunaes (2003) has described how troubled subject positions are constructed as “inappropriate, destabilized, difficult” in relation to what is considered as normal and desired in various types of interactions and specific orderings of power; for example, gender (p. 104). If you are a part of the dominant norm in a specific context, it is possible to talk about yourself in an untroubled manner, as an ordinary and normal person and without feeling the urge to explain your position or actions. Staunaes (2003) defined this as being ‘“in sync” with the discursively constituted appropriate’ category at stake, while some persons talk about themselves as “at the margin of appropriateness” and as not “‘in sync’ with the dominating discourse” (p. 106). In this sense, I understand the women’s narratives as ways of producing/performing different un-/troubled positions or identities as mothers.

Method and empirical data

The empirical data in this analysis consist of women’s narratives about becoming a mother to an extremely prematurely born child. The interviews were conducted as part of a sub-study with the aim to explore the experiences of mothers and fathers to both extremely and moderately premature children. The main project, the Moderately Preterm Infants in Sweden Study (the MPRESS study; an interdisciplinary research programme on mental and physical health, brain functioning, school performance, and parenting in moderately preterm-born children at 10–12 years of age), investigated the health and possible need for support among moderately premature children born at the Umeå University Hospital (Sweden) between the years of 2000 and 2002. The study was approved by the Ethical Review Board at Umeå University.

The parents’ stories are about experiences that occurred relatively long ago and in relation to a subject (i.e. premature birth) that, in the research context, was presented as a possible problem for the child. Although one could argue that birth stories in general are important narratives in the making of both the parents’ and the child’s life stories, which parents cherish and can be quite detailed about (Nylund Skog, 2002), it seems as if the premature birth is described as a specific experience. For example, both mothers and fathers argued that the premature birth has made them different from “ordinary parents”, which they explained as an effect of experiencing the delivery as somewhat of a trauma, having a very ill baby that might not survive, and, in some cases, mothers were struggling with their own poor health. Some parents stated that these experiences have made them more aware that life is not always a simple, happy journey and that since that time they value everyday life more (see also Jackson et al., 2003). It was also evident that the delivery and the time spent at the hospital (weeks but often months) could be recounted in quite detailed, vivid, and emotional ways (see also Hansen, 2010), although the events occurred 10–12 years ago.

The sub-study was conducted during 2013–2014 by the first author of this article and another researcher. Parents who had a premature child born between 2000 and 2002, who had been cared for at the neonatal intensive care unit, Umeå hospital, and who was still alive, were contacted with a letter describing the study. They were then contacted by telephone and asked if they wanted to be a part of the study. If they declined, the next parent on the list was phoned, and so on. Together we interviewed approximately 80 parents, which included around 20 mothers and 20 fathers of extremely premature children and 20 mothers and 20 fathers of moderately premature children. The parents of moderately premature children were recruited from the MPRESS study (i.e. the main project) and the parents of extremely premature children were recruited from a previous but already complete study called the Extremely Preterm Infants in Sweden Study (EXPRESS study, n.d.). Since the parents lived in various places in the northern part of Sweden, they were interviewed by telephone. Our conversations were outlined with reference to different themes, which included the pregnancy, their experiences of the birth, the hospital period, the process of going home, the experiences of pre-school and school, and, finally, thoughts about the future. The interviewed parents were of different ages and had different educational backgrounds and professions. Some of the parents only had one child while others had up to six children, and some of these siblings were also born prematurely. A few of the parents had separated, while others lived in the same family grouping.

At the time when the parents had their premature children, the neonatal hospital care setting was not yet fully transformed into the more family-oriented care with a homelike setting that is the ideal, according to theory on mother–infant bonding (see Eyer, 1992; Fegran et al., 2008). In general, this could mean that the premature baby was placed in one hospital department and the ill mother in another, while the father was referred to the hospital’s patient hotel. When the mother felt better, she was accommodated at the hotel. If there were siblings, the usual arrangement among the larger group of parents was that the father took on the responsibility of caring for them, sometimes with the help of relatives, and it was the mothers who stayed with the premature child during the hospital visit while some of the fathers returned to their work.

The empirical material underlying this article comes from the interviews with 13 mothers and 10 fathers of 14 extremely premature children which were conducted by the first author of this article. The interviews were done in Swedish and lasted from about 45 to 90 min. The conversations were recorded and transcribed verbatim in Swedish. (The extracts selected for this article were then translated into English and analysed.) Taken together, most of the stories were narratives that described a traumatic delivery, a difficult time trying to identify as a parent, and challenges in feeling like a “real family” while being constrained by the care needed at the hospital. Most of the parents had experienced having children at risk of dying (and, in some cases, the parents had lost a child) or having serious complications and suffering from poor health. The focus of this article is, however, the selected stories of four mothers who, in different ways, explicitly narrated their negative feelings towards their child.

Struggling with attachment, bonding, and ideals of motherhood

An important starting point for the stories is that the mothers describe how they quite soon realized that not all extremely premature children survive. One of the mothers explains how she woke up in the mornings without knowing if her son was alive or if he was going to be alive when she came back from the bathroom or after having something to eat (Interview 17). Another mother depicted how the fear of losing her son made it hard for her to like him:

I think that I was, that I was so afraid when he was that small and I thought, oh, whew, it’s for the best that I don’t like him because if anything happens and if he dies right now, then I might not be so sad. That is how I would like to describe it. Almost as if … it is a bit like animals, that when things aren’t the way they should be, you reject them. I think we work this way. (Interview 13)

Following this line of argument, it is striking that a recurring theme in the stories, including the bigger sample of interviews, involves descriptions of premature children as “unfit” in the sense that they are represented as inhuman in various ways. One mother says that she was afraid to touch her child because she might break him: “Because it was a little wrinkled … it was a chick. It wasn’t a human being lying there, it was a chick. It was bones with skin tightened over them … skin that was piercing red and glossy” (Interview 17). If “chick” is the most common metaphor to describe the look of the newborn child, other images used, such as “chimpanzee” or “alien”, also underline the “in-humaneness” and are a part of the mothers’ explanations as to why they could not feel “motherly love” for their infants.

The following quote illustrates a variation of this theme – the really ugly baby and the reference to nature and biology – and was introduced by the mother as a story of how life turned into “hell” (an extreme case formulation) when she began lactating on the third day after birth:

I thought it [referring to the lactation and being affected by hormones] was horrific. I thought … he was ugly. And … looked awful. And I wanted to go home. Because I thought that he was going to die anyway. Well, you know, these things came to my mind. These things are about hormones. And I, yes, I got a real panic … But it was just for one single day … Well, I thought that I would leave him and go back home to my other children and then come back when he was bigger, I thought. Because I, we really got, I got a shock when I saw how small he was … I thought he looked miserable. (Interview 13)

Another mother, who was rather sick and needed help to look down in the humidicrib to see her daughter for the first time, described her experience in the following way:

Well, it wasn’t a child lying there. It wasn’t, you know I know babies, ordinary babies with flesh and baby fat and … and this was something in between … I have seen a chimpanzee baby on TV … that looked exactly like my daughter. So, a cross between, between a chick and some sort of baby … ape, lay there. So my first thought was actually whew, how ugly. And I felt ashamed immediately. So, it took ages before I dared to talk about it, to anyone … I sort of felt like how am I supposed to be able to attach to that. And … when I had thought this I felt … whew, terrible, you aren’t supposed to think and feel this way sort of, so … I was there all the time. I bathed her, I fed her, I washed her, so they sort of expelled me. Because, ‘we can do this’, they said. Yes, but it is my child. You know, I forced myself to … to sort of start to … well … to produce the feelings in a way. Forced myself to perform motherly duties. So to speak … Well, it was probably long after that I really got this “aha experience” … the feeling … as a mother. Actually. Back then I was … I was almost a nurse. (Interview 8)

Unlike the mother quoted above, this woman did not explain her inappropriate thoughts and feelings as being due to hormones or biological instincts. Instead, she seemed to argue that the loss of motherly feelings and hesitancy to attach was her own fault. According to attachment theory, it is her responsibility to respond to her child’s biological needs, which this mother reacted to by repeated performances of nursing. Thereby, the mother reproduces notions of attachment theory, but she also reconstructs motherly love as something that does not have to be an instant and “natural” feeling but, rather, a long and multi-faceted process that is practiced in actions and eventually recognized as a feeling. Motherhood in this narrative is, therefore, represented as more of a socially constructed category that one has to perform repeatedly to identify with, rather than a biological impulse.

In another story, the mother described that she had very few memories from the first three years after giving birth and associated this omission to a period when she did not feel the “right” things for her son. Both she and the child were very ill and spent a long time at the hospital before they were able to go home. When the mother talked about this period, she started by framing the episode by stating that she had never been especially keen on children and had never felt she needed a child to feel her life was complete. What then followed is her description of a period of hardship in which her husband had to take on the main responsibility of parenting:

He got to be the mother. If we put it that way. And … I was a … hmmm, a bit absent daddy that stood beside, watching. So it was changed roles. But this has a lot to do with … For all my life I have never been the one cuddling with children, never in my whole life that is, and all of a sudden there is a child there. My child. Yes, of course. And he is really lovely, of course. But it … he might as well have been a lamp. Do you know what I mean? And it … it was really creepy because … I felt that this is not good so I contacted the … if it was some kind of welfare officer or therapist at the hospital. I felt that this is not good. This is not going to be good if this continues because I have to have a child, I cannot have a lamp … Because it was very clearly a lamp and sort of … Then she, this welfare officer, she said, well, because I felt guilty about all this and that I didn’t have these so-called motherly feelings that … well, so-called motherly feelings. And … mmm, then she said that ‘but you know for one thing that … the main thing is that there is somebody that is the mother, and the mother … the father can be the mother’ … She also said that … ‘you might be, you might have your role as a father’ … And I felt such a terrible guilt that I didn’t … love my child as my child. It was a lamp or a shoe or … it was … no, it was a lamp, that was the thing I had in my head and it … yes, a lamp and I just like, shrugged my shoulders. So, I thought that this isn’t working, this has to, it has to go away. This cannot go on because then it will be a catastrophe. (Interview 17)

Her way of handling her troubled position, depicted in the following part of our conversation, seems to ensure that she can compensate by her toughness and ability to relate to teenagers now when the son is much older. At stake in this story is the mother’s identity as a good (or good enough) mother, and her strategies to solve this dilemma – finally seeking professional help – seem to reproduce the discourse of good motherhood. However, her inability to feel affection for her son questions not only attachment and bonding as biological instincts, but also the way that parenthood is gendered. This means that the description of herself as an “absent daddy” and her husband as the “caring mother” undoes gender and illustrates how parenthood is socially, rather than biologically, gendered.

The last quote also related to how “good motherhood” is gendered. The episode started with a description of how this mother felt uncomfortable touching her child in the humidicrib for the first time. After that, she could not touch her daughter for two days and felt terrible:

Mother: Well, it felt surreal. It was sort of a, a little alien lying there with a giant head and a really tiny body. I had never seen a premature born child before. So it was so surreal that, that it sort of was … that it was my daughter. So … I remember I had a really hard time … to take it in from the start … And it was quite good that my husband could do this. Because he was the one who sort of … well, nursed a bit and started to sort of … wash her and he, he showed me that it wasn’t wrong. That this is our daughter. And later … when it wasn’t so … humid in there, when they sort of lowered the heat a bit and it was sort of a skin you could feel and you could sort of … well, touch without the finger sticking (to the skin). Well … then it was like I could grasp it. But it actually took a couple of days before I could understand that this was my child.

Interviewer: But what were your thoughts about this then?

Mother: Well, I had unbelievable feelings of guilt … It is supposed to be like, well, that the motherly feelings should come before the fatherly feelings, that is, sort of … everybody says that. Oh my god. But that’s the thing that you, you think too much about … what others say and think. If you could just give a crap about it and sort of egoistically think about yourself and that this is ok … Because I have heard this now, that is, I mean now she is … she is twelve years old and now I have heard stories where … other mummies say that, well, goodness, I hadn’t any feeling for the child, but it feels incredible strong now. So … it isn’t that unusual, really, but … but it felt like you were so lonely, alone in the world to feel that way. That you should be a bad mother just because … you didn’t have these motherly feelings immediately … I don’t know, but from the start you sort of took on some kind of nursing role. In some way … before you had that bond and felt that this is your own child. (Interview 4)

Comparable to a previous story, this mother also explains that it was by performing nursing duties that she eventually made “that bond” with her daughter. The story is a bit ambivalent since this woman implicitly talks about her own responsibility – but inability to accept that the child in the humidicrib was hers – which gave her a guilty conscience. However, she also refers to motherly feelings as expectations from “others” to behave as a proper mother and, as such, something that you should be able to ignore without feeling bad about it. Yet, what seems to be the conclusion from her story is that motherly feelings can eventually grow into something “incredibly strong” and that she herself has “that bond” with her daughter. Although this means that she can speak as an untroubled mother, which partly reproduces the discourse of good motherhood and the notion of bonding, she also depicts this identity work as an ambivalent and long process, far from naturally given from her female biology. Further, this perspective is also illustrated by her husband, who was the first of them to make “the bond” and the one to show his wife how to care for their child.

Discussion

There is a general discourse that defines good motherhood as the woman being the main responsible parent for providing love and care for a child. This discourse is interwoven with notions of attachment and mother–infant bonding and is expressed within medicine and nursing, based on the belief that parenting (i.e. motherhood) has a great impact on the growth and development of the preterm infant (see Assel et al., 2002; Beckwith & Rodning, 1996; Feldman & Eidelman, 2007). This means that there is an expectation of mothers to premature children to create a warm and loving attachment/bond with their children, although Eyer (1992) has claimed that this “imperative to bond” tends to leave these mothers “overwhelmed with regret and guilt” due to the critical circumstances surrounding premature births (p. 3). Previous research has reported on such circumstances as, for example, the shock and trauma caused by the premature delivery, the fear of losing the child, anxiety about touching and caring, and feelings of guilt, which also have been described by the women included in this study. The contribution of this article is, however, intended to explore how some mothers mobilize and rework the discourse of good motherhood when they try to make sense of their negative feelings towards their child and their strategies to perform “proper motherhood”.

It has been shown that the mothers actively and creatively used various linguistic resources to explain and justify their troubled position as a mother unable to feel “motherly love”. They also used available ideas and ideals to argue for strategies that have (eventually) positioned them as untroubled mothers with what they describe as a special bond with their child. It is striking how the women’s stories related to notions of attachment and mother–infant bonding, which might work to reproduce a biological understanding of motherhood in which love and care are natural instincts and, therefore, are a mother’s responsibility. However, notions of attachment and bonding were, paradoxically, also used to justify why instincts and hormones caused negative feelings towards the child, and thereby the mothers also destabilized the biological framework.

Further, the narratives also referred to the so-called motherly feelings as a social norm and described the strategy to act like a nurse as a way to perform a kind of motherly care, which eventually produced feelings that they seemed to identify as “motherly love”. Even if this tends to reproduce women’s obligation to feel the “right” thing for their child, the stories also underline how motherhood can be recognized as being socially constructed and as a lengthy (or even ongoing) process that involves ambivalent feelings. The understanding of parenthood as socially constructed is also illustrated by some of the fathers who took a lead in the process of getting to know and care for the child, which can challenge the expectations of mothers to be the main responsible parent. The narratives of these mothers show that motherhood is not a natural, essential trait all women have, but rather something one can learn to perform.

Eyer (1992) has argued that the oversimplified theories on attachment and bonding leave mothers in general in emotional strain, and that these ideas certainly can threaten the health of mothers of premature children – women who often are physically and mentally traumatized by the premature delivery. In line with this argument, it seems that medical professionals working with parents of premature children, such as the welfare officer/therapist who was referred to in one of the earlier extracts (Interview 17), need to help both mothers and fathers to problematize taken-for-granted ideas about motherly love. This could be done by presenting feminist research that questions attachment and bonding theory to parents. Professionals can also supply parents with narratives similar to the ones in this study, so that women understand that they are not abnormal and “all alone in the world” if they have ambivalent feelings towards their child, and that performing care as a nurse can be “good enough”.

Narratives like these can also provide good examples of how men can perform “good parenting”. In this sense medical professionals can also support parents to jointly explore how to care for their child and how to undertake their responsibilities more equally, which can improve the possibilities for adults and children to make the best of their relationship. An equal sharing of parenting is also in line with the restructuring of premature nursing into more family-oriented care. However, in spite of good intentions in involving parents in the care for their premature child, medical professionals need to be aware of lingering ideals of motherhood so that vulnerable and ambivalent mothers are supported and not expected to easily engage in this care. Professionals also need to problematize the strong emphasis on parental responsibility in today’s society and carefully analyse the different needs for support among parents with various social positions and resources. Then parenthood might no longer mainly be the individual woman’s obligation.