Parental liminality: a way of understanding the early experiences of parents who have a very preterm infant

Abstract

The aim of this study was to explore the early experiences of parents who have a very preterm infant. Very preterm infants are physiologically ill-prepared for extra-uterine life, but a greater number now survive birth and the postnatal period. The complex needs of the very preterm infant are met in the technological environment of the neonatal intensive care area, separating parents, physically and psychologically from their very preterm infant. Studies exploring the parental experience have identified parental stress; lowly parental status and attachment issues as areas of concern. However, there is little understanding about the early parental experience. This study used a phenomenological interpretive design. Ethical approval to conduct this study using two study centres was obtained. An interpretive interactionist approach guided this study. Data were collected from three sources: 20 parents of very preterm infants, five senior neonatal nurses and seven neonatal intensive care nurses. Purposive sampling was used for the first and second sources, and data were collected through semi-structured interviews. The third source of data occurred opportunistically through one focus group. Analysis involved constant comparative analysis. Crisis, uncertainty and powerlessness, properties of liminality framed this early complex parental transition. It is argued that the overarching theme of parental liminality best framed the parental physical, psychological and social experiences. This qualitative interpretive study identified that parents of very preterm infants experienced many crises, uncertainty and powerlessness in their transition to parenthood, making them liminal people. Parental liminality provides a means of conceptualising the early experiences of parents of very preterm infants, providing practitioners, at strategic and operational levels, with the means of developing supporting interventions in the early stages of transition for parents of very preterm infants. Such support could mediate parent-infant relationships.