In the 1960s, Dr Marshall Klaus noticed that mothers who had their newborns separated from them, had trouble forging a bond later on. The neonatologist and Adjunct Professor of Paediatrics at the University of California at San Francisco said that the bonds were an intimate dance of eye contact, facial expressions and the rhythmic sound of speech. The bond would increase the likelihood of breastfeeding, enhances the child’s development and even reduces the potential for child abuse and neglect.

Through the observation, thus began Dr Klaus’s dedication and research towards improving mother-baby bonding.

Welcoming all into the birthing picture

Together with his colleague, paediatrician Dr John Kennell, Dr Klaus conducted early trials of allowing families into Neonatal Intensive Care Unit (NICU)—instead of having the newborn isolated in incubators – and to allow maximum mother-baby bonding postpartum. He also researched supporting families who had lost a baby. Ultimately, their work has helped influence the establishment of the 1991 Baby-Friendly Hospital Initiative (BFHI)—a global joint effort between World Health Organisation (WHO) and UNICEF—to implement practices that protect, promote and support breastfeeding.

Dr Marshall Klaus (L) with his colleague Dr John Kennell at University Hospitals Cleveland Medical Center in an undated photograph. Photo credit: University Hospitals Cleveland Medical Centre/The New York Times
Dr Marshall Klaus (L) with his colleague Dr John Kennell at University Hospitals Cleveland Medical Center in an undated photograph. Photo credit: University Hospitals Cleveland Medical Centre/The New York Times

In 1972, Dr Klaus and Dr Kennell advanced their bonding theory in The New England Journal of Medicine—after exploring the behaviour of goats. They monitored that mother goats that had given birth – and immediately separated from their offspring – would kick the baby goat away; and would not successfully form an attachment with it thereafter.

Following the findings, many hospitals were quick to allow more private time for mothers and their newborns—having fathers in the delivery room, and older siblings visiting the new addition to the family.

“We are bringing back an essential ingredient of birth,” Klaus told The New York Times in 1993. “This is humanising maternal care.”

Doulas – a growing force in maternity culture

In 1992, Dr Klaus, his wife (Phyllis Klaus), Dr Kennell and two other members founded DONA International (Doulas of North America) – which has since grown to be the world’s largest and most respected doula organisation. Doula is the Greek word for servant-woman and a doula – as coined by Dr Klaus – is a trained professional, who provides continuous physical, emotional and informational support to a mother before, during and immediately after birth.

Scientific trials that examine births under doula care have shown improved wellbeing for both mother and baby. Dr Klaus claimed that the presence of a doula shortens labour, reduces the demand for pain relievers, decreases the number of caesarean births and promotes an enduring attachment between mother and baby.

Dr Klaus had made monumental changes through two of Lamaze’s Healthy Best Practices – Practice 3: Bring a Loved One, Friend or Doula for Continuous Support and Practice 6: Keep Mother and Baby Together, It's Best for Mother, Baby and Breastfeeding. He also authored the books “The Amazing Newborn: Discovering and Enjoying Your Baby’s Natural Abilities” (1985) and “Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth” (1993), which inspired many to become doulas.

Dr Klaus passed away recently at the age of 90, in his home in San Francisco. The man who had developed polio while he was in medical school—leaving him with a frail right arm—had always wanted to become an obstetrician. As fate would have it, he went into paediatric pulmonology and neonatal development, in part because of his disability—leaving behind a legacy that lives on beyond hospitals and delivery rooms. MIMS

Marshall Klaus Tribute from DONA International on Vimeo.

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