Mother cradling a premature baby with gentle light

Decoding Maternal Instinct: How Premature Birth Impacts a Mother's Primary Concerns

Reese Marlowe in Health & Wellness December 2025 • 3 min read.

"Explore the intricate psychological landscape of new mothers facing premature birth. Learn how early delivery challenges maternal instincts and what support can help."

The journey into motherhood is often portrayed as a seamless transition filled with innate understanding and effortless connection. However, this ideal often collides with reality, especially when a baby arrives prematurely. Premature birth introduces a unique set of challenges that can disrupt the natural unfolding of maternal instincts, leaving mothers feeling anxious, overwhelmed, and disconnected.

Primary Maternal Preoccupation (PMP), a term coined by psychoanalyst Donald Winnicott, describes the heightened sensitivity a mother develops towards her child, starting in pregnancy and extending through the early postpartum weeks. This state of heightened awareness allows a mother to intuitively understand and respond to her baby's needs. But what happens to this delicate process when a baby is born too soon?

A recent study published in the journal Psicologia Clínica sheds light on the specific challenges faced by mothers who experience preterm labor. The research investigates how the threat of premature birth influences the development of PMP and what factors contribute to a mother's ability to connect with her baby under such stressful circumstances. By understanding these dynamics, we can better support mothers of premature infants and help them navigate the complex emotional landscape of early motherhood.

The Premature Birth Paradox: Heightened Anxiety vs. Maternal Connection

Mother cradling a premature baby with gentle light

The study, conducted with a group of mothers who experienced clinical complications during pregnancy and delivered preterm infants, revealed a complex interplay of emotions. Initially, the possibility of preterm birth intensified anxiety among these mothers, seemingly hindering the development of PMP. This anxiety stemmed from several sources:

Fear for the baby's health: The uncertainty surrounding a premature infant's survival and potential health complications understandably triggers significant worry.
Disruption of the natural birthing process: The unexpected and often rapid onset of preterm labor can leave mothers feeling unprepared and out of control.
Feelings of inadequacy: Mothers may question their ability to care for a fragile infant, especially when faced with the advanced medical interventions common in neonatal intensive care units (NICUs).

However, the study also revealed a remarkable resilience among these mothers. As they gradually assimilated their health conditions and the reality of their premature delivery, they began to develop positive indicators of PMP. This transition was facilitated by:

Empowering Mothers, Strengthening Bonds

The findings from this study underscore the importance of early and targeted support for mothers who experience premature birth. Interventions should focus on:

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1590/s0103-56652011000200006, Alternate LINK

Title: Indicadores Da Preocupação Materna Primária Na Gestação De Mães Que Tiveram Parto Pré-Termo

Subject: Psychiatry and Mental health

Journal: Psicologia Clínica

Publisher: FapUNIFESP (SciELO)

Authors: Carolina Marocco Esteves, Márcia Camaratta Anton, Cesar Augusto Piccinini

Published: 2011-01-01

Everything You Need To Know

What does Primary Maternal Preoccupation (PMP) mean, and why is it important?

Primary Maternal Preoccupation, or PMP, describes a mother's heightened sensitivity and awareness towards her child, which typically begins in pregnancy and continues through the early postpartum period. It's significant because it enables a mother to intuitively understand and respond to her baby's needs. Without PMP, a mother might struggle to connect with her baby and accurately interpret their cues. The concept of maternal instinct plays a role, suggesting an innate ability to nurture, but PMP highlights the psychological processes that underpin this instinct, especially when a baby is born prematurely.

In what ways can premature birth affect a mother's mental and emotional well-being?

Premature birth can significantly impact a mother's psychological state by introducing challenges that can disrupt the natural unfolding of maternal instincts. It often leads to feelings of anxiety, being overwhelmed, and disconnection. These emotions stem from fears about the baby's health, the disruption of the natural birthing process, and feelings of inadequacy in caring for a fragile infant. Understanding these impacts is important because it highlights the need for targeted support and interventions to help mothers navigate the complex emotional landscape of early motherhood after a preterm birth.

Why might mothers who deliver prematurely experience increased anxiety?

Mothers who experience preterm labor often face heightened anxiety due to the uncertainty surrounding their premature infant's survival and potential health complications. This anxiety can hinder the development of Primary Maternal Preoccupation (PMP). However, as mothers assimilate their health conditions and the reality of their premature delivery, they can begin to develop positive indicators of PMP, demonstrating resilience in adapting to the situation. This highlights the complex interplay of emotions and the need for support to facilitate the development of PMP despite initial anxieties.

What actions or support systems can effectively aid mothers dealing with premature births?

The study's findings suggest that early and targeted support for mothers who experience premature birth is crucial. Interventions should focus on empowering mothers by involving them in their baby's care, providing education and resources about premature infant care, and creating supportive environments where mothers can connect with other parents and healthcare professionals. Strengthening the bond between mother and child through skin-to-skin contact, breastfeeding support, and responsive caregiving can also facilitate the development of Primary Maternal Preoccupation (PMP) and improve maternal well-being.

How does the NICU environment influence a mother's ability to connect with her premature infant?

The NICU environment can significantly impact a mother's ability to connect with her premature infant due to advanced medical interventions. The constant monitoring, medical procedures, and separation from the baby can create distance and feelings of inadequacy. Supporting mothers in the NICU involves educating them about their baby's condition, encouraging their participation in caregiving tasks, and providing emotional support to cope with the stress and anxiety associated with the NICU environment. These interventions help facilitate the development of Primary Maternal Preoccupation (PMP) and promote a stronger maternal-infant bond despite the challenging circumstances.