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2 March 2004

When the Baby Arrives, Everything Changes

New course programme at the University Hospital Complex in Heidelberg — Parents learn how to establish a secure bond with their children — Midwife training before and after birth

How can parents establish a stable relationship and a secure attachment to a newborn child? For young mothers and fathers, this is a challenge in which professional courses can provide support and help prevent permanent psychic and relational disturbances. After the birth of a child about one third of all couples and families encounter a crisis; separations are more frequent and the relationship with, and the development of, the child can be exposed to lasting impairment.

Accordingly, the Department of Psychosomatic Cooperation Research and Family Therapy of the University of Heidelberg (medical director Prof. Dr. Manfred Cierpka) has elaborated a course programme for prospective parents preparing them for the first few months with their new baby and providing support and advice after the birth. Part of it is a five-unit training course for midwives advising parents on their new task in life. The course programme entitled "Now We Are Three" was presented for the first time at a press conference in Heidelberg yesterday. Scientific support comes from Heidelberg doctors and psychologists and from the Karl Kübel Foundation. The idea is to extend this initiative to a national level.

Problems with the baby endanger child development and partnerships

"The programme we offer," said Professor Cierpka, "is designed to prevent disturbances affecting children and their parents in the initial stages of their new life together." About 15 percent of all newborn infants are "cry babies". Sleeping and eating problems can also endanger the establishment of a stable relationship with the child. Marriage and partnership are exposed to special risks under the influence of this kind of stress. "The earlier we can help to prevent conflicts, the bigger is the likelihood that children and their parents can learn to organise their life together and master crises," said Professor Cierpka.

Especially qualified as course leaders are midwives, whose job it is to look after prospective parents and the newborn child before, during and after birth. So far, some 30 midwives from northern Baden-Württemberg and Hesse have been trained for this purpose. Initial experience shows that this new offer of assistance has been readily accepted by mothers, whereas the fathers have been more hesitant. At the press conference, midwives from Baden-Baden and Heppenheim reported that the course participants had been enthusiastic about the way they were able to put what they had learned into immediate practice with their children. In the pilot phase, the costs for the course (between 80 and 150 euros per course for both parents) have to be shouldered by the parents themselves. At present, solutions are being investigated for financial support for socially disadvantaged families.

Video recordings help in learning to "read" signals emitted by the baby

"We use video recordings to demonstrate what the baby wants to communicate to caregivers by means of subtle changes in facial expression or body movements," said Dr. Angelika Gregor, the psychologist in charge of the Heidelberg training course for midwives. Though many parents instinctively react in the right way, tension and exaggerated expectations can sometimes interfere with perception of the actual needs of the child. If needs are not satisfied, the child will react in a negative way and further rejection of the reference person by the child can lead to a negative relation spiral.

Accordingly, the course programme centres around the baby's relational desires and its "signal language". Why does the baby cry? How can partners cooperate in providing care for the child? How can I look after myself? These questions are core elements of the course.

"The planning stage for the development of the programme has been going on since 2002," Professor Cierpka reported. "Now we are in a position to lay on the first training courses for midwives. Feedback from midwives in the region can help us to modify individual points in the programme. Our aim is to provide a programme of this kind all over Germany as of summer 2004." The representative of the Karl Kübel Foundation for Children and Families, Dr. Georg Ludwig, said that the Foundation would like to provide long-term support for this initiative in establishing a promising programme. Professor Cierpka knows from his own experience with the anti-aggression programme for children called "Faustlos" ( that a regionally initiated programme can take on considerable dimensions. In the meantime, this programme providing training for teachers and caregivers at nursery schools has been implemented at over 600 kindergartens and 1,000 primary schools.

Please address any inquiries about the course programme for midwives and prospective parents to
Dr. Angelika Gregor,
Department of Psychosomatic Cooperation Research and Family Therapy, phone: 06221/564716, e-mail:

Other inquiries should be addressed to
Dr. Annette Tuffs
Public Relations Officer
Medical Faculty of the University of Heidelberg
Voßstr. 2, Building 4040,
D-69115 Heidelberg
phone: 06221/564536
fax: 06221/564544
mobile phone: 0170/5724725
e-mail :

Dr. Michael Schwarz
Press Officer of the University of Heidelberg
phone: 06221/542310, fax: 54317

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