The holding environment: Considerations for healthy birthing care

Amy L. Harris (2005)

This dissertation is an application of D. W. Winnicott's theory of early human development to healthy birthing care. Winnicott articulated several important concepts such as "primary maternal preoccupation" and "the holding environment." These ideas are useful in understanding how to care for women in labor. This paper includes an overview of Winnicottian theory along with concise definitions of each concept. I have provided a summary of current birthing practices in the United States and outlined the education, training, and practice style of different birthing practitioners. The phenomenology of four birthing settings is described and the outcomes associated with each are reviewed. I applied Winnicottian concepts to labor and delivery practices and developed specific recommendations for healthy birthing care.