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Health Sociology Review ISSN: 1446-1242 (Print) 1839-3551 (Online) Journal homepage:

Health Sociology Review

Health Sociology Review ISSN: 1446-1242 (Print) 1839-3551 (Online) Journal homepage:

ISSN: 1446-1242 (Print) 1839-3551 (Online) Journal homepage: http://www.tandfonline.com/loi/rhsr20

The negotiations of involved fathers and intensive mothers around shared-bed sleeping with infants (co-sleeping)

Jennifer Dodd & Tanyana Jackiewicz

To cite this article: Jennifer Dodd & Tanyana Jackiewicz (2015) The negotiations of involved fathers and intensive mothers around shared-bed sleeping with infants (co-sleeping), Health Sociology Review, 24:2, 213-225, DOI: 10.1080/14461242.2015.1032321

Published online: 12 May 2015.  

Published online: 12 May 2015.

 
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Health Sociology Review, 2015 Vol. 24, No. 2, 213225, http://dx.doi.org/10.1080/14461242.2015.1032321

213 – 225, http://dx.doi.org/10.1080/14461242.2015.1032321 The negotiations of involved fathers and intensive mothers

The negotiations of involved fathers and intensive mothers around shared- bed sleeping with infants (co-sleeping)

Jennifer Dodd a * and Tanyana Jackiewicz b

a Centre for Aboriginal Health Research, School of Psychology and Exercise Science, Murdoch University, Perth, Australia; Collaboration for Applied Research and Evaluation, Telethon Kids Institute, University of Western Australia, Subiaco, Australia

( Received 24 October 2014; accepted 15 March 2015 )

b

This article discusses some emerging issues that arose during a much wider evaluative investigation of the Western Australian Health Department s bed-sharing policy and how effectively health professionals provided advice to parents. The broader evaluation report was developed for a clinical and health bureaucratic, policy-making audience. In contrast, this article adopts an approach that is more sociologically informed to tease out some of the social and cultural discourses that in uence how bed-sharing advice was interpreted and used by the mothers interviewed for the study. We ponder the in uence of current parenting discourses on parental decision-making, including those that construct fathers as involved and mothers as intensive , as well as the theory of attachment parenting, which has enjoyed something of a resurgence in Australia. We also touch on and alert to the differences in responses to this information reported by the Aboriginal and non-Aboriginal women interviewed for the study. This article highlights areas that may require further consideration and investigation by social and health researchers in maternal and child health, as well as practitioners involved in the development or delivery of bed-sharing information for parents.

Keywords: bed-sharing; co-sleeping; infants; attachment parenting; Aboriginal women; fathers; health information; parenting decisions

De nitions Bed-sharing with infants (co-sleeping): is de ned in this article as either one or both parents (or any other person) being asleep on the same sleeping space as the baby; this may include bed- sharing or sleeping on a couch, and can be intentional or accidental. This may also be described as co-sleeping in government policy, informational and published literature (Department of Health Western Australia, 2013 ). Attachment parenting: The theory of attachment has its roots in the work of John Bowlby on the emotional and secure bonding between an infant and their signi cant care-givers. According to this theory, the cementing of this attachment between parent and infant is essential to the healthy psychological functioning of individuals and has implications for every aspect of their lives (Ainsworth, Blehar, Waters, & Wall, 1978 ; Kope, 2007 ). The mothers interviewed for this study de ned attachment parenting as instinctive and natural. Attachment parenting

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involves understanding a child s emotional and physical needs and responding sensitively to these needs. The focus of attachment parenting is building a strong, emotionally bonding relationship between parents and child; the parents respond to the childs feeding, sleeping, physical and emotional demands as dened by the child. This style of parenting may include bed-sharing or co-sleeping with the child. Anthropological and biological theory also informs attachment theory and refers to evolution- ary reasons why humans evolved to sleep in groups, including increased protection against pre- dators during a vulnerable time (Dahl & El-Sheikh, 2007 ; McKenna, Ball, & Gettler, 2007 ). These theories are also cited in some of the health literature that is supportive of bed-sharing, suggesting that it promotes breastfeeding and feelings of security, which in turn enables better sleep for both parents and infants (Ball, 2006 ; McKenna, 1996 ). Attachment parenting is described by a popular Australian website (www. attachmentparentingaustralia.com ) as having the potential for contributing to the emotional secur- ity and healthy psychological development of babies, both in the short term and contributing to longer term healthy functioning as children and adults. In the context of our study, one of the ways in which this was demonstrated was by parents expressing strong opinions on the bene ts of infant bed-sharing for parents and their children and their longer-term relationship with that child.

Introduction The issue of parental bed-sharing with infants is controversial and features polarised views and a wide range of perspectives espoused by health professionals, health educators, researchers and parents (Ball, Hooker, & Kelly, 1999 ; Germo, Chang, Keller, & Goldberg, 2007 ; Mace, 2006 ; McKenna & McDade, 2005 ; McKenna & Volpe, 2007 ). The State Health Department of Western Australia strongly advises against infant bed-sharing, particularly with infants under the age of six months. A number of studies report that bed-sharing increases the risk for Sudden Infant Death Syndrome in infants aged 03 months (ABM Protocol, 2008 ; Blair, 1999 ; Carpenter et al., 2004 ; Fu et al., 2008 ; Tappin et al., 2005 ; Ruys et al., 2007 ). The Child Death Review Committee of Western Australia has completed a total of 14 reviews since the inception of the committee in 2003. Two cases were reported during 2007 08 in which children who were less than six months of age died in circumstances that included bed-sharing. Bed-sharing was associated with 16 (24%) of the 68 cases reviewed to date, indicating that unsafe bed-sharing practices have contributed to the deaths of these children. Rates of Sudden Infant Death Syndrome are reported as decreasing worldwide while deaths associated with acci- dental asphyxia or undetermined causes have increased (Department of Health Western Australia, 2013 ; Escott, 2009 ). This article draws on data collected for an evaluation of Western Australian Health Depart- ment s bed-sharing policy, but focuses in particular on how mothers responded to the information they were provided about shared sleeping, and how they negotiated decisions about infant bed- sharing with their partners or spouses (Dodd, 2012 ). Our objective for this paper is not to debate the safety, or otherwise, of infant bed-sharing, which was the objective of the larger study. Instead, we discuss how decisions about infant bed-sharing are made by mothers and fathers who are negotiating parenting roles in the context of multiple and competing parenting discourses as well as complex social and cultural conditions. We consider how the social con- struction of parenting roles, informed by discourses about the intensive mother and involved father, as well as child-centred approaches, in uence parental decision-making. We also discuss how chil d-centred approaches and attachment theory can appear to be at odds with mainstream safe sleeping advice and may contribute to dilemmas in decision-making for parents. Our

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discussion in this article also points to some cultural and attitudinal differences in the ways that Aboriginal mothers may engage in decision-making regarding this issue. We highlight these issues to show how they may affect the ways in which parents interpret and use bed-sharing information, and suggest they may also usefully inform future considerations for health practitioners and policy-makers in the development and delivery of bed-sharing infor- mation for parents. This article provides us with an opportunity to engage with sociological ana- lyses of the emergent eld of sleep studies. This eld of research was not drawn on in the main study because it had a different audience and purpose. Engaging with sociological thinking in this area for this article enables a more nuanced interrogation of the social and cultural complexities that were touched upon in the original study, but were not a primary focus. Studies in the sociology of sleep provide useful insights regarding the social and family con- texts in which parents may make decisions about and interpret bed-sharing information. They also offer useful ways for thinking about how gender relations may be played out and inuence the ways parents negotiate and make decisions about infant bed-sharing. Stewart and Reigle ( 2014 , p. 1) have asserted that sleeping is a social phenomenon that should be examined in the family context . These authors report that while the practice of bed-sharing is controversial, it has become increasingly common; associated with broader social trends such as women s increasing involvement in the paid workforce and the busy, time-poor lifestyles of families. These authors also differentiate between parents who adopt bed-sharing as part of an ongoing life- style, and those who bed-share intermittently as a short-term solution to acquiring sufcient sleep for the family to function (Stewart & Reigle, 2014 ). Other factors identi ed in the sociological literature may be useful in understanding decision- making or negotiations regarding bed-sharing. For example, Williams ( 2008 ) maintains that an individual s sleep enables a reprieve from the waking and doing world, and is a socially nego- tiated and regulated role. A sense of entitlement around sleep is observed, in which normal role obligations (such as paid work or parenting) are suspended. Williams ( 2008 ) also discusses how the roles and rights associated with sleeping can be viewed as manifestations of power relations, in uenced by social status and inequality. Individuals are expected to remain alert during their waking hours since lack of sleep is associated with a host of problems, including dangerous driving, compromised cognitive functioning and domestic violence. Ensuring ade- quate sleep then becomes a moral imperative for the individual in working towards being a well-rested, productive adult who can operate in an increasingly switched-on world. This imperative contrasts with notions of sleepy, problematic and inef cient bodies and minds (Coveney, 2013 ; Williams, 2008 ). Parental negotiations about bed-sharing may also include discussions about whether or not this practice is a long-term lifestyle choice or a periodic stop-gap measure to ensure effective familial functioning (Stewart & Reigle, 2014 ). Viewed in this light, fathers, who are more likely to be constructed as the family breadwinners, may be seen as more deserving of good sleep, as they need to be productive for their employers. In contrast, mothers, who are more likely to be constructed as the family caregivers, may nd their daytime fatigue represented as an inconvenience, rather than as dangerous or unproductive. The gendered power relations around rights to undisturbed sleep are also discussed by Hislop and Arber (2004 ), who suggest that women may be disadvantaged compared to men in asserting this right; perhaps because being tired is viewed as being a more natural and acceptable state of affairs for women. Sociologi- cal studies permit a more social appraisal of the ways that women negotiate with male partners around bed-sharing. This kind of analysis is useful as other studies tend to focus on the individual, psychological dynamics of parental relationships, rather than changing social and economic trends and evolving parenting roles (Miller, 2014 ; Sadeh, Flint-O r, Tirosh, & Tikotzky, 2007 ). These evolving roles were discussed by the parents in our study, particularly how the

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role of the father has become increasingly associated with more active parenting and how mothers are expected to parent with more intensity.

Paternal involvement and intensive mothering

In recent years there has been an increasing focus on the conduct of fathers and the important role they play in their children s lives. More fathers appear to be involved in the everyday care of their children and many articulate their desire for a close emotional connection with their children from

a young age (Shaw, 2008 ). The degree to which there is support, respect and agreement between

both parents in adjusting to caring for young infants has been associated with the functional attachment and healthy physical, emotional and intellectual development of children, as well as parents (Daly & Allen, 2007 ; Schoppe Sullivan, Mangelsdorf, Brown, & Sokolowski, 2007 ; Solmeyer & Feinberg, 2011). The mental health bene ts for fathers who have increased involvement in the care of their children have been documented in the literature (Daly & Allen, 2007 ). Furthermore, some studies contend that relationships between parents are more egalitarian where father involvement is supported by health professionals and mothers (Daly & Allen, 2007 ; Eardley & Grif ths, 2009 ). Current media representations of fathers increasingly emphasise men as nurturers as well as breadwinners (Gatrell, 2007 ; Milkie & Dennie, 2014 ). While men may still often be expected to act as the primary family breadwinners, fathers involvement in parenting has adapted to include more active caring of infants. This shift has been interpreted as possibly also a response to women s increased participation in paid work (Barry, Smith, Deutsch, & Perry-Jenkins, 2011; Duncan, 2005 ; Gatrell, 2007 ; Miller et al ., 2011). The increased awareness of the importance of fathers being involved with the everyday emotional and physical care of their children from the perinatal period (pregnancy to one year) and beyond, has translated into changes in family policy and law in Australia. These include the necessity for health, child protection, family services and educational professionals to be more father-inclusivein their practice (Department of FaHCSIA, 2009 ; Fletcher, 2008 ; Moloney, Weston, & Hayes, 2013 ). Although the subject of father involvement may have become a focus of policy development, the way this manifests at the service-delivery level is reportedly patchy, with the centrality of a mother s role in decision-making re ected in the

mother-centricnature of maternity, child-health, child-care and other services, as discussed in

a number of studies (Berlyn et al., 2008 ; Doucet, 2006 ; Fletcher, 2008 ). These authors contend

that despite increased education of health practitioners regarding fathers roles, mothers them- selves may still gatekeepand align themselves with more traditionally gendered parenting pat- terns (Berlyn et al., 2008 ; Doucet, 2006 ; Fletcher, 2008 ). Other studies have found that although fathers may expect to be more involved in the day-to-day care of their children, health and family service workers do not respond to fathers in this way. Instead, fathers have described feeling that they are treated as secondary players or as a third wheel (Cosson & Graham, 2012 ; Pryor, Morton, Dinusha, Robinson, & Cameron, 2014 ). As the role of the father has evolved, so too has that of the mother. Hays ( 1996 , p. 8) describes how the mothering role, at least in developed Western countries, has become child-centred, expert-guided, emotionally absorbing, labour-intensive, and nancially expensive . This view is supported by Caputo ( 2007 , p. 131) who states that in a neoliberal society, mothers are expected to consistently adopt intensive mothering roles, whether or not they add the role of paid working woman. Developing this theme, Butler (2010 , p. 244) highlights how the trend for women s increased engagement in the economic world coalesces with putting the sacred child at the centre of the home , resulting in an increased intensity of the mothering role. Badinter ( 2010 ) similarly analyses how constructions of good mothers impose a checklist of time-consuming

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duties (such as sourcing organic food, using cloth nappies and sleeping with the child in the same bed), with the result being that mothers may be represented increasingly like slaves to the needs of the child. Badinter ( 2010 ) asserts that this intensive work diminishes the likelihood that a mother can form a parenting partnership with a father that fairly shares the load of caring. Other studies assert that mothers are not only held responsible for the physical health and well-being of their children when infants, but also for their long-term emotional and intellectual development (Wall, 2004 ; Weingarten, 1995 ). Miller ( 2014 ) has argued that the normative gender roles in families may be dif cult to disrupt because of the absence of the necessary social support networks to support more progress- ive parenting arrangements. The limited social and workplace support necessary to support a more egalitarian shift means that most new parents will default to traditional roles and expectations about parenting. Furthermore, families may be differently positioned with respect to exibility of work arrangements and the necessary economic resources to support less traditional parenting patterns (Shaw, 2008 ). The willingness of fathers to disrupt traditional gender role boundaries is also discussed by Flood ( 2012 ) and Miller ( 2014 ). These studies maintain that even in countries where policies have enabled increased participation for fathers, many choose not to. They report that it is dif cult for fathers to immerse themselves as intensively as mothers in the caring of infants because the majority return to full-time paid work sooner than mothers. This then results in the inevitable outcome that mothers become parenting experts due to their increased and more intensive experiences with their children, particularly when they are very young (Gatrell, 2005 ; Miller, 2014 ). One examination of the philosophy, process and rhetoric of much of the fathers rights movements argues that asserting equal rights of fathers seems more about re-asserting a father s authority and less about involved fatherhood in a more positive, nurturing or sharing sense (Flood, 2012 ). The involvement of Aboriginal fathers in parenting practices, discussed in the very few pub- lished Australian studies available, is described differently to those of the involved non-Aborigi- nal father. Due to the perceived and real disadvantage of many Aboriginal families, father involvement is often viewed more as a x for dysfunction, rather than as something self-actua- lising and egalitarian, as represented in the context of non-Aboriginal families. The published studies in Australia emphasise the experiences of vulnerable families or fathers who are cur- rently or likely to be in prison (Hammond, 2008 , 2011 ; Scott & Arney, 2013 ). This may also re ect what has been termed and critiqued by Aboriginal academics as the decitmodel, in which Aboriginal people are framed as disadvantaged or dysfunctional, particularly in the area of health and family life (Eckerman, Dowd, & Chong, 2005 ; Manahan & Ball, 2007 ; NACCHO 2013 ). There are also other assumptions about Aboriginal families that may be chal- lenged. For example, it cannot be assumed that all Aboriginal families are divided along tra- ditional cultural lines, with distinctive women s and men s roles, such as women s and men s business , as these roles are changing too, particularly for urban Aboriginal families (Berlyn, Wise, & Soriano, 2008 ; Hammond, 2008 ; Newell, Franks, Lloyd, Telford, & Binge, 2006 ). Our study explores how the social disadvantage and systemic racism experienced by many Abori- ginal people may in uence the ways in which decisions are made by families about bed-sharing.

Intentional or incidental bed-sharing There are a number of factors that may in uence parents decisions to adopt bed-sharing practices with their babies. Studies show that while for some parents infant bed-sharing is a conscious decision, most do not plan to bed-share with their infant before the birth. The reasons that parents do adopt infant bed-sharing re ect opinions that it is easier to breastfeed, increases the

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frequency and length of parental sleep, promotes parent/infant bonding, reduces infant crying, makes it easier to tend to sick children, and may even help prevent Sudden Infant Death Syndrome (SIDS) (Ball et al., 1999 ; Germo et al., 2007 ; Mace, 2006 ; McKenna & McDade, 2005 ; McKenna & Volpe, 2007 ; Stewart & Reigle, 2014 ). A less reported factor in the health literature is the effect that bed-sharing might have on a couple s relationship, how much sleep each parent should expect, and the effects on their sexual and emotional intimacy (Hansson & Ahlberg, 2012 ). In a sociological study of shared-sleeping patterns of parents in the US, the issue of sexual intimacy was raised by some of the participants. However, this issue is reported more as an inconvenient side issue for parents and refers typically to the challenges of bed-sharing with older children rather than infants (Stewart & Reigle, 2014 ).

Methods This article is informed by interviews and focus-groups with mothers that were conducted as part of a much larger study, which included surveys, interviews and focus groups with a range of health professionals and policy-makers. The objective of that study was to evaluate how ofcial bed-sharing information was disseminated by health professionals to parents and what health pro- fessionals knew about the of cial bed-sharing policy. The experience of mothers in making decisions or negotiating with their partners about bed-sharing was not the primary consideration of the study, even though this was referred to consistently in their responses. This article explores these issues in detail, as they were beyond the scope of the original study. The study was approved and received Ethics Approval from King Edward Memorial Hospital Ethics Committee, Western Australian Country Health Service Ethics Committee and the Western Australian Aboriginal Health Ethics Committee. We conducted in-depth interviews and focus groups with different groups of mothers. The lead researchers recruited participants through consent received from earlier surveys, play-group and health service newsletters, posters and local newspaper advertisements as well as snowball techniques and word of mouth . The lead researcher conducted the individual interviews at the participant s home or at another location, such as a café. All participants were provided with an information sheet about the project and invited to ask any questions about the project or interview before interviewing commenced. Informed consent was also secured and all participants were assured in writing and verbally of con dentiality and the security of their personal and identifying information. One of the focus groups was conducted with Aboriginal women and was co-facilitated by an Aboriginal research assistant to ensure the cultural security of the discussion and the appropriate write-up and analysis of this data. The women were all asked the same questions regarding whether or not they had adopted infant bed-sharing practices, the reasons for their decisions, and their views about the infant bed-sharing information provided to them by midwives, child health nurses and other health pro- fessionals. Although they were not speci cally asked about how they negotiated decision-making about infant bed-sharing with their partner or other family members, discussions about this fea- tured in all the interviews and the focus groups. The birth time-frame for recruitment (i.e., birthed 2 12 months prior to data collection) enabled mothers to describe their practices after discharge from hospital, while also enabling them to accurately recall any information provided whilst in hospital. Data was analysed according to the constructivist grounded theory approach in the context of a participatory collaborative methodology with the research communities (Charmaz, 2006 ; Pyett, 2000 ; Sandelwoski, 2004 ). A constant comparative analytical method was used to elicit common themes and issues. Findings from the interviews and focus groups were compared and contrasted to identify points of difference and similarity. A matrix was developed to illustrate key themes and

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sub-themes derived from the data. The matrix set out key themes and supporting quotes extracted from interview and focus group transcripts, which were used to identify meanings and highlight differences as well as commonalities. These were then reviewed by the lead researcher and co-researcher for con rmation of content and similarities and contrasts across the different methods and cohorts. Preliminary and emerging results of the study (including the results discussed here) were continuously disseminated to the project reference group members, key infor- mants from Aboriginal reference groups and the steering group for feedback and comment. The interview and focus group ndings were also distributed to a consumer representative for feedback and participants were provided with a summary of interview data for verication. The study authors acknowledge that there is a greater diversity of Australian family types and caring arrangements than those discussed in this study and that our discussion is limited to the experiences of mostly middle-class, non-Aboriginal couples who were either married or in com- mitted partnerships. All of the participants were also women, as attempts to recruit fathers were unsuccessful. While the sample of Aboriginal participants in our study is small, the issues that were discussed by them inform interesting considerations for more thorough investigation.

Results Twenty-four mothers from metropolitan and regional areas of WA were interviewed using a semi- structured, in-depth interviewing method. All participants had birthed within the previous 212 months. All participants were over the age of 18 and lived in the metropolitan area of Perth, Western Australia. One focus group comprised four non-Aboriginal mothers who attended the same weekly play group and were strong advocates for attachment theory . The other focus group comprised ve Aboriginal mothers and one Aboriginal grandmother. The Aboriginal womens group participants included women who regularly met at an Aboriginal community- controlled health and support organisation. While the non-Aboriginal mothers had given birth in public and private hospitals within the Perth metropolitan area, the Aboriginal mothers had mostly given birth in an Aboriginal maternity clinic that was part of a public hospital in the metro- politan area of Perth, Western Australia. Women s discussions about infant bed-sharing decisions, whether as individual interviews or as part of focus group discussions, aligned with the following key themes: sleep (the baby s, their own and their partner s); sexual intimacy (their partner s fears about the loss of this) and concerns about losing their authority as the primary care-giver to their children. While dif culties in assur- ing adequate sleep was the primary issue for the majority of participants, the issue of sexual and emotional intimacy with a partner was also discussed by several participants. Six of the mothers who were interviewed, as well as three of the attachment playgroup mothers, related their partners reluctance to room- or bed-share with their baby; this was mainly due to fears about the effects on their sexual and intimate relationships. Four of the mothers also expressed frustration with their partner s views that infant bed-sharing would affect the child s ability to sleep independently when they were older. Several of the mothers stated that their partner s views on bed-sharing was at odds with their own concerns about attach- ment and bonding with their infant. This eventuated in them reluctantly deciding they would not bed-share with their baby. A majority of these women also related that this was the most in uen- tial factor in their decision-making; the health information provided about the possible dangers or disadvantages of infant bed-sharing was a secondary consideration. Four of the mothers who regularly bed-shared with their babies described how they had to negotiate with their partners and reassure them that the infant bed-sharing would be for a de ned time. They all represented these negotiations as dif cult; one of the women explained how these differences in opinion around infant bed-sharing and attachment theory had resulted

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in her separating from her partner. One mother viewed infant bed-sharing as potentially positive for the marital relationship and explained how she negotiated this:

Infant bed-sharing doesn t destroy the marital relationship sleep deprivation does though! You can always put your kids in their own beds, have time with your husband and then they come in. There are ways around if you have the resources, sleep with your husband for the rst few hours then sleep with the baby in a guestroom on a bed.

One woman who occasionally practised infant bed-sharing stated that she had initially argued with her husband about this. Her husband was an advocate of bed-sharing because their babies had both taken a long time to settle. She did not agree with this position because when she had occasionally fallen asleep with them in the bed, she described waking up with her heart pounding, very worried I had squashed them . This participant referred to the safe-sleeper aids that can be used in the par- ental bed, claiming that if one had been approved ofcially, she would have felt more comfortable using one of these. She re ected this would have been a good compromise for her and her husband and would have prevented a lot of arguing and stress in the relationship. Another woman described her resentment about what she termed the rise of the involved dad , claiming there were advantages and disadvantages to this. Touching on the potential power imbalances in some relationships, she asserted a pressing need for information that was designed speci cally for involved dads about infant bed-sharing:

Im against infant bed-sharing and I really did have a worry with her [baby s] dad he is an involved father . There are plusses and minuses to this. He used a traditional African carry sac to walk baby around with (close to body) because he had heard about how Western mothers separatechildren and he didn t like it. I really used to worry because sometimes he would walk around the house with baby like this [in the sac] and then once he and baby were tired would lie down on the couch. I would be frantic and have to get up to make sure my daughter was okay. Dads can sometimes think they know so much more. It was hard because I felt grateful that he was doing his bit, but I was also worried about the baby being rolled over on. I also was so tired that I couldn t ght about it all the time, I really feel as though the crashing fatigue I experienced and this issue took away from my mothering experience.

Four other mothers who bed-shared regularly with their babies also raised concerns about needing to negotiate this decision with involved fathers and the dif culties they had in resisting the feeling that they were being disempowered in their mothering role. In our study, the Aboriginal women who participated in the focus group were the least in u- enced by their partners in their decision making about infant bed-sharing. The topic of infant bed-sharing was not something they speci cally made a decision about; rather, it was just seen as a normal part of their mothering and nurturing role. These participants explained that if fathers were disturbed by the baby being in the same bed, they would simply sleep on another mattress or in another room if that was available. Two of the mothers stated they would kick part- ners out of the bed so that other children could sleep with mum and baby in the same bed. This was quali ed by the comment that they would sleep between the other children and the baby, as this was safer for the baby. All of the Aboriginal women described infant bed-sharing as natural, as forming part of their family and cultural traditions, and as ensuring the adequacy of breastfeed- ing, closeness and improved sleep for mothers and babies. One woman stated that the government should butt out of giving us advice and do something about housing and overcrowding, a senti- ment that was shared by others in the group. In contrast to the non-Aboriginal women interviewed for the study, the Aboriginal women were much more likely to explain that they would listen to their own mothers, aunties, sisters and grandmothers about how to care for their baby, rather than their partners or health

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professionals. They all agreed that the child comes rstand that not to bed-share with their

infants was unnatural . There was also general agreement that larger families, lack of appropriate housing and the socio-economic circumstances for many Aboriginal families meant that infant bed-sharing was inevitable. Two of the women viewed this as even more likely in rural areas. None of the Aboriginal women in this focus group were concerned about the involved father s in uence and seemed to nd the concept somewhat amusing when the researcher explained what was meant by it. All of the Aboriginal women described their role and place as mother as being central to the child s wellbeing with more con dence than the non-Aboriginal women interviewed. This was the case even when fathers were described as being hands-onor

as playing an active role in the parenting.

Discussion Our study shows that information about bed-sharing occurs in the context of numerous competing

health and parenting discourses, including attachment theory, child-centred care and father invol- vement, and that all of these have the potential to shape parental decision-making (Badinter, 2010 ; Butler, 2010 ; Caputo, 2007 ; Miller, 2014 ). The medicalisation and moral imperatives underpinning popular notions of the necessity of adequate sleep in enabling effective functioning of individuals and families is well recognised (Stewart & Reigle, 2014 ; Williams, 2008 ).

A majority of the women we interviewed for the study also emphasised the importance of ade-

quate sleep for their families to function well. In addition, many of the non-Aboriginal women suggested that they needed to negotiate their parenting decisions with fathers who wanted to be actively involved in the decision-making and day-to-day care of their infants. This contrasted with the Aboriginal mothers, who were more likely to describe less ambiguous boundaries between the mother s and father s roles. These results suggest that health practitioners may need to adopt different approaches in developing and disseminating bed-sharing information. The parenting discourses that construct mothering as intensive and fathering as involved may, for example, have less in uence on Aboriginal parents then they do non-Aboriginal parents. In

contrast to the Aboriginal women, the non-Aboriginal women interviewed in our study referred

to

the increased involvement and in uence of fathers as creating challenges for them, which could

be

experienced as a loss of control over one of the few areas in which they could claim expertise

and power. Butler ( 2010 ) has highlighted the impetus for women to adopt more intensive mother- ing styles and to keep well informed and make the right decisions for their children, alongside a simultaneous appeal for fathers to be more involved in the everyday care of their children. The idea that children require constant attention, and that a mother s needs are secondary to the child s needs, may result in mothers feeling less con dent about asserting their preferences, including those regarding bed-sharing. The authority mothers have more traditionally held as primary carers and nurturers of infants may therefore be undermined by theories that place children at th e centre and advocate the increased involvement of fathers (Warner, 2005 ). The in uence of attachment and child-centred theories may also create con ict for individuals

and couples, who may interpret these as being at odds with mainstream infant bed-sharing infor- mation. The information provided by health professionals to women and their families in Western Australia emphasises the risks associated with infant bed-sharing and advises instead that parents keep infants (particularly those under six months of age) out of the parental bed. Our study found that navigating these competing discourses could be potentially disruptive to harmonious relation- ships between a woman and her partner. In our discussions with the non-Aboriginal women who were interviewed, many described feeling unsure about how they were to negotiate with fathers who wanted to be more involved; these tensions intensi ed when they disagreed about the poten- tial risks or bene ts associated with infant bed-sharing. Conversely, those women who may have

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considered regular infant bed-sharing, but then chose not to, experienced a different tension with respect to attachment theory and were more affected by the concerns raised by their partner about sexual intimacy and how long the child would be sharing the bed. This fear regarding possible loss of sexual or emotional intimacy does have implications beyond the obvious effects on the parental relationship. A mother may then only bed-share with her baby when either she or the baby is sick, when the child is particularly restless, or if the mother is very tired herself. This kind of irregular infant bed-sharing has been shown to be particularly risky for the health of the child (Ball, Hooker, & Kelly, 2002 ; Blair, Sidebotham, Evason-Coombe, Edmonds, & Heck- stall-Smith, 2009 ). While negotiation with involved fathers was identi ed as a signi cant issue for several of the non-Aboriginal women interviewed for this study, this was not referred to explicitly by the Abori- ginal women interviewed. Furthermore, the Aboriginal women in the focus group did not raise the issue of sexual intimacy. This does not mean that this was not a factor; perhaps it was not one they felt comfortable discussing openly, either as a group or with a non-Aboriginal researcher. Discus- sions about intensive mothering , however, were very present in our discussions with the Aboriginal women, sometimes manifesting in different ways to those of non-Aboriginal women. For Aboriginal women, the role and position of mother as an authoritative gure was described as secure and culturally valued in a different way to that of non-Aboriginal women. This may be because raising a child within an Aboriginal family is viewed as not just the respon- sibility of the biological parents, but also an extended family and community responsibility (Scougall, 2008 ). For example, a mother s sister or aunt may hold the same responsibility for infant care as the biological mother (SNAICC, 2010 ). This in uenced the ways the Aboriginal women discussed the absence of expectation for negotiating bed-sharing decisions with the childs father because, as it was put in the focus group, he would already understand and know that the child came rst . The results of the study suggest that bed-sharing information is provided in the context of a diversity of views about parenting roles. In some cases there are limits as well as opportunities for negotiation within these roles that may depend on how parents differentially align themselves to more or less traditional roles. They may also vary because of the cultural background of parents and how they choose to adhere to their own understandings about parenting roles and negotiation around this. The unintended consequences of involved father and intensive mothering discourses (including attachment and child-centred theories) may contribute to a reinforcing of more tra- ditional, less egalitarian parenting models. This in turn may limit the potential for individuals to negotiate on equal terms about bed-sharing information provided by health practitioners.

Conclusion Information about bed-sharing is provided in contexts where parental roles are evolving and parents can easily access parenting information that may be at odds with the bed-sharing guidance offered by health practitioners. Mothers and fathers may also negotiate parenting decisions within relationships that are more or less traditional or egalitarian in nature. For some parents there may be little space for negotiating bed-sharing decisions that follow mainstream guidelines. This is not just in cases where there is an imbalance of power relations between genders, but also where the cultural boundaries of parental roles are less ambiguous and where shared-sleeping is viewed as inherently bene cial. We have raised some areas for further consideration by health practitioners and policy-makers who are involved in the development and delivery of bed-sharing information. We suggest that although health practitioners are increasingly emphasising the role of paternal involvement, this may not always be positive, or even result in compliance with the bed-sharing guidance

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provided by mainstream health providers. We also recommend that health practitioners and policy-makers recognise that, apart from negotiating parental roles and boundaries, parents may also individually hold very different views on the bene ts and risks associated with bed- sharing. We suggest that health practitioners and policy-makers need to consider these multiple and competing in uences on, and tensions in, parental decision-making about bed-sharing and tailor information that is more responsive to these nuances.

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