Examining the transition from “womb to world”

In his book, Phenomenology of the new born: Life from womb to world, Michael van Manen (2019) guides readers through an exploration of the experiences of newborn infants in a neonatal intensive care unit (NICU). As a specialist in neonatal-perinatal medicine in Canada, van Manen brings together in this book the skills and knowledge of a researcher using phenomenology as an approach to understand the life world and that expertise and experience of a medical doctor who works with infants and their families in a NICU.

Researchers with an interest in phenomenology are likely more familiar with studies that are based on in-depth interviews (Goble, 2017) or personal experience (Allen-Collinson & Hockey, 2011). Readers might be puzzled, then, to find that van Manen’s exploration of newborn infants’ experiences relies primarily on observation and what has been learned from medical research. “Data” in this study is drawn from van Manen’s extensive experience and acute observations of infants during his work in a NICU, along with findings from medical research and the kinds of clinical data used in medical decision-making. In the book, van Manen poses the following questions (p. x):

  • What experiences do these newborns have?
  • What experiences are we giving them?
  • How can we and do we understand what their lives are like?
  • What are the inventions and actions of intensive care actually like for newborns?

This short, readable book is organized in eight chapters, beginning with van Manen’s reminder that little attention has been given to exploring the experiences of those “unable to describe and reflect on their own experiences” (p. xii). Chapters One and Two focus on methodological issues. Chapter 1 focuses on phenomenological concepts employed in the study, and how observational data might be used to explore infants’ experiences. Throughout the book, van Manen uses the strategy of “constative reflection”, which he defines as “the attempt at phenomenal truth by exploring the meaningfulness of an experience that is based on established empirical evidence” (p. 12). van Manen encourages researchers to question their ontological assumptions about the language used in a particular discipline. As one example, he questions what it might mean for infants to demonstrate a “preference for their mothers’ voices” (De Casper & Fifer, 1980 cited by van Manen, 2019, p. 12). Van Manen is careful not to make assertions about what we cannot know. He argues, however, that “[a] constative questioning aims at understanding the possible subjective experiences of others, recognizing that such understanding necessarily comes from our own personal understanding of the world – and therefore is necessarily exploratory, tentative, and wondering, based on available evidence” (p. 101). The idea that the findings of van Manen’s research are “exploratory, tentative, and wondering, based on available evidence” should go some way to alleviating concerns that the study’s findings are likely to essentialize infants’ experiences.

Chapter Two reviews embryological, developmental and behavioral research to support the study of infants’ premature transitions from the womb to the world. The remaining chapters focus on different aspects of infants’ lifeworlds, including the infant’s first cry, the meanings derived from observation of infants born prematurely, adults’ expressive relationships with newborns (e.g., eye contact and gaze), infants’ experiences of distress, and newborns’ suckling. The book concludes with an overview of the themes presented. As a reader unfamiliar with the world of the NICU, I learned much from this book, including surprises. For example, van Manen discusses the premature infant’s gaze, asking “what is seen?” (p. 63). Another chapter examines what might be going on when newborns exhibit signs of distress (Chapter 6).

Who might read this book? Scholars interested in conducting phenomenological inquiries are encouraged to look closely at the world around them, and consider what they can learn about the lives of those who cannot speak for themselves. Physicians and nursing staff, and parents and family members of infants in NICU can learn more about medical research concerning premature infants, as well as how to appreciate the immense transitions experienced by newborns. van Manen asks readers to question taken-for-granted assumptions about what is observable about infants’ behaviors and responses (e.g., “agitation”, p. 99).

This book takes up Max van Manen’s call for a “phenomenology of practice” (Max Van Manen, 2014) that contributes understanding to the everyday world – in this case the “everyday world of newborns requiring medical care” (p. 103). Michael van Manen asserts that his intent is “not to reduce, objectify, or totalize descriptions of lived experiences, but rather, to gain insight into the meaningfulness of possible human experiences. Indeed, in our professional practice we recognize that our patients and families are unique, with varied life experiences, predicaments, core values and so forth” (p. 103). Although in this book, van Manen implores medical staff to ask phenomenological questions of their patients in a NICU, the question “what might this experience be like for them?” is a good one for each one of us to pose in any everyday context. In reading both Max and Michael van Manen’s books on phenomenological research, I have been repeatedly struck by the call to be attentive to lived experience in the here and now. Overall, this book represents a quiet and immensely thoughtful approach to the study of what goes on in an NICU, and provides a strong case for slowing down to really attend empathetically to the lives of all others in everyday encounters.

Kathy Roulston

References

Allen-Collinson, J., & Hockey, J. (2011). Feeling the way: Notes toward a haptic phenomenology of distance running and scuba diving. International Review for the Sociology of Sport, 46(3), 330-345. doi:10.1177/1012690210380577

Goble, E. (2017). Visual phenomenology: Encountering the sublime through images. New York and London: Routledge.

Van Manen, M. (2014). Phenomenology of practice: Meaning-giving methods in phenomenological research and writing. New York & London: Routledge.

van Manen, M. (2019). Phenomenology of the newborn: Life from womb to world. New York & London: Routledge.

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