Boundary issues in the experience of grandparenting a preterm grandchild

• Published date: 01 October 2022
• Author: Ayelet Zafrir Priel,Chaya Possick,Ahuva Even‐Zohar
• Date: 01 October 2022
• DOI: http://doi.org/10.1111/fare.12687

RESEARCH

Boundary issues in the experience of grandparenting a

preterm grandchild

Ayelet Zafrir Priel

1

|Chaya Possick

2

|Ahuva Even-Zohar

2

1

School of Social Work, Faculty of Social

Sciences, Ariel University, Israel

2

Senior Lecturer, School of Social Work,

Faculty of Social Sciences, Ariel University,

Israel

Correspondence

Dr. Chaya Possick, School of Social Work,

Ariel University, P.O.B. 3, Ariel 40700, Israel.

Email: chayapossick@gmail.com

Abstract

Objective: The aim of this study is to examine the experi-

ence of grandparenting a preterm grandchild up to first

year after the birth, in the Israeli context.

Background: The birth of a preterm infant has an impact

on the entire family, including grandparents. Although

preterm birth is very common, thus far, there are only a

few published studies about grandparents of premature

infants.

Method: The study was designed and conducted according

to the Interpretative Phenomenological Analysis method.

In-depth semi-structured interviews were conducted with

13 grandparents ages 54–72 years.

Results: Results indicated that the issue of boundaries was

the core category and yielded three subthemes: (1) internal

boundaries—our experience or internalized prematurity,

(2) interpersonal boundaries—my grandchild and me, and

(3) external boundaries between the medical facility and

the grandparents—the omnipotent NICU (neonatal inten-

sive care unit).

Conclusions: The current research demonstrates the impor-

tance of focusing on grandparents of premature infants as

individuals in need of support, as well as an important

resource for the immediate family of the baby.

Implications: This should be taken into consideration in

visiting policies and delivery of psychosocial services in

NICUs.

KEYWORDS

family and premature birth, family boundaries, grandparents, neonatal

intensive care unit, preterm grandchild

Received: 19 April 2021Revised: 11 October 2021Accepted: 20 February 2022

DOI: 10.1111/fare.12687

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits

use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or

adaptations are made.

© 2022 The Authors. Family Relations published by Wiley Periodicals LLC on behalf of National Council on Family Relations.

Family Relations. 2022;71:1817–1833. wileyonlinelibrary.com/journal/fare 1817

INTRODUCTION

Preterm birth is likely to upset the balance of the entire family system and its functioning. The

preterm birth involves coping with emotional turbulence that is not fully compatible with the

expectations and hopes that the family had before the birth. Moreover, the family often has to

face uncertainty about the health of the new infant and a rigid policy of hospitals and the neo-

natal intensive care unit (NICU) regarding treatment and contact with family members. With

the understanding that the family system is critical to the medical condition of the preterm

infant, there is awareness and attention to the newborn’s needs and those of the parents. The

purpose of this study is to examine the experience of grandparenting a preterm grandchild. This

qualitative study is unique in that it explores the inner world of grandparents during the first

year after the birth of a preterm grandchild.

BACKGROUND

Advances in medical treatment and technology have led to an increase in life expectancy and in

the percentage of old people in the population. As a result, intergenerational bonds, including

those of grandparents and grandchildren, take place over a longer period of time and take on

greater significance (Geurts et al., 2015).

The grandparent–grandchild bond

Family members, including grandparents, often provide practical and emotional help in dealing

with both everyday and acute difficulties in childcare. The involvement of grandparents in the

lives of their grandchildren is influenced by many factors, including gender (Bao &

Huang, 2020; Barnett et al., 2010), health status (Stelle et al., 2010), the impact of the middle

generation (Silverstein & Giarrusso, 2010), and cultural background (Hank & Buber, 2009;

Silverstein & Zhang, 2020). A combination of three factors explain why grandparents are

increasingly involved in their grandchildren’s care: longevity, a greater number of adults in the

workforce, and longer work hours (Luo et al., 2012; Silverstein & Giarrusso, 2010;G.C.

Smith & Lee, 2021; Zamarro, 2020). In addition to these general factors, there are structural

factors that explain grandparents’involvement with caring for grandchildren that are country

dependent. For example, in cross-cultural surveys of grandparenting in the EU (e.g., Glaser

et al., 2013), the following structural factors were found to influence grandparental involvement

in childcare: parental and grandparental policies for leave and flexible work, family support

from the state in the form of childcare and family benefits, retirement and adult care policies,

and labor market. In Israel, there is a particularly high level of grandparental involvement—

almost 80% of Israeli grandparents are regular babysitters for their first grandchild, compared

with 55% of European grandparents (the percentage in both cases declines with the number of

grandchildren). In addition, 78% of Israeli grandparents provide financial support for their

adult children, compared with 65% of European grandparents (Kahelet Forum, 2016).

In addition to general and structural factors, cultural norms regarding family influence

grandparental involvement in childcare (Glaser et al., 2013). Israeli society has remained highly

familistic (Fogiel-Bijaoui & Rutlinger-Reiner, 2013), with a substantially higher marriage rate

and lower divorce rate than in other postindustrial countries (Israel Central Bureau of Statistics

[ICBS], 2014) and with children and childbearing considered a defining characteristic of the

Israeli family (Gavriel-Fried et al., 2014). According to latest data, the fertility rate for women

in Israel is 3.01 (the average of OECD countries is 1.6) and the average age of women who gave

birth to their first child is 27.7 (ICBS, 2021). This strong familial aspect of Israeli culture is

1818 FAMILY RELATIONS