ch. 22 transition into parenthood

Question 1

parent-infant relationships, bonding, and acquaintance

Answer 1

1) process:
- attachment
- bonding
(enface - newborn looks into parents eyes), orientation)
- proximity
- mutuality: communication between infant/parents
- acquaintance: with family routine, claiming process

2) assessment of bonding behaviors: baby on chest of mom/dad?
- careful observation of specific behaviors thought to indicate the formation of emotional bonds between the newborn and family, esp. the mother

Question 2

parent infant interaction early vs. extended

Answer 2

early:
- early skin to skin contact
- facilitates parental affectionate bonding behaviors and is recommended as a standard of care owing to many benefits
- partners can also hold newborns skin to skin
- breastfeeding enhances bonding
- play music, rooming in

extended:
- couplet care or rooming in
- optimizes family-centered care

Question 3

communication between parent and infant

Answer 3

1) the senses
- touch
- eye contact
- voice
- scent

2) entrainment: part of family unit

3) biorhythmicity: feeding schedule (Q2-3H), then B/L/D

4) reciprocity and synchrony

Question 4

parenteral role after childbirth

Answer 4

1) transition to parenthood

2) parental tasks and responsibilities

3) becoming a mother
- 4 stages in the process of becoming a mother:
1) during pregnancy the woman is adjusting to the physical, psychologic, and social aspects, exploring expectations of the maternal role, seeking information from others, and visualizing herself as a mother
2) beginning with birth of the infant and including the recovery from birth, the woman begins to take on the maternal role as she learns from others in the role and/or from professionals
3) 2 weeks to 4 months after birth the mother is individualizing the maternal role, developing her own unique style of mothering as she learns to respond to infant cues and settles into the maternal role
4) 4 months and beyond, the mother is incorporating the maternal identity into her self-system and gaining competence in her role
- maternal sensitivity or maternal responsiveness
- time frames for each stages of becoming a mother vary based on each individual mother and family
- the most influential factors are the relationships with her partner and with her baby (strong family units, well outcomes)

Question 5

parenteral role after childbirth: becoming a father

Answer 5

1) transition to parenthood for fathers involves the formation of the fatherhood identity
- most fathers expect to have an immediate emotional bond with their newborns
- confronting reality, realizing the expectations were inconsistent with realities of life with a newborn during the first few weeks
- challenges in balancing personal and work related responsibilities with family needs
- fathers spend considerable time communicating with their infants and taking delight in the infant’s response

2) engrossment

3) often receive less interpersonal and professional support compared with mothers

Question 6

parenteral role after childbirth: adjustment for the parents

Answer 6

1) strong healthy marriage/partnership is the best foundation for parenthood (family unit)

2) common issues parents face:
- sexual intimacy (mom tired)
- division of responsibilities
- financial concerns
- balancing work and parental responsibilities
- social activities (babysitter)

3) enlist support early on from family, friends, community health professionals

Question 7

influences on transition to parenthood

Answer 7

1) age
- adolescents as parents
- adolescent mother (do better than 40 year old moms)
- adolescent fathers
- midlife parenting: maternal age older than 35 years (hard adjustment)

2) same sex couples
- lesbian couples
- gay couples
- surrogacy
- adoption

3) social support

4) culture

5) socioeconomic conditions

6) personal aspirations

Question 8

parental sensory impairment

Answer 8

1) visually impaired parent

2) hearing impaired parent

Question 9

sibling adaptation

Answer 9

1) reactions manifested in behavioral changes

2) strategies for facilitating sibling acceptance of a new baby

3) sibling rivalry
- spend time with other siblings
- parter hold baby, mom hold toddler

3) acquaintance process
- take newborn clothes home so pet is sued to scent

overall, initial adjustment of older children to a newborn takes times, and parents should allow children to interact at their own pace rather than forcing them to interact

Question 10

grandparent adaptation

Answer 10

1) circumstances surrounding the pregnancy and birth influence the feelings, reactions, and responses of grandparents

2) contributes to family continuity

3) intergenerational relationships shift

4) involvement depends on cultural and familial factors

Question 11

nursing care mgmt

Answer 11

1) assess the woman’s bonding with the fetus and identify special needs and concerns

2) engage the woman in discussions about her expectations of parenthood, previous experiences, role models, social support, and other relevant topics

3) provide anticipatory guidance on what to expect as the infant grows and develops
- this will prevent a shock of reality in the transition from birth facility to home that might negate the parents’ joy or cause them undue stress

4) discuss the usual postpartum concerns and provide information on coping strategies

5) advocate the extension of support services well into the postpartum period, since long-term interventions tend to be more successful one time encounters

6) encourage the woman to bring her partner to prenatal visits and arrange to teach infant care when the father or co-parent is present

7) perinatal education should include information on role changes associated with parenting, the importance of teamwork, the increased risk for mental distress and depression, how to interpret and respond to infant behaviors, and how to deal with infant crying