Chapter 18: Postpartum Psychosocial Adaptations Flashcards
1
Q
what are Rubin’s process of maternal adaptation?
A
- taking in
- taking hold
- letting go
2
Q
Taking In Phase
A
- mother is focused primarily on her own need for fluid, food, and sleep
- May try to take in every detail of the baby but be content to let others make decisions
- Major task: to integrate birth experience into reality
- Discusses labor and delivery and attempts to piece all the pieces together
- Allows mom to realize that the pregnancy is over and newborn is now a separate individual
- Lasts a day or less
- May be prolonged in a cesarean delivery b/c the woman may have difficulty in assimilating the procedures that occurred
3
Q
Taking Hold Phase
A
- mother becomes more independent
- Exhibits concern about managing her own body functions and assumes responsibility for her own care
- When she is more confident in her own care, she can shift attention to the infant
- Often compares her infant with others to validate wellness and wholeness
- Mother may verbalize anxiety
- As a nurse: encourage mother to care for the infant as well as the father
- Lasts for several days
- Good time to review material and provide instructions
4
Q
Letting Go Phase
A
- time of relinquishment for the mother and often for the father
- If the first child, couple must give up role as a childless couple
- So have to relinquish this freedom
- Some parents are disappointed by size, gender, or characteristics of the infant, so must give this us and accept reality
- May have feelings of grief, so it is helpful to be able to discuss these
- Mother may refocus on relationship with partner and return to work
5
Q
Mercer’s Maternal Role Attainment
A
- anticipatory stage: begins during pregnancy when mother chooses a physician and location for birth
- childbirth classes help mom gain control
- formal stage: begins with birth and continues for 4-6 weeks
- behaviors are largely guided by others
- major task: to become acquinted with the infant so parent can mesh caregiving with infant cues
- informal stage: may overlap with formal stage
- begins when mom learns appropriate responses to infants’ cues
- mother begins to respond according to unique needs of infant
- personal stage: attained when mother feels a sense of harmony in the role, enjoys infant, sees infant as central
- mother feels comfortable and competent
- usually occurs by about 4th month
6
Q
3 parts of Heading Toward a New Normal
A
- appreciating the body: centers on the way a woman feels physically
- must cope with discomfort and sleep interrupted
- changes in body function
- settling in: involves becoming competent, developing confidence, and accommodating and integrating infants into the parents’ lives
- mother more secure and competent with infant
- mother glad to have help
- becoming a new family: modify relationships with partner and other family members
7
Q
redefined roles
A
- Mother is particularly concerned about redefining roles and focuses on maintaining a strong, adaptive relationship with her partner
- Observes him for changes in behavior and is acutely aware of interaction with the infant
- The father feels pressure to succeed in his new role
- New parents may need to agree on a division of tasks and responsibilities that was not necessary before birth
- Process can be simple, easy, and quick or may be difficult is role assignment is inflexible
- role conflict may occur
8
Q
what are the major maternal concerns after childbirth?
A
- body image: concerned with regaining normal figures
- nurses hsould teach that weight loss should be gradual and should teach the importance of safe activities to regain muscle
- smoking: many will restart w/in 6 mos
- postpartum bles
9
Q
Fatherhood
A
- facilitated by engrossment: intense fascination and face to face observation b/w father and child
- characterized by father’s intense interest in how the infant looks and responds and a desire to touch and hold the baby
- may be unsure of new role
- many fathers lack confidence in providing infant care and may feel that others expect them only to provide support to the mother
- nurse can assist the new father by involving him in child care activities
- many fathers lack confidence in providing infant care and may feel that others expect them only to provide support to the mother
10
Q
Siblings
A
- response to a new baby depends on their age and developmental level
- adjustment depends on age
- may be aggressive
- may be regressive: go back to infantile behavior
- need to be taught appropriate interaction w/ infant
- siblings often need extra attention and reassurance
- parents can emphasize the advantages of being the older sibling and can allow siblings to participate in age appropriate aspects of infant care
11
Q
Grandparents
A
- Involvement of grandparents may depend on proximity
- If close: can develop a strong bond, and be a source of unconditional love and an added sense of security
- If further away, may have sporadic contact
- Degree of grandparent involvement should be a comfortable arrangement for both families
- Often a major support system for new parents
12
Q
factors that affect family adaptation
A
- discomfort and fatigue
- knowledge of infant needs
- previous experience: multiparas are more comfortable with infants and exhibit attachment sooner
- expectations about newborn
- maternal age
- maternal temperament
- temperament of infant
- availability of a strong support system
- cesarean delivery: longer recovery, additional discomfort, inc stress, financial strain
- preterm or ill infant
- birth of multiple infants
13
Q
how does the birth of multiple infants affect family adaptation?
A
- Often follows a high risk pregnancy in which mother was confined to bed rest
- Infants may be preterm or unhealthy
- Financial strain may occur bc mother has had to stop working
- Problems of attachment may occur b/c of more than one infant
- Parents have to attach to each infant separately and get to know each as an individual with individual personality traits
14
Q
bonding
A
- rapid initial attraction felt by parents for their infant
- Unidirectional: from parent to child
- Enhanced when parents and infants are permitted to touch and interact during first 30-60 min after birth
- Infants are placed skin to skin for bonding time
- delay procedures if possible
- all is not lost if delayed
15
Q
attachment
A
- process by which an enduring bond between a parent and child is developed through pleasurable, satisfying interaction
- Begins in pregnancy and extends for months after childbirth
- Infant receives warmth, food, and security and mother receives enjoyment and establishes identity as mother
- Rarely instantaneous
- Reciprocal–bidirectional b/c parent and child
