Chapter 8 Flashcards
1
Q
maternal psychological response during the 1st trimester
A
- uncertainty
- ambivalence: often experience conflicting feelings (b/c half of pregnancies are unintended)
- excitement
- self-focused: fetus seems vague/unreal, but she notices physical changes and n/v
- nurse should focus on the mother’s physical and psychological needs during this period
2
Q
maternal psychological response during the second trimester
A
- physical evidence of pregnancy make the fetus seem real
- can see on U/S, experiences quickening
- fetus as focus: concerned about producing a healthy infant
- very interested in info about diet and fetal development
- narcissism and introversion:
- women concerned about ability to provide for fetus and this manifests as narcissism and introversion
- changes in body image and sexuality
- can be a negative or positive change in body image
- sexual interest may inc, decline, or remain unchanged, but her physical comfort and sense of wellbeing are linked to her sexual activity
- intercouse is safe as long as no complications
3
Q
maternal psychological response during 3rd trimester
A
- vulnerable: worry about harm to baby
- increasingly dependent: relies on others and seeks help in making decisions
- often have fear about safety of partner and love is often more pronounced
- better for woman when she knows partner is concerned and willing to help her
- accept that fetus is separate but totally dependent
- preparing for birth
- more fear if first pregnancy
- seek out information
- nesting takes place
4
Q
steps in maternal role taking
A
- mimicry: observing and copying the behavior of other women who are pregnant or mothers in an attempt to discover what the role is like
- role play: acting out aspects of what mothers actually do
- “practice” her role as mother by wanting to care for other infants
- fantasy: allow the woman to consider possibilities and “try on” a variety of behaviors
- often revolve around the way the infant will look and the characteristics it may have
- search for a role fit: occurs once the woman has established a set of role expectations for herself and internalized view of a good mother’s behavior
- grief work: sense of grief when realize they must give up aspects of their previous selves
5
Q
attachment
A
- begins during pregnancy
- by 2nd trimester, feelings of love and attachment surge, especially when experience quickening and see fetus on U/S
- 3rd trimester: love becomes possessive and leads to feeligs of vulnerability
- previous loss can disrupt attachment
- may wait to attach to infant until they can feel sure that the pregnancy is normal and will continue
6
Q
4 maternal tasks of pregnancy
A
- seeking safe passage: priority
- to ensure safe passage: seek prenatal care and follow recommendations of HCP
- securing acceptance: throughout pregnancy
- involves reworking relationships to help important ppl in her life accept her in the role of mother
- esp need support from partner and her own mother
- learning to give of herself
- committing herself and developing attachment to the unknown child
7
Q
variations in paternal response to pregnancy
A
- some men are emotionally invested and comfortable as full partners exploring every aspect, but others are more task oriented and may view themselves as managers
- some men prefer just to observe
- readiness for fatherhood more likely if a stable relationship, financial security, and desire for parenthood are present
- common concerns: health of mother and baby, financial concerns, apprehension about his role
8
Q
3 developmental processes that an expectant father must address
A
- grappling w/ the reality of pregnancy and new child
- some things help make child more real like seeing fetus on U/S, hearing fetal heart beat, and feeling infant move
- also have to prepare room and accumulate supplies for baby
- struggling for recognition as a parent
- have to focus on both the father and mother as our patients
- making an effort to be seen as relevant to childbearing
- work on relationship with their own father
- “try on” fathering behaviors to see where they are comfortable
-
couvade: pregnancy related S/S and behaviors in expectant fathers
- sometimes they experience n/v, HA, fatigue, and weight gain
- may be cause by stress/anxiety for their partner
9
Q
adaptation of grandparents
A
- age: determines emotional responses of prospective grandparents
- number and spacing of other grandchildren
- first: very exciting, joyful
- another may be welcomed, but w/ less excitement which may disappoint the couple
- perceptions of role of grandparents
- help prepare for baby, give gifts, watch older children
- give advice
- parents should communicate with the gparents about what their expectations are
10
Q
adaptation of toddlers to pregnancy
A
- unaware of maternal changes occurring and are unable to understand that they will have a new sibling
- any changes in sleeping arrangements should be made several weeks before birth so they don’t feel displaced by the new baby
- may show feelings of jealousy and resentment, so need frequent reassurance that they are loved
11
Q
adaptation of older children to pregnancy
A
- from 3-12 yo: more aware of changes in mom’s body and may realize a baby is to be born
- may have lots of questions
- need preparation for when baby is born and mom has to be away at the hospital for several days
- benefit from being included in preparations for the new baby
- provide time along with the parents to ensure a sense of security
- sibling classes can be helpful
12
Q
adaptation to adolescents during pregnancy
A
- depends on developmental level
- some are embarrassed b/c pregnancy confirms the continued sexuality of their parents
- may be indifferent or very involved
13
Q
factors influencing psychosocial adaptations
A
- age of parents
- teens: major task of “forming sense of self” in adolescence vs “giving of self” needed for pregnancy
- multiparity: may experience guilt in expanding love to include 2nd child
- they don’t have as much time to take care of themselves as they did w/ 1st pregnancy
- social support
- depression may occur if lack of support during pregnancy
- absence of partner: may lack financial and emotional support
- inc risk for delaying prenatal care
- socioeconomic status
14
Q
barriers to prenatal care
A
- limited by financial, systemic, and attitudinal barriers
- financial are of most importance
- may have no insurance
- Medicaid application is burdensome and length
- systemic: institutional practices that interfere w/ care
- insurance controls when can have 1st prenatal visit
- prenatal care often done during the day
- lack of transportation
- attitudinal: unsympathetic attitude of some health care workers for those who can’t pay
- financial are of most importance
- nurses must tx each family w/ respect
- assess for barriers to care
- schedule prenatal visits in the evening/weekend, offer Medicaid and WIC applications, decreasing wait time before appintments
15
Q
cultural differences in pregnancy
A
- belief in fate: may not prepare for baby (Southeast, Middle East, Russian)
- prevent illness: involve using foods, charms, amulets
- restoring health: charms, herbs/plants, holy words
- modesty: may prefer not to be exposed to men (Muslim, Hindu, Hispanic, Orthodox Jew)
- female genital cutting
- communication:
- use interpreters if language barrier
- decision making: determine who makes decisions for the family
- eye contact:
- in US, most say eye contact=honesty
- avoiding eye contact is a sign of respect in some cultures
- Latino: evil eye–>if an indiv with special powers admires a child too openly
- touch:
- offensive to men: Hindu, Muslim
- appreciate: Hispanics
