Postpartum Care Fundamentals (1) Flashcards
Puerperium
Birth to the return of reproductive systems to pre-pregnant state
- Birth to 6 weeks
Factors Affecting Postpartum Psychosocial Adaptation
- Pregnancy/birth experiences
- Physical recovery
- Role attainment
- Bonding and attachment behaviours
- Newborn/infant characteristics
- Fatigue
- Ability to meet needs
- Emotional responses
- Socioeconomics
- Social support
- Family dynamics
- Cultural considerations
Cultural Considerations and influences in Postpartum
- Beliefs and values
- Health, self-care and newborn care practices
- Interactions with health care providers
- Family dynamics
- Newborn and infant feeding practices
Parental Psychosocial Adaptations to Postpartum
Rubin - Phases of maternal postpartum adjustment
- Taking in (dependent)
- Taking hold (dependent-independent)
- Letting go (interdependent)
Mercer - Becoming a mother
- Acquaintance and attachment to newborn
- Moving toward a new normal
- Achievement of maternal identity, redefinition of self, integration of motherhood
Rubin; Taking in (Phases of maternal postpartum adjustment)
- First 24 hours client in taking in phase (at this point still in hospital); observe and perceive them as fulfilling their own basic needs
- More passive, more indecisive, rely on others to have their needs met, sense of wonderment about baby, excitedness
Rubin; Taking hold (Phases of maternal postpartum adjustment)
- Day 1-3 to 10 days- several weeks
- As the stay in hospital shortens move faster through phases
- Take change of baby, more responsibility, still some lack of confidence, more active decision making, eagerness to learn and practice
- For most have already gone home
- Prime opportunity to start learning and absorb information
- Community supports are key
Rubin; Letting go (Phases of maternal postpartum adjustment)
- Forward movement in family movement, changes of roles within family
- Reassert relationship with partner, back to sexual activity, parent division of labour
Mercer; Becoming a mother
- Maternal identity not reflects in Rubin’s work
- The process of becoming a birth parent and growing into identity of parent requires commitment and attachment that begins in pregnancy
- For those who do not meet that pregnancy tasks may have challenges and face mental difficulties
- First stage is accepting we are pregnant
- Then attachment to newborn when baby is born
- Then moving towards a new normal within the family
- Redefining one’s self
Father’s parental developmental tasks
- New expectations and priorities
- Striking balance between work, own needs, needs of partner and baby
- Redefinition of role
- Reaping rewards
LGBTQ+ parental developmental tasks
- Similar challenges: attachment in pregnancy and newborn; new priorities; new normal; striking a balance; achievement of identity as parent, redefinition of self, integration of parenthood
- Added challenges: lack of family acceptance, public/provider ignorance and judgement; social invisibility and more
Fahey and Shenassa: Learning Needs
- physical recovery
- meet own needs
- parental role attainment
- effective mobilization of support
- self-efficacy
- positive coping strategy
- realistic expectations
Learning needs in the postpartum period
- “readiness to learn” considerations
- Nurses; teaching priorities can differ from client learning priorities
- Change over time
- Common needs vs individual needs
- Individualized care; client satisfaction; client behaviours and health outcomes
Examples of Postpartum community resources
- Community Health Centres
- Hospital outpatient clinics
- Health Care Providers’ (HCP) offices
- Online resources (MotHERS program, OMama)
- Ontario Early Years Centres
- Private organizations
- Public Health (telephone, clinic, home, infant hearing, parenting classes, HARP)
- HBCB (Healthy Babies Healthy Children)
Postpartum Nurse’s Role
- Assess, monitor, support adaptations (psychosocial, emotional, physical)
- Identify and build on strengths
- Identify and meet leaning needs
- Care coordination
- Health promotion
- Illness prevention
- Teaching and facilitating client learning
G/P (2 digit) system
G = gravidity; total number of pregnancies for that person's body (uterus or abnormal) P= parity; the number of pregnancies beyond 20 weeks that have completed regardless of outcome