Postpartum Part 1 Flashcards
What are the 6 periods of Perinatal Continuum of care?
Occurs over 12-14 month period
- Preconception
- 1st Trimester (Antepartum)
- 2nd Trimester (Antepartum)
- 3rd Trimester (Antepartum)
- Labour and Birth (Intrapartum)
- Postpartum/Newborn
- Partum = preganancy
- Postpartum = after pregnancy
- Intrapartum = during pregnancy
Describe the locus of care for each period of the perinatal continuum of care?
- Locus of care between preconception and 3rd trimester can be in the home/community setting
- Locus of care during labour and birth occurs in a hospital/birthing centre or at home
- Locus of care postpartum can occur in the home/community setting
Describe the Intensity of care for each period of the perinatal continuum of care?
- Independent self-care can is the intensity of care from pre-conception to 2nd trimester where there is low risk
- From the second trimester to third trimester home care can be considered for high-risk pregnancies and independent care can be considered for low-risk pregnancies
- During labour and birth, the intensity of care can range from low-risk hospitalization, high-risk hospitalization and neonatal intensive care
- The postpartum intensity of care can range from independent self-care in low-risk pregnancies and home care in high-risk pregnancies
Define puerperium
Puerperium: birth to the return of the reproductive system to the pre-pregnant state (also known as 4th trimester)
What is the duration of 4th trimester?
From birth to 6-8 weeks after birth
What type of healthcare model do we use in postpartum care?
- Health-focused model (try not to use the word patient, focused on health)
- Wellness-oriented (focused on bringing the client back to optimal health and wellness after pregnancy)
Describe the factors in the transition to parenthood
- Parenthood is thought of now as a developmental transition rather than a major life crisis
- Emotional, psychological, sociocultural and economic transitions continue well beyond physical recovery, 4th trimester and perinatal period (1 year)
List the factors that affect postpartum psychosocial adaptation
- Pregnancy/birth experiences
- Physical recovery
- Role attainment
- Bonding and attachments behaviours (ex. making eye contact with the baby, calling baby by name, etc.)
- Newborn/infant characteristics (ex. illnesses, temperament, etc.)
- Fatigue
- Ability to meet needs
- Emotional responses
- Socioeconomics
- Social supports
- Family dynamics
- Cultural considerations
In a postpartum setting, what are some cultural influences and/or considerations to keep in mind?
- Beliefs and values
- Health, self-care and newborn care practices
- Interactions with health care providers and family members (family dynamics)
- Newborn and infant feeding practices
What are the 2 theories of parental psychosocial adaptation?
- Rubin’s “Phases of Maternal Postpartum Adjustment” theory
- Mercer’s “Becoming a Mother” theory
Describe Rubin’s theory?
- Taking in (dependent)
- Taking hold (dependent-independent)
- Letting go (interdependent)
Describe the “Taking in” phase in Rubin’s theory?
- Mother is passive and willing to let others do things for her
- Focuses on food, fluids and restorative sleep
Describe the “Taking hold” phase in Rubin’s theory?
- Mother becomes interested in caring for the infant
- May be critical about her care-giving abilities
- Interested in learning about caring for her baby and herself
Describe the “Letting Go” phase in Rubin’s theory?
- Giving up old life to accommodate new infant
- Coming to terms with the reality of the birthing experience
- Giving up the fantasy of what their ideal child would be
Describe Mercer’s theory
• Commitment and attachment in pregnancy • Acquaintance and attachment to newborn • Moving toward a new normal • Achievement of maternal identity, redefinition of self, integration of motherhood
