Week 6 - Transition to Parenthood Flashcards
Parenting is a time of role:
a) attainment
b) transition
c) both
both
attainment AND transition
T or F: Transitioning to parenthood is a period of change and instability that occurs in all families.
TRUE
similar processes in transition, whether its a birth, adoption etc.
Transitioning to parenthood is a:
a) static process
b) ongoing process
b) ongoing process
What supports families during this period?
family-centred care
good time to use the Calgary Model
What specific principle of family-centred maternity and newborn care is essential during this period?
“Early PARENT-INFANT ATTACHMENT is critical for newborn and child development and the growth of healthy families”
attachment/bonding
process by which a parent comes to love and accept a child AND
a child comes to love and accept a parent
How can nurses facilitate parental attachment?
1) parenting awareness
-infant responses, ability to communicate
e.g. facial expressions, hunger cues
2) building confidence
Attachment is maintained and developed through…..(2)
1) proximity
2) interaction
Good thing to do right after birth to promote attachment
skin-to-skin
rooming in
Acquiantance
important part of attachment
eye contact, touching, talking, and exploring to become acquainted during the immediate postpartum period
Claiming process
identification of the new baby
likeness to other family members, differences, uniqueness
e.g. has the dad’s nose
What is important to look for during the acquaintance period?
NEGATIVE reactions
e.g. interpreting baby’s crying negatively rather than as communicating
e.g. “the baby must not like me”
Types of parental behaviours affecting attachment (2)
1) facilitating behaviours
2) inhibiting behaviours
Parenting - facilitating behaviours (many)
pride in infant
views in a positive light
engages and interacts
hovers, maintains proximity
touches, progressing from fingertip to palmer contact
talks, coos, sings
interpret’s infant’s needs
Parenting - inhibiting behaviours (many)
disappointment
negative comments
views infant as uncooperative
ignores infant
remains at fingertip contact
handles roughly, hurries feedings
makes no effort to interpret infant’s needs or actions
What to do as a nurse if parents are exhibiting inhibiting behaviours
explore with family
create strategies
Infant - facilitating behaviours (many)
vocalization, crying when hungry or wet
easily consolable
visually alert, eye-to-eye contact
enjoys being cuddled
Infant - inhibiting behaviours
continuous crying, colicky
inconsolable, unresponsive to parenting
gaze aversion
resistant to being held
Potential explanation for infant’s inhibiting behaviours
underlying medical diagnoses
e.g. reflux
Main assessment techniques for assessing parent-infant attachment (2)
observation
interviewing
Things to assess for (many)
parenting reaching out to infant
calling infant by name
talk about similarities/uniqueness
fingertips or palm
visual contact
comfortability
affection
responsiveness to cues
comforting techniques
Consideration with naming infants
some cultures don’t name the baby right away
Considerations for adolescent mother
additional challenges
concrete thinking, egocentrism
assess support system
make sure teaching is developmentally appropriate
Considerations for 35+ mom
loss of work relationship can be hard
child care considerations
loss of control - seen with higher levels of education, income, career
Nursing interventions
respect and support family’s cultural value system
skin to skin (if they agreed)
provide opportunities to hold, see etc. newborn immediately after birth
rooming in
active participating in care
enforce positive behaviours
knowledge and readiness to learn
teaching parenting skills
referring to appropriate community agencies
Phases of Maternal Postpartum Adjustment (3)
1) Dependent: Taking In
2) Dependent-Independent: Talk Hold Phase
3) Independent: Letting Go Phase
Dependent: Taking In phase
First 24hrs (range 1-2days)
focus: SELF AND BASIC NEED
reliance on others
excited and talkative
desire to review birth process
Dependent-Independent: Talk Hold Phase
Day 2-3; lasts 10 days to several weeks
focus: CARE OF BABY & COMPETENT MOTHERING
take charge
nurturing and acceptance by others still important
eagerness to learn (optimal teaching time)***
postpartum blues
Independent: Letting Go Phase
Focus: FORWARD MOVEMENT of FAMILY as unit with interacting members
reassertion of relationship with partner
resumption of sexual intimacy
resolution of individual roles
Sibling adaptation
adjustment can take time
may regress
positive behaviours changes
aggression towards baby
