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Chapter 22.docx

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McGill University
NUR1 233
Sonia Elizabeth Semenic

Chapter 22: Transition to Parenthood Parental attachment, bonding and acquaintance  Attachment: process by which a parent comes to love and accept a child and a child comes to love and accept a parent o Includes mutuality, acquaintance  Bonding: takes longer than first few minutes or hours  Factors which influence maternal-fetal attachment include: family support, psychological well-being, and having an ultrasound  Attachment is developed and maintained by proximity and interaction with infact  How closely the “dream” child resembles the real child influences the bonding process  Labor process significantly affects the immediate attachment of mothers to their newborn infants Parent-Infant Contact  Early contact o May facilitate attachment process between parent and child – delay doesn’t necessarily inhibit process o Immediate contact after birth is not essential for the human parent-child relationship  Skin-to-skin contact o Positive effect: breastfeeding, breastfeeding duration, maternal affectionate love/touch during observed breastfeeding, and maternal attachment behaviour o Better cardiorespiratory stability was observed in late-preterm infants with early SSC o When fathers hold newborns SSC after caesarean birth, the infants cry less, calmer, and drowsy sooner than babies cared for in a cot Communication between parent and infant  Touch o Desire in parents to touch, pick up, and hold the infant o As parents become increasingly sensitive to infant’s likes or dislikes of different types of touch, they draw closer to their baby o Variations in touching noted in mothers from different cultural groups  Eye contact o Mother remark that once babies have looked at them, they feel much closer to them o In NA, eye contact appears to cement the development of a trusting relationship and is an important factor in human relationships at all ages o En face position: parents face and infant’s face are approximately 8 inches apart and on the same place o Immediately after birth, the baby can be placed on mother’s abdomen or breasts with the mother’s and infant’s faces on the same plane so that they can easily make eye contact o Light dimmed so baby will open eyes  Voice o Cry: assures them of baby’s health and parents begin comforting behaviours  Uses crying to signal hunger, boredom, and fatigue o High-pitched voices: infant alerted and turns towards them o Can distinguish mothers voice at birth  Odor o Mothers comment on the smell of their babies when first born and have noted that each infant has a unique odor o Infants learn rapidly to distinguish the odor of their mother’s breast milk  Entrainment o Newborns move in time with the structure of adult speech o Culturally determined rhythms of speech are ingrained in the infant long before spoken language is used to communicate o This shared rhythm gives parent positive feedback and establishes a positive setting for effective comm.  Biorhythmicity o Fetus in tune with mother’s natural rhythms such as heartbeats o After birth, a crying infant may be soothed by being held in position where mother’s heartbeat heard o Newborn task: establish a personal biorhythm or to achieve biorhythmicicity  Can help this process by giving consistent loving care and using their infant’s alert state to develop responsive behaviour and increase social interactions and opportunities for learning  Reciprocity and synchrony o Reciprocity: type of movement or behaviour that provides the observer with cues – observer or receiver interprets cues and responds  Often takes several weeks to develop with new baby o Synchrony: fit between the infant’s cues and the parent’s response  Parents need time to interpret infant’s cues correctly Parental role after childbirth Transition to parenthood  Developmental transition rather than crisis  Time of disorder and disequilibrium as well as satisfaction for mothers and their parents  Transition harder for fathers who feel deprived when mothers who are also expressing stress, cannot provide usual support  Strong emotions such as helplessness, inadequacy and anger that arise when dealing with a crying infant catch many parents unprepared  Parents stimulated to try new coping strategies as they work to master their new roles and reach new developmental levels Parental tasks and responsibilities  Need to reconcile actual child with fantasy and dream child  Assistance can be seen either as supportive or an indication of how inept these others judge the new parents to be  Criticism of new parent’s ability to provide adequate physical care, nutrition, or social stimulation for the infant can prove to be devastating Becoming a mother  2 social processes in maternal transition o Primary process: engagement – making a commitment to being a mother, actively caring for her child, and experiencing his or her presence o Secondary process: experiencing herself as a mother, which leads to growth and transformation  Must learn how to mother and adapt to a changed relationship with partner, family, and friends  Phases of postpartum maternal adjustment o Dependant (taking in): first 24 hours – focus on self and meeting basic needs – reliance on others to meet needs of comfort, rest, closeness, and nourishment o Dependant-independent (taking hold): 2-3 day and lasts 10 days-several weeks – focus on care of baby and competent mothering  Desire to take charge – nurturing and acceptance by others still important  Eagerness to learn and practice – optimal period for teaching by nurses  Handling of physical discomforts and emotional changes  Possible experience with blues o Interdependent (letting go): focus on forward movement of family as unit with interacting members  Reassertion of relationship with partner, resumption of sexual intimacy, resolution of individual roles  Stages in process of establishing a maternal identity while becoming a mother o 1) Commitment, attachment and preparation (pregnancy) o 2) Acquaintance, learning, and physical restoration (first 2-6 weeks following birth) o 3) Moving toward new normal (2 weeks – 4 months) o Achievement influenced by mother and infant variables and the social environment  More reality-based perinatal education programs are necessary to prepare mothers better and decrease anxiety  Need to know that it is common to feel overwhelmed and insecure and to experience physical and mental fatigue in the first months of parenthood Postpartum blues  Pink period: first day or two after birth – heightened joy and feelings of well-being  Blue period: 50-80% women experience this – emotionally labile and often cry easily for no reason  Lability: peaks around 5 day and subside by 10 day  Symptoms: depression, let-down feeling, restlessness, fatigue, insomnia, headache, anxiety, sadness, and anger  Mild and short-lived  10-15% experience a more severe syndrome called postpartum depression – mild to severe – also in fathers Resuming sexual intindcyth  May resume in 2 -4 week  Enhances adult aspect of family  Changes in woman’s sexuality related to: hormonal shifts, increased breast size, uneasiness with a body that has yet to retune to prepregnant size, fatigue, physical exhaustion Postpartum adjustme
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