The Joy of Motherhood
By Rosario Alvarado, MSN, RN, CCRN
Pregnancy has a profound impact in a woman’s life and the lives of those around her. This marks the beginning of the journey toward motherhood. The psychological adaptation is less visible than the physical adaptation but just as profound in the development of her identity and a crucial step during the childbearing years. Successful adaptation and motherhood is influenced by several factors including maternal age, sexual orientation, number of pregnancies and single parenting. For example, pregnancy presents a challenge to the adolescents who are trying to cope with their own growth and development tasks in addition to the pregnancy. Reva Rubin, a maternity research nurse, believes women go through “Maternal Phases,” which occur during the first weeks after delivery during the postpartum period, and it includes three phases: taking in; taking hold, and letting go. In the “Taking-In Phase,” the mother focuses on her own needs, sleeping and eating. She is passive and dependent due to the intense physical effort of labor and delivery. Usually she does not initiate physical contact with her infant, not due to lack of interest but as a result of her own immediate dependency. She is taking in information that helps her identify her infant, like touching her baby with her fingertips, and facing her infant to explore his/her face. The nurse can assist and support the mother by coordinating activities to allow
her to rest and sleep, and incorporate the father and family in a supportive role. This phase lasts for a day or two. In the “Taking-Hold Phase,” the mother becomes more independent and is concerned with controlling her bodily functions (bowel, bladder and breastfeeding). She worries about the quantity and quality of her milk and her ability to care for her newborn. A mother in this stage may be very anxious, especially if she is a first-time mother. Nurses should assist and support the mother by reinforcing
positive actions, providing instructions and demonstrations about infant care (do not impose yourself). This phase lasts about 10 days. The “Letting-Go Phase” occurs after the mother is discharged home. During this phase the mother needs to realize and accept the physical separation from her baby and also let go of her role of a childless person. During this phase, the mother is at risk for experiencing postpartum “blues,” a form of depression that is usually temporary.
To be able to implement a successful breastfeeding and lactation program, it is essential for nurses to provide gentle, compassionate care to mothers and to understand and consider these maternal phases when caring for the mothers and infants. Hospitals and especially perinatal nurses have the opportunity to impact the health of women and children by promoting breastfeeding. Houston Methodist Hospital is a designated Texas Ten Step Hospital and Mother-Friendly Worksite by the Texas Department of Health & Human Services. The Houston Methodist Center for Women’s Health promotes and supports breastfeeding not just for women delivering at HMH, but for all breastfeeding employees. An example of this effort can be seen through some of our own nurses from Dunn 6W who delivered recently and have returned to work and still continue to breastfeed their infants.
Congratulations to: Krystie Haden; Yamileth Gladney; Crystal Plumley; Denisse Gonzalez; Trang Nguyen; and Olubunmi Cordero.
References
Chapman, L.; Durham, R. (2010). Maternal Newborn Nursing The Critical Components of Nursing Care. Variables that Influence Maternal Adaptation. Chapter 5: 70-71 Mothers’ Milk Bank at Austin. (2013). Donor Milk for Your Baby – Information for Parents. Retrieved from: www.mmbaustin.org Parenting in the Loop (2011). Tag Archives: Reva Rubin. A Shift in Strategy to Get More Mothers to Breast Feed. Retrieved March 4, 2014 from: http://parentingintheloop.com/tag/reva-rubin/ “Breastfeeding and the Use of Human Milk.” Pediatrics 2012;129 (3): e827-e841 (doi: 10.1542/peds.2011-3552 The American Academy of Pediatrics. Texas Department of Health & Human Services. United States Department of Health & Human Services. Healthy People 2020: Breastfeeding Objectives - United States Breastfeeding Committee
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