OB NURS 306 Study Guide for Week 4 Content

OB NURS 306 Study Guide for Week 4 Content • Transition to Parenthood ◦ Role Transition to Motherhood/Fatherhood ▪ Motherhood • Fatherhood Mercer describes four stages • Commitment, attachment, and preparation for an infant during pregnancy • Acquaintance with and increasing attachment to the infant, learning how to care for the infant, and physical restoration during the early weeks after birth • Moving toward a new normal during the first 4 months • Achievement of a maternal identity around 4 months In general, men do not fantasize about being a father, nor do they role-play being a father during childhood The meaning of “father” varies based on the man’s interpretation of the role and its expectations and responsibilities. This is influenced by: • How he was fathered • How his culture defines the role • In some cultures, men are not expected to be involved in the birthing process and/or care of the newborn. • By friends and family, and by his partner. Factors that influence the man’s transition to fatherhood are: • Developmental and emotional age • Cultural expectations • Relationship with his partner/wife • Knowledge and understanding of fatherhood • Previous experiences as a father • The manner in which he was fathered • Financial concerns • Support from partner/wife, friends, and family ◦ Special populations: Adolescent parents ▪ Adolescence is the transition between childhood and Adulthood + working through the developmental tasks of being a teenager (Erik Erikson: identity vs role confusion) • Less experiences to none ◦ Signs of normal bonding and attachment ▪ BONDING: directional  baby emotional feelings that begin during pregnancy ▪ ATTACHMENT: bidirectional ↔ emotional connection between both ▪ When to intervene when it is abnormal • Expected assessment findings: • ■ Parents hold the infant close. • ■ Parents refer to the infant by name or proper sex. • ■ Parents respond to the infant’s needs. • ■ Parents speak positively about the infant. • ■ Parents appear interested in learning about the infant. • ■ Parents ask appropriate questions about infant care. • ■ Parents appear comfortable holding and caring for the infant. • Maladaptive assessment findings: • ■ Parents call the infant “it.” • ■ Parents avoid eye contact with the infant (this can be viewed as adaptive based on culture). • ■ Parents do not respond to the infant’s cries. (ignores the baby) • ■ Parents are emotionally unavailable to the infant. • ■ Parents allow others to care for the infant, showing no interest (this can be viewed as adaptive based on culture). • ■ Parents demonstrate poor feeding techniques such as propping bottles, not burping the infant, or seeming to be uncomfortable and/or irritated when nursing. o Postpartum Blues vs Postpartum Depression Postpartum Blues *aka Baby Blues occur during the first 2 postpartum weeks, last for a few days Occurs or affects a majority of women. *feels sad and cries easily, but she is able to take care of herself and her infant (seek help after 4 weeks) Possible causes of postpartum blues are: • Changes in hormonal levels • Fatigue • Stress from taking on the new role of mother Signs and symptoms of postpartum blues are: • Anger ■Anxiety, • Mood swings ■ Impatience • Sadness ■ Weeping, ■ Crying • Difficulty sleeping • Difficulty concentrating • Difficulty eating • Feeling “I’m not myself” • Restlessness Postpartum Depression Postpartum depression (PPD) is a mood disorder characterized by severe depression that: -occurs within the first 6–12 months postpartum. - occurs in 14.5% of postpartum women PPD is classified as a major depressive disorder when the woman has a depressed mood or a loss of interest or pleasure in daily activities for at least 2 weeks plus four of the following symptoms: • Significant weight loss or gain: a change of more than 5% of body weight in 1 month • Insomnia or hypersomnia • Changes in psychomotor activity: agitation or retardation • Decreased energy or fatigue • Feelings of worthlessness or guilt • Decreased ability to concentrate; inability to make decisions • Recurrent thoughts of death or suicide attempt • A major difference between postpartum blues and PPD is that PPD is disabling; the woman is unable to care for herself and/or her baby • Requires psychiatric intervention & unable to care for herself and/or her baby • Signs & Symptoms • Sleep and appetite disturbance • Fatigue greater than expected for caring for a newborn • Despondency (low spirit, low hope) Hopelessness • Uncontrolled crying • Anxiety, fear, and/or panic • Inability to concentrate • Feelings of guilt, inadequacy, and/or worthlessness • Inability to care for self-and/or baby • Decreased affectionate contact with the infant