Chapter 22 Transition to Parenthood Learning Objectives Identify

Chapter 22 Transition to Parenthood

Learning Objectives �Identify parental and infant behaviors that facilitate and those that inhibit parental attachment. �Describe sensual responses that strengthen attachment. �Examine the process of becoming a mother and becoming a father. �Compare maternal adjustment and paternal adjustment to parenthood.

Learning Objectives (cont) �Describe nursing interventions that facilitate parentinfant adjustment. �Examine the effects of the following on parenting responses and behavior: parental age (i. e. , adolescence and older than 35 years), social support, culture, same -sex parenting, socioeconomic conditions, personal aspirations, and sensory impairment.

Transition to Prarenthood ØTransition-a passage or process occurring over time involving development, flow, or movement from one state, condition, or place to another ØSix conditions that influence the transition experience: Ø Meanings Ø Experience Ø Level of knowledge Ø Environment Ø Level of planning Ø Emotional and physical well-being

Parental Attachment, Bonding, and Acquaintance �Processes �Attachment �Bonding �Proximity �Mutuality �Acquaintance �Claiming process �Assessment of attachment behaviors

Transition to Parenthood Ø Attachment is developed and maintained by: Ø Proximity and interaction with the infant Ø Through which the parent becomes acquainted with the infant Ø Identifies the infant as an individual Ø Claims the infant as a member of the family

Transition to Parenthood Ø Attachment is facilitated by: Ø Positive feedback Ø Social, verbal, and nonverbal responses Ø Whether real or perceived that indicate acceptance of one partner by the other Ø Attachment occurs through a mutually satisfying experience Ø Attachment has been extended to include mutuality (the infant’s behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics) Ø Important part of attachment is acquaintance (parents use eye contact touching, talking, and exploring to become acquainted with their infant during the immediate postpartum period Ø Families engage in the claiming process (identification of the new baby)

Parent-Infant Contact �Early contact �Early skin-to-skin contact �Promotes early and effective breastfeeding �May facilitate attachment process �Extended contact �Couplet care or rooming in �Optimizes family-centered care

Communication Between Parent and Infant �The senses �Touch �Eye contact �Voice �Odor �Entrainment �Biorhythmicity �Reciprocity and synchrony

Transition to Parenthood Ø Reciprocity-type of movement or behavior that provides the observer with cues Ø Synchrony-refers to the fit between the infant’s cue and the parent’s response

Transition to Parenthood ØDependent phase Ø First 24 to 48 hours after childbirth Ø Taking-in phase-time when nurturing and protective care required by the new mother Ø Last two to three days Dependent-Independent Phase Ø Mother alternates between a need for extensive nurturing and acceptance by others and the desire to “take charge” once again Ø Taking-hold-phase Ø Last approximately 10 days

Parental Role After Childbirth �Transition to parenthood �Parental tasks and responsibilities �Becoming a mother �Becoming a father �Adjustment for the couple �Postpartum “blues” �Resuming sexual intimacy

Transition to Parenthood Ø Father-Infant Relationship Ø Engrossment-father’s absorption, preoccupation, and interest in the infant Ø Two consistent findings are that: Ø Fathers spend less time than mothers with infants Ø Father’s interaction with infants tend to be characterized by stimulating social play rather than care taking Ø U. S. , fathers tend to take the lead in initiating play and to play in a rougher manner Ø Mothers tend to take the lead in care giving activities Ø Fathers can benefit from nursing interventions during the postpartum period

Transition to Parenthood Ø Infant-Parent Adjustment Ø Can be facilitated in three ways: Ø Modulation of rhythm-both parent and must be able to interact Ø Infant must be in the alert state Ø Occurs most often during a feeding or face-to-face play Repertories of Behaviors Ø Fathers and mothers engage in these behaviors depending on the extent of contact and care giving of the infant Ø Infant’s behavioral repertoire includes gazing, vocalizing, and facial expressions Ø Baby’s early language-body gestures

Transition to Parenthood Ø Responsivity Ø Those that occur within a specific time and are similar in form to a stimulus behavior Ø Adult has the feeling of having an influence on the interaction Ø Infant behaviors such as smiling, cooing, and sustained eye contact are viewed as contingent responses

Transition to Parenthood Ø Paternal Adjustment Ø Fathers go through a predictable three-stage process during the first three weeks of transition to parenthood Ø Stage 1 expectations Ø Has preconceptions of what life will be like after baby comes home Stage 2 Reality Ø Father realizes that expectations are not always based on fact Ø Common feeling experienced are as follow: Sadness Ø Ambivalence Ø Frustration Ø Overwhelming desire to be more involved Stage 3 Transition to mastery Ø Makes a conscious decision to take control and become more actively involved with infant Ø

Transition to Parenthood Ø Postpartum “Blues” Ø Women are emotionally labile, often crying for no apparent reason Ø Lability peaks around the fifth day, and subsiding by the tenth day Ø Symptoms of postpartum blues include: depression, a let-down feeling, restlessness, fatigue, insomnia, headache, anxiety, sadness, and anger Ø Fatigue as early as 7 days after birth is predictive of depression at 28 days after birth Ø Exhaustion is rated by women as one of the top four contributing factors to post partum depression Ø “Am I blue” a self administered questionnaire that can help mothers to assess their level of blues and to decide when to seek professional help

A nurse educator has provided an in-service session to nursing staff, and the topic of the discussion is postpartum blues. Which statement by a nursing staff member would indicate the need for further discussion? � 1. “Postpartum blues are usually described as transient and mild mood disturbances. ” � 2. “Postpartum blues usually start at approximately the third day postpartum and usually last 2 to 3 days. ” � 3. “Some women may experience postpartum blues for several weeks. ” � 4. “Postpartum blues are always due to a psychological alteration in the woman. ”

Diversity in Transitions to Parenthood �Age �Adolescent mother or father �Maternal or paternal age older than 35 years �Social support �Postpartum adjustment in the lesbian couple �Culture �Socioeconomic conditions �Personal aspirations

Transition to Parenthood Ø Factors Influencing Parental Responses Ø Adolescent Mother Ø Feel different then their peers Ø Excluded from fun activities Ø Forced to enter an adult social role Ø Use less verbal interaction than do older parents Ø Less responsive and interact less positive with their infants Ø Respond to their infants inappropriately Ø Continued support from family members, grandparents, as well as home visits and group sessions for discussion of infant-care and parenting problems Adolescent Father Ø Developmental tasks of adolescences Ø Transitioning into parenthood Ø Adapting to marriage Ø Counseling the father in topics such as : finances, child care, parenting skills, and the father’s role in the birthing experience

Transition to Parenthood ØMaternal Age Older Than 35 Years Ø Have a harder time coping Ø Especially with irregular sleep patterns and the fussy periods babies have in the late afternoon and early evening Ø Adjust to changes in the relationship with their partners Ø Work and career issues are sources of conflict Ø Main drawback of midlife parenting is that the parenthood makes in the relationships with their partners

Transition to Parenthood ØCulture Ø Defines what is socially acceptable in terms of eye contact, touch, and space Ø Influences the interaction with the baby as well as the parents’ or family’s care giving style Ø The provision for a period of rest and recuperation for the mother after birth is prominent in several cultures Ø Nurses may become concerned when they observe cultural practices that appear to reflect poor maternalinfant bonding

Parental Sensory Impairment �Visually-impaired parent �Hearing-impaired parent �Section 504 of the Rehabilitation Act of 1973 requires hospitals to use various communication devices and resources with the deaf

Transition to Parenthood Ø Parental Sensory Impairment Ø Visually impaired parent Ø Do differently include the preparation of the infant’s nursery, clothes, and supplies Ø Put an entire clothing outfit together and hang it in the closet rather than keeping the items separately in draws Ø Labeling system for the infant’s clothing Ø Put diapering, bathing, and other care supplies where these will be easy to locate with minimal searching Ø Concerns expressed by visually impaired mothers include: Ø Their infant’s safety Ø The extra planning, time, and effort needed to accommodate their visual limitations beyond those parenting usually requires Ø Transportation Ø Handling other people’s reactions Ø Missing out visually

Transition to Parenthood ØHearing-Impaired Parent Ø Devices that transform sound into light flashes are now marketed and can be fitted into the infant’s room to permit immediate detection of crying Ø Provide additional vocal training by use of recordings and television so that from birth, this child is aware of the full range of the human voice Ø Young children acquire sign language readily, and the first sign used is as varied as the first word Ø Lip reading

Transition to Parenthood �Parenting in same-sex couples �Lesbian couple �Gay couples

Sibling Adaptation �Reactions manifested in behavioral changes �Involvement in planning and care �Acquaintance process

Transition to Parenthood Ø Sibling Adaptation Ø Older children have to assume new positions within the family hierarchy Ø Older child’s goal is to maintain a lead position Ø Parents need to distribute their attention in an equitable manner Ø Sibling reactions are manifested in behavioral changes: Ø Positive behavioral changes include interest in and concerns for the baby and increased independence Ø Regression in toileting and sleep habits, aggression toward the baby, and increased seeking of attention and whining are examples of negative behaviors Ø Initial adjustment of older children to a newborn takes time, and children should be allowed to interact at their own pace rather than be forced to do so. Ø The relationship that develops between siblings has been conceptualized as sibling adjustment Ø Sibling rivalry- negative behaviors in siblings

Grandparent Adaptation �Contributes to family continuity �Intergenerational relationships shift �Involvement depends on cultural and familial factors

Grandparent Adaptation �Contributes to family continuity �Intergenerational relationships shift �Involvement depends on cultural and familial factors

Transition to Parenthood Ø Grandparent Adaptation Ø Contribute to a sense of family continuity and provide maintenance of cultural traditions Ø Educate their grandchildren about their roots and relate anecdotes about their parents Ø Grandchildren often help relieve the grandparents’ loneliness and boredom Ø Significant positive influence on the child’s life Ø Extent of the involvement of grandparents in the care of the newborn depends on many factors: Ø Willingness of the grandparents to become involved Ø The proximity of the grandparents Ø Ethnic and cultural expectations of the grandparents’ role Support of grandparents can be a stabilizing influence for families undergoing developmental transitions such as childrearing and new parenthood Grand parents can foster the learning of parental skills and preserve tradition

Key Points �The birth of a child necessitates changes in the existing interactional structure of a family. �Attachment is the process by which the parent and infant come to love and accept each other. �Attachment is strengthened through the use of sensual responses or interactions by both partners in the parent-infant interaction

Key Points (cont) �Women go through predictable stages in becoming a mother. �Many mothers exhibit signs of postpartum blues (baby blues). �Fathers experience emotions and adjustments during the transition to parenthood that are similar to, and also distinctly different from, those of mothers

Key Points (cont) �Modulation of rhythm, modification of behavioral repertoires, and mutual responsivity facilitate infantparent adjustment. �Many factors influence adaptation to parenthood (e. g. , age, culture, socioeconomic level, expectations of what the child will be like). �A parent who has a sensory impairment needs to maximize use of the remaining senses.

Key Points (cont) �Sibling adjustment to a new baby requires creative parental interventions. �Grandparents can have a positive influence on the postpartum family. �Nurses play a major role in educating and supporting new parents in the transition to parenthood.

Key Points (cont) �Parents face a number of tasks related to sibling adjustment that require creative parental interventions �Grandparents can be a source of knowledge and support and have a positive influence on the postpartum family