1. Psychological changes of Pregnancy Effects on the patient and her family

2. Mother’s Reactions Initial reaction may run the gamut of emotions. May be surprised, pleased, disturbed, disappointed, frightened. There is element of surprise in every pregnancy. As the pregnancy progresses must reach an acceptance.

3. Cultural Background Influences Acceptance Background and society influence a mother’s reaction to her pregnancy. Emphasis on pre-natal and medically oriented society. Child-bearing is a woman’s work. Beliefs about health of the baby Supernatural being in total control Mother is totally responsible

4. Other Influences Attitude of health care provider. Home life in childhood “people love as they as loved” Basic temperament of mother ability to adapt and cope may view pregnancy as a threat

5. Mother’s Emotional Responses Narcissistic response is an early reaction. Extroversion, glowing behavior is common. Has difficulty staying focused. Emotional mood swings are frequent. Husbands need to be forewarned about these changes to expect in wife.

6. Psychological tasks for Pregnancy Acceptance is the major task that must be accomplished. - For many a specific time - Indications are preparations for new arrival Resolve old fears and / or conflicts Evaluate relationships Nurse’s role--be a good listener and facilitate expressions of feelings to work through these tasks

7. Steps in Preparing for Motherhood Mimicry and role-playing association with other pregnant women or new mothers spend time with own mother. Identifies parenting role she wants to mimic Fantasy--How will it be to be a mother Grief work--giving up her current lifestyle as life will never again be the same.

8. Hindrances associated with a mothering breakdown Multiple births Children born within 10--12 months apart. Moving Loss of security job/illness of self or family Loss of husband/ or infant’s father. Previous loss of a child

9. Practical Tasks Physical preparation for new arrival Financial re-arrangements Household chores and responsibilities Acquisition of new knowledge regarding pregnancy and childbirth.

10. Father’s Reaction to Pregnancy Fathers are becoming more involved in the childbearing process from pre-natal care to participating in the labor and birth process. Acceptance is also his major developmental task to be achieved. Needs to accept the reality of the child.

11. Father’s Reaction to Pregnancy Need preparation for the changes that will take place for his wife. Mood swings are common and emotions are unpredictable. Narcissistic or self-centered response of mother may be misunderstood. May feel “left out”

12. Father’s Reaction to Pregnancy May have feelings of jealousy. His childhood background will also influence his preparation. Needs to also identify a role-model or parenting style he wants to mimic. Preparation also includes fantasy and grief work.

13. Concerns of Fathers Breadwinner--most are still primarily concerned with the financial obligations. Protective and supportive role Symptoms of pregnancy often are felt by dads.

14. Effects of Pregnancy of Other Children Most parents agree children will need some warning. Effects of the pregnancy may occur early for the children. Mood swings of Mom and unpredictable response to behavior. Mom ‘sick’ and Dad fixing breakfast. Visits to the doctor. Physical changes in the home

15. Preparing Children for a New Sibling How soon to tell children depends on their ages and personality of the child. The parents reactions and acceptance of the new baby also will influence the children. The attitude of the older children often will reflect the attitude of the parents.

16. Preparation by Ages School-age children should be told when the parents know for sure. Pre-School age children probably should be told when preparation for the baby begins. Toddlers are often the most affected and must give up the role of “baby of the family”

17. Answering their questions Answer questions honestly and simply depending on age and understanding. Answer only what he is asking.

18. The unwed Pregnant Patient Overall birth rate is decreasing, but for the teen -age mother under age 15, it is rising. Teens are more prone to complications than older mothers. Infant mortality is higher as well. Often may have a problem with acceptance of the pregnancy and seek to hide it.

19. Teen-age Mothers Often the first major decision is to tell the parents of the pregnancy. There may be an initial reaction of anger, disappointment and even grief. After parents have time to adapt and accept the pregnancy, they can be the teen-age mother’s best ally.

20. Options facing the teen-age Mother Stay in school is the first option to be stressed. Marriage may be considered. Abortion--may feel initial relief, and then guilt and depression. Adoption--a beautiful option. Single-parenting.