Psychological Adaptation to Pregnancy 11/28/2018

Psychological Adaptation to Pregnancy First trimester task Accept the pregnancy Second trimester task Accept the baby Third trimester task Prepare for parenthood 11/28/2018

The Formation of Maternal Identity: Supporting Women in their Transition to Motherhood 11/28/2018

Maternal Tasks of Pregnancy Safe Passage Acceptance of Others Binding-in to the Child Giving of Oneself “Maternal Identity and the Maternal Experience”. Reva Rubin. 1984 (Springer Co.) 11/28/2018

1st Trimester Safe Passage Safety of self is more important than the baby 11/28/2018

1st Trimester Acceptance of Others The woman is realigning with the “idea” of being pregnant 11/28/2018

1st Trimester Binding-in to the Child Very little binding-in to the child “Binds-in” to the idea of the pregnancy itself 11/28/2018

1st Trimester Giving of Oneself The Child is still an abstraction She weighs the risks and benefits: What may be given with what may be taken away 11/28/2018

2nd Trimester Binding-in to the Child Quickening All tasks are undertaken more seriously after movement is felt Fetal movement transforms the baby to personhood 11/28/2018

2nd trimester Safe Passage Begins to be more protective of her unborn child 11/28/2018

2nd trimester Acceptance of others Progresses to focus on “the child” rather than the pregnancy 11/28/2018

2nd trimester Giving of Oneself Directly explores the meaning of the act of giving and of being given to 11/28/2018

3rd Trimester Safe Passage Concern is for self and baby Seeks out information to ensure safe passage in labor and birth 11/28/2018

3rd Trimester Acceptance of Others Conditional vs. unconditional acceptance of others 11/28/2018

3rd Trimester Binding-in to the Child Grows tired of being pregnant She loves the child but hates the pregnancy 11/28/2018

3rd Trimester Giving of Oneself Begins the act of giving Receives from others as a symbol of giving and receiving 11/28/2018

Adolescent Pregnancy Relationship with the father of the baby is important Social support Knowledge of Infant Development Maternal confidence 11/28/2018

Motherhood Constellation Life/Growth (concern for G&D) Primary Relatedness (emotional engagement) Supporting Matrix (support systems) Identity Reorganization (transformation of self-identity) 11/28/2018

Questions: “Will I be able to keep my infant protected and alive?” (Life/Growth) “Will I be able to love my infant in a special way so that she/he will become ‘my baby’ and not just any baby?” (Primary Relatedness) “Will I be helped in this task?” (Support Matrix) “How will this experience shape my life?” (Identity Reorganization) 11/28/2018

Signs of difficulty with the maternal tasks: Little or no prenatal care High-risk health behaviors Nothing prepared for the baby at term Refers to fetus in negative terms 11/28/2018

High Risk Historical Factors Unplanned/Unwanted pregnancy Short interconceptional period Previous traumatic birth Previous pre-term birth 11/28/2018

High risk factors, cont. Previous pregnancy or newborn loss Previous loss of own mother (death, adoption, abandonment) Current or past abuse Depression Substance Use/Abuse 11/28/2018

Maternal/Fetal Attachment Behaviors Interacting with the fetus Giving of self Identifying the fetus(gender,naming) Fantasizing or Attribution of characteristics 11/28/2018

Role of the nurse Skillful screening and history taking Empathic listening Therapeutic use of self Have a thorough knowledge of community resources for referral 11/28/2018