Midwifery Care during Postnatal Period (class 2) (2)

Page 1: Introduction

  • Psychological Adaptation during Postnatal Period

  • Presented by Dr. Safaa G. Salem, Ph.D., RN

  • Institution: Princess Nourah bint Abdulrahman University

Page 2: Learning Objectives

  • After this lecture, students will:

    • Define psychological adaptation during the postnatal period.

    • Determine the maternal role during this period.

    • Recognize the development of positive family relationships.

    • Identify challenges faced by women.

    • Understand cultural influences on mothers.

    • Be aware of postnatal psychological disorders.

Page 3: Psychological Adaptation

  • Role changing is crucial, especially for first-time mothers.

  • Adaptation involves the whole family adjusting to a new member.

  • Midwives play a vital role in fostering positive family relationships.

    • Assessment of maternal psychological adaptation is important.

    • Guidance on postpartum blues and psychological adjustments is key.

Page 4: Maternal Role Development

  • Women's adjustment to motherhood follows developmental stages:

    • Influenced by culture, upbringing, and role models.

    • Reva Rubin identified three phases:

      1. Taking In

      2. Taking Hold

      3. Letting Go

Page 5: Taking In Phase

  • Early postpartum stage characterized by:

    • Dependent behaviors and difficulty making decisions.

    • Focus on physical needs: food, rest, and elimination.

    • Need to discuss delivery experience; not ready for instruction.

    • Midwives should listen and affirm feelings.

Page 6: Taking Hold Phase

  • Transition to increased independence.

  • After rest, mothers focus on the newborn and seek guidance.

  • Duration: from 2 days to several weeks.

  • Importance of encouraging self-care for the newborn.

Page 7: Letting Go Phase

  • Late postpartum phase involves:

    • Letting go of previous roles and embracing parenting.

    • Emphasis on emotional range as mother gets to know the infant.

    • Family relationships adjust to accommodate the newborn.

Page 8: Development of Positive Family Relationships

  1. Attachment: Emotional bond between parent and infant formed through interaction.

    • Mothers may experience mixed emotions, including disbelief.

Page 9: Development of Positive Family Relationships

  1. Ambivalence: Normal feelings of uncertainty about assuming parenthood.

    • Mothers may express negative feelings about the baby post-birth.

    • Acknowledge responsiveness to these feelings is crucial for acceptance.

Page 10: Development of Positive Family Relationships

  1. Bonding: Process through which parents develop a relationship with their newborn.

    • Begins with gentle exploration of the baby (fingers, palms).

    • Involves increasing physical closeness and attention over this is own

    • time.

Page 11: Maternal Concerns and Feelings

  • Abandonment: Shift in focus from mother to newborn can lead to feelings of jealousy and confusion.

  • Midwives can help mitigate these feelings through shared responsibilities.

Page 12: Maternal Concerns and Feelings

  • Disappointment: Mothers may struggle to accept differences in the newborn versus expectations.

    • Can impact the mother’s ability to engage positively with the newborn.

Page 13: Midwives’ Role in Supporting Mothers

  • Acceptance of mothers' negative feelings is important.

    • Midwives should respond supportively to negative comments about the baby.

    • Normalize feelings of uncertainty during this transitional period.

Page 14: Challenges of Motherhood during Postnatal Period

  1. Finding personal time for activities and self-care.

  2. Feelings of incompetency due to uncertainty in mothering skills.

  3. Fatigue from sleep deprivation due to newborn care demands.

Page 15: Challenges of Motherhood during Postnatal Period

  1. Sense of lost freedom and an awareness of new responsibilities.

  2. Adjusting to an altered body image post-pregnancy.

  • Multiparas often feel more positive about postnatal appearance than primiparas.

Page 16: Cultural Influences during Postnatal Period

  • Culture and personal values impact maternal beliefs and practices.

    • Expectations around food, rest, hygiene, and newborn care are culturally specific.

    • Extended family often plays an essential role postnatally.

Page 17: Postnatal Psychological Disorders - Postpartum Blues

  • 50% to 70% experience postpartum blues (temporary depression).

  • Symptoms: tearfulness, difficulty sleeping/eating, feeling let down, generally lasts 2-3 days.

  • Factors include hormonal drop and adjustment stress.

Page 18: Managing Postpartum Blues

  • Tips for midwives:

    • Allow expression of feelings, reassure normalcy of emotions.

    • Encourage self-care practices like balanced diets and exercise.

    • Suggest support groups for new mothers.

Page 19: Postnatal Psychological Disorders - Postpartum Depression

  • More severe depression post-birth with symptoms like irritability, guilt, and negative feelings toward the newborn.

  • Contributing factors: hormonal changes, body image issues, stress, and sleep deprivation.

Page 20: References

  • "Myles Textbook for Midwives," 17th ed. by Jayne E. Marshall & Maureen D. Raynor.

  • "Maternal-Newborn’s Nursing and Woman’s Health Care," 7th ed. by Sally B. Olds et al.

Page 21: Closing

  • Thank you from Princess Nourah bint Abdulrahman University.