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Unit 5 - 5.2 PP TAYLOR

The document discusses postpartum family adjustment including bonding, psychological changes, Reva Rubin's phases of adjustment, and the impact of birth on adolescents and older women. It also covers discharge planning, teaching topics like Kegel exercises, who provides postpartum care, and community resources for new mothers.

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Krista Klose
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72 views16 pages

Unit 5 - 5.2 PP TAYLOR

The document discusses postpartum family adjustment including bonding, psychological changes, Reva Rubin's phases of adjustment, and the impact of birth on adolescents and older women. It also covers discharge planning, teaching topics like Kegel exercises, who provides postpartum care, and community resources for new mothers.

Uploaded by

Krista Klose
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Topic 5.

2 Postpartum
Family Adjustment
Topic 5.2 Postpartum Family
Adjustment
• Psychosocial changes and phases of maternal role adjustment
• Behaviours indicative of parental:
– Attachment
– Bonding
– Negative family relationships
• Impact of birth on adolescent and older woman
• Discharge planning and resources available
Psychological Changes Postpartum
Bonding:
• Mutual attraction between parent and child
• Feeling of affection/loyalty that binds one person to another
• Starts during pregnancy, intensifies after birth and is constant/consistent
once established

• Some women can feel abandoned – feeling less important, people focused
on baby
Psychological Changes Postpartum

Bonding (continued)
• Eye contact, touching, talking, exploring
• Father becomes engrossed (engrossment) with the baby. Bonds
differently from mother
• Things that may interfere with bonding:
– Unplanned pregnancy
– Baby has abnormality
– Emotional instability/lack of support
– Negative reaction – associates baby with pain
– Financial instability
Psychological Changes Postpartum
• Reva Rubin’s psychological changes of the puerperium
• Taking in phase -day or two
• Taking hold phase -days or weeks
• Letting go phase - ffuture
• Mothers move through these phases at different rates
Reva Rubin’s Psychological Changes
• Phase 1: Taking In

Mother is passive & willing to let other do for her. Lets others take care of
her. Primary focus is rest, nutrition, recovery. (not a good time to teach but
have to do some basics)

Wants to talk about her experience


Reva Rubin’s Psychological Changes
• Phase 2: Taking Hold

Mother begins to initiate action. Interested in caring for baby. Critical of her
performance. Assumes responsibility for self care.
( A GOOD time to teach)
Reva Rubin’s Psychological Changes
• Phase 3: Letting go

• Giving up previous lifestyle. Mothers reconcile their birth experience.


Gives up the fantasy child and accept the real child.

• Mothers move through these phases at different rates.


Impact of Birth on the Adolescent
• Inability to adapt after the birth
– May be a surreal time for them
– Urge her to talk about her labor and birth

• Lack of knowledge of baby care


– Show the same positive bonding behavior as other women
– May lack knowledge of infant care
– They can be overwhelmed
Impact of Birth on Pregnant Women
Over 40
• May have adjustment issues with role change
• Difficulty accepting the event
• May have done a lot of reading during pregnancy but still feel
unprepared
• May need to be taught about balance
Discharge Planning and Teaching
• Mothers are usually discharged with their babies within 24 hours of birth.
• If the mother has had a caesarean birth then they may stay in 2-3 days.
• If baby is ill in the neonatal unit mother can be discharged but baby will
remain.
Postpartum Discharge Planning
• On the day of discharge from hospital Public Health receive a fax sent by
postpartum stating the client’s information. Public Health then take over
and follow the mother and babe.

• Midwives follow their own clients for six weeks afterwards and do home
visits for the first week. Public health will phone only and give information
regarding immunization and clinic hours.
Postpartum – Discharge Teaching
• What teaching do you think is required for the mother in the ONGOING
postpartum period?

• Look at the care maps for vaginal & C-section deliveries

• What about the father or other members of the family?


Postpartum Discharge Teaching
Kegel Exercises:
• Invented by Dr. Kegel over 40 years ago.
• Important to regain the integrity of pelvic floor in order to prevent
urinary incontinence.
How do we do them?
– Stand, sit or lie down – knees slightly apart
– Squeeze the muscles that would prevent you from urinating/having bowel
movement
– Tighten the muscles for 5-10 seconds
– Relax the muscles for 10 seconds
– Do the set of 12 – 20 contractions 3 times a day
Postpartum Discharge Planning
• The postpartum period last for 6 weeks. A 6 week check up is done by
physician or midwife.
• Family doctors check mother and babe.
• Midwives check mother and babe.
• Obstetricians only check mother. Babe goes to family doctor or
pediatrician.
Resources for new mothers
• Public Health “Healthy Beginnings”
• Mothers and Babies Program
• La Leche League
• Family Doctor
• Exercise programs for new mothers
• ASAC

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