Maternity Nursing and The Role Of The Maternity Nurse

By Julie-Ann Amos

If you like working with infants and enjoy helping mothers, you should consider entering the field of maternity nursing. Maternity nursing can be a rewarding career choice. It is an area where an intensive working relationship develops between the maternity nurse and her wards: the mother and new born child. It is also a demanding career. In maternity nursing, you must be prepared to be on call 24 hours a day for 7 days of the week.

What is Maternity Nursing?

Maternity nursing is a form of intensive, informative and knowledgeable care provided by a maternity nurse. In most instances, the maternity nurse provides 2 related and integrated services. The first one is pre-birth care. The maternity nurse is there to help the mother and the family during their pregnancy and afterwards. In maternity nursing, the provider prepares the family for the entire birthing experience. The second responsibility of the maternity nurse is post birth. The nurse is also there after the birth. In this role, he or she advises mothers on such things as post natal care of themselves and their newborns.

What do You do in Maternity Nursing?

Overall, maternity nursing focuses on the well-being of mother and child. The focus of a maternity nurse is on the emotional and physical well-being of both their patients. They provide advice and health care. They are there for emotional support as well as providing physical care for both mother and infant. In maternity nursing, you learn how to:
Help mothers feel comfortable handling their infant. Show first time mothers how to wash the baby. Show mothers how easy it is to feed, change and dress the newborn Organize the clothing, toys and other accoutrements of the baby Prepare necessary meals Pass on knowledge of the strengths and weaknesses and pros and cons of baby

care issues, e.g., Cloth diapers versus pampers, bottle feeding versus breast feeding.
Wash and sterilize bottles

Maternity nursing does focus on the primary unit of mother and child. Yet, the maternity nurse must also know how to interact with the other members of the family. In modern times, it is not only the mother who feeds, dresses and bathes the child. The father is increasingly playing a more significant role. In maternity nursing, this involves educating the father as well in the different aspects of child care.

From pregnancy until the child reaches two years of age, you'll serve as a trusted advisor to first-time moms. Youll be offering the support they need to deliver healthy babies, become confident parents, and ultimately, encourage them to pursue a better future for themselves and their children.

Psychologic Needs During Pregnancy

PSYCHOLOGIC NEEDS DURING PREGNANCY 4-1. GENERAL Being pregnant is a very personal experience for each patient. This period in her life poses many new challenges and possible problems. How she responds to these challenges is dependent on her emotional maturity or lack of it. It is the responsibility of the practical nurse to help her understand and meet these challenges appropriately. You can help the patient, her mate, and significant others in their understanding of the physiologic changes that may occur during pregnancy. 4-2. EMOTIONAL REACTIONS EXPERIENCED BY A NEWLY PREGNANT PATIENT Throughout a patient's pregnancy, her emotional reactions have been described as ambivalence, fear and anxiety, introversion or narcissism, and uncertainty. These feelings predominate at different periods of the pregnancy; other tends to fade in and out as the pregnancy progresses. a. Ambivalence. This refers to the patient's simultaneous attraction for and against the pregnancy. The negative response to the pregnancy does not mean that she doesn't want the baby. She may simply have doubts as to whether she will be a good parent, wonder if she is ready for a baby, how a new baby will affect her family and her lifestyle, and so forth. This is not to say that she doesn't feel good about the pregnancy. Even though she may be doubtful in some ways, she may be experiencing joy and excitement as well as happiness and anticipation. b. Fear and Anxiety. This refers to the patient being concerned for her own health and the health of her baby. c. Introversion or Narcissism. The patient becomes concerned for herself. She may be preoccupied with her own thoughts and feelings. d. Uncertainty. Before the patient can accept the fact that she is pregnant, she must ask herself "Am I really pregnant?" This may last until a positive diagnosis of pregnancy is confirmed by a physician. "Quickening" is usually a big milestone in the process of accepting the pregnancy. 4-3. FACTORS THAT MAY INFLUENCE THE EXTENT OF THESE REACTIONS The previously mentioned emotional reactions of a pregnant patient may have some bearing on the following factors: a. Is it a planned or a wanted pregnancy? b. Is it the first pregnancy? c. What experiences and memories does the patient have about previous pregnancies?

4-4. FIRST TRIMESTER OF PREGNANCY New behaviors a prospective mother may engage in includes the following: a. Displays a Sense of Ambivalence to the Pregnancy. You, as the practical nurse, must explain to the patient that what she is feeling is not unnatural. She must not be made to feel guilty about her ambivalence. b. Fantasize About The Pregnancy. This may be mixed with a sense of fear or dread. The patient may dream about the impact a baby will have on her life and the lives of other family members. If the fantasies become moribund or characterized by excessive fear and cause despair, the patient may require counseling. c. Role Playing. The patient may act the part of being a mother. She may spend time playing with children or babysitting other friends' babies. She may show more interest in caring for babies. She may pick them up more or talk with other women about their babies. d. Increased Concern For Financial and Social Problems. Paying for a child, losing a job, or losing a second income for a while, the cost of child care, loss of freedom to come and go, and the requirement for a total commitment that may prevent her from performing social obligations may all be concerns for the new mother. e. Decreased Interest In Sex Due To Bodily Changes. Nausea, vomiting, fatigue, and fear of injury to fetus may cause a loss of interest in sex. Increased vascularity to breast may yield breast tenderness or discomfort initially but this decreases as the pregnancy continues. Increased vascularity to the genitalia area may also be of concern. Fear of a miscarriage may cause the patient not to want sexual intercourse. 4-5. CHARACTERISTICS OF SECOND TRIMESTER OF PREGNANCY a. The patient develops a sense of well-being. Her body becomes adjusted to hormonal changes. The early discomforts of pregnancy have subsided. Usually, she has adjusted psychologically to the realities and inconveniences, which accompany pregnancy. Her fears have subsided, at least temporarily. She has passed the initial miscarriage stage; she begins telling everyone she is pregnant. She develops a "glow" of pregnancy. b. "Quickening" is experienced. The patient actually feels life; this act of fetal movement confirms the pregnancy. The father can also feel the movement; he can then identify with the reality of pregnancy and accept it. c. The fetus heartbeat is heard. d. Both parents develop an interest in fetal growth and development. e. The interest in processes of labor and delivery is expressed. At this point, the parents may enroll in classes on childbirth and read appropriate literature. f. The patient may have wide mood swings. She may be happy to sad for no apparent reason. NOTE: Reassurance to the pregnant patient is very important to her--these are normal emotional reactions to pregnancy. g. The patient may have a tendency to introvert or to focus on herself as the center of attention. She may concentrate on her own needs and the needs of the fetus inside her. She reflects on her own childhood and her relationship with her mother. She is preoccupied with her own thoughts and feelings. Preoccupation may cause trouble for her and those around her. Those persons close to the patient must be informed to expect her passiveness and dependency during this time. Extra love and attention should be given to her during this time, as

this will allow the patient to give more of herself. h. Changes in sexuality. The patient may have increased her interest in sex, the fear of pregnancy is no longer a problem and the fear of hurting the fetus is gone. There is an increase in sexual fantasies and dreams, and an increase in vaginal lubrication. An increase in vaginal lubrication increases comfort for the mother during intercourse. However, the partner may need to change positions for the comfort of the female. 4-6. PSYCHOLOGICAL CHARACTERISTICS OF THE PREGNANT PATIENT DURING THE THIRD TRIMESTER a. Altered Self-Image. The patient is vacillating, going from being special, beautiful, and pretty to being ugly, awkward, unsexy, and feels fat. b. Fear. She dreams about the infant and what the future holds for the new baby. She is concerned for the health and well-being of her baby. She is also concerned for her own safety and "performance" during labor and delivery. c. Aggravation. The patient is aggravated over things she can't do for herself due to her size. d. Fatigue. She becomes tired easily. e. Obsession. She is concerned with delivery. f. Wondering. The patient wonders what kind of parent she will be. 4-7. ADJUSTMENTS OF FATHERS DURING PREGNANCY a. Men undergo far less social preparation than women do for parenthood. With a close, supportive family relationship, the father can receive help in his adjustment if needed. Essentially, there is nothing to prepare him for pregnancy per se. There are no doctor's appointments, baby showers, or the physiologic changes of true pregnancy, although some men have expressed having some of the physical discomforts. b. Introduction comes with the actual confirmation of the diagnosis of pregnancy, focusing more on impending fatherhood rather than the immediate state of pregnancy. Accepting the fact of pregnancy can raise excitement versus denial, that is, is it really his? This may cause guilt feelings over the discomforts his partner may be experiencing and may develop a new image of himself and his altered responsibilities. c. The father is busily reworking the family budget to afford a child. d. He may need encouragement to participate in the preparation for parenting. Encourage him to accompany his partner on prenatal visits. These visits can allow him to listen to the fetal heart tones (FHT). The growth and development of the fetus should be explained to him. He should also be included in office visits. Encouraging him to participate in classes on natural childbirth, parenting, and childcare are all important. Allow the father to participate in the labor and delivery process if he expresses a desire to participate. 4-8. SINGLE MOTHERS a. Reasons for Single Mothers. (1) Unmarried. Several reasons contribute to the woman being unmarried. There may have been an unplanned pregnancy and a decision was made not to marry the father of the child. Pregnancy could marry the father of the child. Pregnancy could There may have been an unplanned pregnancy and a decision was made not to be the

result of a rape and the patient decided not to terminate the pregnancy. A patient just may desire a child without the commitment of a marriage. (2) Widowed. (3) Divorced. There may have been a planned pregnancy in an effort to save a marriage and it did not work. It may have been totally unplanned and the patient decided to continue with the divorce and the pregnancy. (4) Separation. The father may be imprisoned, may be on military duty, or just separated from the mother. (5) Surrogate mother. A woman who carries the fetus of the infertile woman's husband and then relinquishes the child to the couple for rearing. This is usually done for couples that have difficulty with delivering a viable fetus. b. Counseling. Most single patients need counseling regardless of their age. This counseling is done to: (1) Aid her to make realistic plans for her child's future. (2) Provide assistance to help her cope with emotional stress especially during labor. If at all possible, have the patient find a friend to go through labor with her. (3) Provide sources of counseling to include whether to have an abortion, keep the child, or put the child up for adoption. (4) Inform her of community agencies that may help her financially with childcare and other responsibilities. (5) Provide mechanisms to help her cope with loneliness. c. Pregnant Teenager--Married or Not. (1) The teenager is still growing. She needs a specialized nutritional nursing care plan. The diet should be adjusted to what and where she normally eats. (2) There is a high mortality and morbidity for mothers under 20 years of age and their infants. Because of the lack of prenatal care, she may try to hide the pregnancy. (3) The teenager lacks compliance with instructions and lack of physical and psychological maturity. She has not yet achieved physical and psychological maturity. 4-9. FACTORS INFLUENCING THE ROLE OF THE UNWED FATHER a. Economic--Can He Support a Child. Does he have a job? Is he married with another family to support? What is the age of the father? If a teenager, is he still in school? b. Social Implications. These implications indicate the reaction of the news by his peers. Will the pregnancy

force an early marriage? If married to someone else, how will this affect that relationship? c. Psychological Response. (1) May question whether he is the father. (2) May experience a sense of loss or grief if he cannot be involved with the child. In some states, adoption without his consent may be allowed. (3) May experience anger from the girl, her or his parents. (4) May affect his relationship with another female. 4-10. FACTORS AFFECTING THE PARENTS OF THE UNWED MOTHER AND FATHER The parents of the unwed mother and father are also important. They may be concerned with the following reactions/emotions: a. Rejection or neglect from family or friends. b. May feel exposed to judgmental attitudes of medical and nursing personnel over how they could have let this happen. c. May feel guilty for what happened. d. May face financial burden, especially if they decide to keep or adopt the child. e. May face a permanent loss of a grandchild if the child is given up for adoption. f. May face loss of relationship with their child as a result of the decision made.