Chapter 20 Transition to Parenthood All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Chapter 20

Transition to Parenthood

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Period of change and instability for all men and women Adoptive or biologic parents Married or single parents Lesbian or gay couples

Parenting is a process of role transition Requires cognitive, affective, and motor skill Infant’s well-being and development depends on

these components

Transition to Parenthood

2All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Process Attachment

Bonding Proximity Interaction

Mutuality Acquaintance Claiming process

Parental Attachment, Bonding,and Acquaintance

3All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

4All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

5All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

6All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Careful observation of specific behaviors Formation of emotional bonds

Skillful observation and intervening Enhance parent-infant contact by increasing parent’s

awareness of infant responses Rooming-in

Assessment of Attachment Behaviors

7All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Early contact May facilitate attachment process Skin to skin immediately after birth

Extended contact Optimizes family-centered care Achieved through couplet care Family is encouraged to participate

Parent-Infant Contact

8All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

The senses Touch Eye contact (en face) Voice Odor

Entrainment Biorhythmicity Reciprocity and synchrony

CommunicationBetween Parent and Infant

9All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

10All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

11All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

12All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Transition to parenthood Parental tasks and responsibilities Becoming a mother

Dependent behavior Dependent-independent behavior Interdependent behavior

Postpartum blues

Parental Role After Childbirth

13All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Becoming a father Father-infant relationship Engrossment

Adjustment for the couple Resuming sexual intimacy

Parental Role After Childbirth (Cont.)

14All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

15All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Rhythm Alert state Sleep wake patterns

Behavioral repertoires Gazing, vocalizing, facial expressions Body gestures

Responsivity Smiling, cooing, en face

Infant-Parent Adjustment

16All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

17All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Age Adolescent mother or father New parents older than 35 years

Parenting in the lesbian couple Social support Culture Socioeconomic conditions Personal aspirations

Diversity in Transitions to Parenthood

18All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Visually-impaired parent Does not have negative effect on parenting Heightened sensitivity to other sensory output Skepticism by health care professionals Infant will need sensory input from other parent

Parental Sensory Impairment

19All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Hearing-impaired parent Mother and partner establish an independent

household Technologic devices aid in parenting Young children acquire sign language readily

Parental Sensory Impairment (Cont.)

20All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Siblings have to assume new positions within the family hierarchy

Reactions manifested in behavioral changes Involvement in planning and care Acquaintance behaviors

Sibling Adaptation

21All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

22All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Most often associated with joy May feel regret due to poor health or geographical

distance Grandparents are eager to help

Maternal grandmother is called on the most Intergenerational relationships shift Involvement dependent on cultural and familial

factors

Grandparent Adaptation

23All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

24All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

25All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Nursing care directed toward: Helping parents cope with infant care Role changes Altered lifestyle Change in family structure due to new baby Anticipatory guidance

Care Management

26All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

A 30-year-old multiparous woman has a boy who is 2½ years old and now an infant girl. She tells the nurse, “I don’t know how I’ll ever manage both children when I get home.” Which suggestion would best help this woman alleviate sibling rivalry?

Tell the older child that he is a big boy now and should love his new sister.

Question

27All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Let the older child stay with his grandparents for the first 6 weeks to allow him to adjust to the newborn.

Ask friends and relatives not to bring gifts to the older sibling because you do not want to spoil him.

Realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time.

Question (Cont.)

28All Elsevier items and derived items © 2014, 2010, 2006, 2002 , Mosby, Inc., an imprint of Elsevier Inc.