to actually perform infant care tasks, reinforce all positive actions (do not impose
yourself), and provide guidance, instruction, and demonstration, as necessary.
Reassurance and explanation about infant care are especially needed in this phase.
This phase lasts for about ten days (most of this phase is accomplished at home).
c. Letting-Go Phase. Generally, this phase occurs when the mother returns
home. The mother must accomplish two separations during this phase. The
separations are to realize and accept the physical separation from the baby and to
relinquish her former role of a childless person. The mother must adjust her life to the
relative dependency and helplessness of her child. If she quits work, she must adapt
(even if only temporarily) to less freedom, less autonomy, and less social stimulation. If
she continues to work, she must handle the additional strain of finding sitters and
meeting additional workload. The mother may experience a let-down feeling, which is
called postpartal, or baby, "blues." This is a form of depression that is usually
temporary and may occur in the hospital.
6-9.
POSTPARTUM "BLUES"
a. Possible causes of postpartum "blues" are: hormonal changes that occur
during the postpartal period; the emotional stresses associated with increased
responsibilities of an infant and restrictions imposed by caring for an infant; ego
adjustment that accompanies role transition from wife and childless person to mother;
and the discomfort, fatigue, and exhaustion that may contribute or cause the condition.
b. Common manifestations experienced by the mother are let-down feeling (for
no apparent reason, so the mother thinks), irritability, tears, loss of appetite, and
difficulty sleeping.
c. Associated feelings experienced by the mother, secondary to her depression
are:
(1) Guilt about her unaccustomed emotional displays (does not know why
she is crying and identifies, "the tears just come").
(2)
Loss of control over herself and over lack of the ability to care for herself.
(3)
Feelings of failure as a mother, wife, or any other role of her
involvement.
d. Nursing care responsibilities for postpartal "blues" patients.
(1) Recognize and interpret the mother's behavior on an individual basis.
Not all women act the same way during childbirth and not all women will react to
childbirth in the same way. There may be underlying things influencing the mother's
behavior that may not be apparent.
MD0922
6-10