Section II. PSYCHOLOGICAL NEEDS OF THE POSTPARTAL PATIENT
6-7.
GENERAL
A major psychological task for the parents is the process of bonding and
attachment with their newborn. This takes place the first three to four days of
postpartum. The practical nurse is in a unique position to observe and offer
psychological support and reassurance to the postpartal patient. This supportiveness
can help in correcting negative bonding and reinforce the positive maternal infant
adaptations that are the basis for a strong and healthy family relationship. This lesson
will focus on the processes by which the psychological needs of the postpartal patient
are actually filled.
6-8.
PHASES OF THE RESTORATIVE PERIOD OF MATERNAL BEHAVIOR
FOLLOWING DELIVERY
The restorative period is the postpartal period/time of delivery to the four to six
week stabilization point. The phases are referred to as the taking-in phase, taking-hold
phase, and letting-go phase.
a. Taking-In Phase. During this phase the mother is oriented primarily to her
own needs. She primary focuses on sleeping and eating. She may be quite passive
and dependent. The mother is reacting to the intense, physical effort expended during
delivery and the intense, emotional effort required of her during labor. The mother does
not usually initiate contact with the infant. This is not out of disinterest. It may result
from her own immediate dependency. Nevertheless, she is taking-in information that
helps her to identify the infant. She may use her finger-tip to touch her infant. This
serves as one of the first steps in the identification process. She holds the baby facing
her so they can explore each other's face (in the face position). The mother relives the
delivery experience which allows her to integrate it fully with reality, fully realized her
baby is born, and to identify her infant as being outside and separate from her. This
phase, taking-in phase, may last for a day or two. The nurse should plan activities so
that the patient can rest as much as possible because failure to allow the patient to
receive the necessary and earned rest may yield a "sleep hunger" which may be
manifested by irritability, fatigue, and general interference with the normal restorative
process. The father's role is primarily being supportive of his wife and his family.
b. Taking-Hold Phase. During this phase the mother strives for independence
and autonomy, she becomes the "initiator." She is concerned about her ability to
control her bodily functions (that is, bowels, bladder, and if breast-feeding, concerned
about adequate amount and quality of milk). She takes an active part in trying to control
these functions. She is concerned about her ability to take care of her newborn. This
phase is associated with a great deal of anxiety (especially by a new mother). She may
have several mood swings. The mother might be involved in a lot of activity trying to
accomplish tasks. Fatigue and exhaustion may occur if the mother is not helped to set
realist expectations and limits for herself. The nurse is responsible to allow the mother
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