Maternity Nursing: Postpartum Q 48
Four hours after a difficult labor and birth, a primiparous woman refuses to feed her baby, stating that she is too tired and just wants to sleep. The nurse should: Select all that apply.
A. Tell the woman she can rest after she feeds her baby.
B. Recognize this as a behavior of the taking-in stage.
C. Record the behavior as ineffective maternal-newborn attachment.
D. Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time.
E. Acknowledge this as a behavior of the letting go stage.
Correct Answer: B and D.
The behavior described is typical of this stage and not a reflection of ineffective attachment unless the behavior persists. Mothers need to reestablish their own well-being in order to effectively care for their baby. The taking-in phase usually sets 1 to 2 days after delivery. This is the time of reflection for the woman because within the 2 to 3 day period, the woman is passive. The woman prefers to talk about her experiences during labor and birth and also her pregnancy. The woman becomes dependent on her healthcare provider or support person with some of the daily tasks and decision-making. The changes that the woman undergoes are crucial within the first 24 hours of postpartum, especially the psychological changes. These changes might affect the woman permanently if not given the appropriate attention and care.
Option A: This does not take into consideration the need for the new mother to be nurtured and have her needs met during the taking-in stage. The taking-in phase provides time for the woman to regain her physical strength and organize her rambling thoughts about her new role. Encouraging the woman to talk about her experiences during labor and birth would greatly help her adjust and let her incorporate it into her new life.
Option C: This dependence is mainly due to her physical discomfort from hemorrhoids or the after pains, from the uncertainty of how she could care for the newborn, and also from the extreme tiredness she feels that follows childbirth. The taking-in phase provides time for the woman to regain her physical strength and organize her rambling thoughts about her new role.
Option E. During the letting go phase, the woman finally accepts her new role and gives up her old roles like being a childless woman or just a mother of one child.