Paper
Wednesday, 19 July 2006
This presentation is part of : Women's Health Issues Examined
Prenatal Maternal Role Transition: Primigravidae and Multigravidae Women
Mary Reid Nichols, PhD, RN, FNP, Family Nursing Department, Frontier School of Midwifery and Family Nursing, Hyden, KY, USA and Gayle Roux, PhD, RN, CNS, NP-C, Nursing, Virginia Commonwealth University, Richmond, VA, USA.
Learning Objective #1: Discuss the Prenatal Adjustment to Motherhood framework and three prenatal tasks of maternal role transition.
Learning Objective #2: Describe clinical implications for assisting primigravidae and multigravidae pregnant women during adjustment to new motherhood.

The purposes of the study were to describe prenatal adjustment to motherhood among personal and psychosocial variables and maternal perceptions of the pregnancy experience and to apply findings to the Prenatal Adjustment to Motherhood (PAM) model which was derived from the framework guiding the study, Mercerís Becoming a Mother Model. This was a mixed-method descriptive study and included 50 primigravidae and 50 multigravidae married women, aged 23-37, in the last trimester of an uncomplicated pregnancy. As part of a larger, longitudinal study, the main focus for the current report describes personal variables (parity, maternal age, educational level, employment status, family income, race/ethnicity), maternal psychosocial factors (plans for return to work, planned infant feeding method, marital satisfaction, maternal-fetal attachment, and self-esteem) and maternal perceptions about the pregnancy experience. Unexpectedly, multigravid women had lower levels of maternal-fetal attachment and marital satisfaction than did primigravid women. Maternal perceptions of prenatal role adjustment included positive pregnancy experiences, negative pregnancy experiences, and maternal and family well-being issues. Financial issues and changes in marital relationship were of concern to both groups of mothers. Findings supported the development of the Prenatal Adjustment to Motherhood (PAM) model and provided evidence that three prenatal tasks are required during early maternal role transition: commitment, attachment, and preparation. The data support the premise that for nurses to lead primigravidae and multigravidae mothers and families through this transition, evidence is needed to guide practice. Prenatal differences in primigravid and multigravid women is an important, but neglected topic that needs to be addressed and defined more clearly in the literature. Future research is needed to identify resources and prenatal interventions designed to individualize the pregnancy experience for primigravidae and multigravidae women and to test the application of the Prenatal Adjustment to Motherhood model.

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