Method: A qualitative study using grounded theory methodology was conducted to generate a substantive theory - ‘getting the feel for it’- describing patterns and processes of mothering and caregiving in first-time mothers of medically fragile young infants.  Eight first-time, adult-aged mothers of medically fragile infants who were 6 months of age or younger at study enrollment were recruited. Twenty-eight semi-structured interviews were conducted in participant homes. Data were analyzed using the constant comparative method consistent with grounded theory. 

Results: Findings from the study showed include that:  (a) management of unknown responsibilities associated with care of the baby was a shared problem;  (b) mothering subsumed caregiving; (c) mothers moved through a time-and-experience-mediated evolution in managing responsibilities, from ‘feeling overwhelmed with responsibility’ through feeling ‘more at ease’ through recognition that mothering became ‘routine’; (d) mothers’ development of comprehensive knowledge of  their infants and their infants’ patterns significantly influenced  the movement from feeling ‘overwhelmed’ to ‘more at ease’ to feeling ‘it’s routine; (e) participants used several strategies in the movement from ‘overwhelmed’ to ‘routine’:  appraising, normalizing, redefining self, organizing, assessing, practicing, experimenting, validating, nurturing, and negotiating.   From the standpoint ‘it’s routine’, mothering became predictable, expected, automatic and integrated in everyday life.   

Conclusions: Study findings add to the evolving body of knowledge regarding mothering transitions, particularly in the population of inexperienced first-time mothers with medically fragile infants.  Implications for clinical practice and future research with this specialized population of new mothers, particularly within a broader family context, will be addressed.