Paper
Thursday, July 12, 2007
This presentation is part of : Access to Care: Caregiving Across the Life Span
Getting the Feel for it: Mothering and Caregiving in First-Time Mothers of Medically Fragile Young Infants
Marcia R. Gardner, PhD, RN, CPNP, CPN, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA

When medically fragile infants are discharged home from a health care setting, their mothers provide both nurturance and medicalized care. Prior research has focused on care burdens for mothers of medically fragile older children, with less attention given to overall maternal experiences or to the specific experiences of first-time mothers of infants.  

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.