Maternity Nursing: Pregnancy, Birth and The Newborn

Table of Contents

Introduction.

Role of a health professional in promoting maternal emotional well being.

Pregnancy.

Labour and birth.

Post natal period.

Conclusion.

References.

Introduction to Prevalence of Tocophobia in Pregnant Women

Pregnancy and childbirth can be extremely difficult for a woman, both in terms of the physical discomforts involved as well as the psychological aspects. In addition, transitioning to parenthood is also a fairly vulnerable time, with recent reports showing that more than 9% of women experiencing acute signs of mental stress during the process (McLeish & Redshaw, 2017). Consequently, the role of health professionals in this regard is extremely important. Ranging from the provision of maternal care to looking after the emotional well being of the woman, health professionals have a diverse array of roles and responsibilities throughout the continuum of pregnancy. The current study highlights the different barriers and enablers of emotional well being throughout pregnancy, labour and birth and the postnatal period while evaluating the role played by health professionals.

Role of A Health Professional in Promoting Maternal Emotional Well Being

It is fundamentally well recognised in clinical research that women can be at heightened risks of mental health problems and emotional distress during the period of pregnancy. However, studies suggest that mental health screenings for pregnant women usually take place at a single point in time, thus failing to represent the actuality of how women feel throughout the period (Fancourt & Perkins, 2017). Expectant mothers go through a plethora of different emotions and feelings, and typically tend to overlook the emotions while prioritising the growing baby. The role of medical health professionals is supporting the emotional well being of these women is of paramount importance given the difficulties involved in the process of pregnancy. Nurses and midwives not only provide the necessary emotional support to the expectant mothers but also look after the different physical and physiological aspects involved from the peri natal period to the post natal period (Leahy-Warren, Newham & Alderdice, 2018). The following segments speak about the different enablers of emotional well being as well as the barriers along with how health professionals can support the emotional well being within expectant mothers.

Pregnancy

The stage of pregnancy is the first step in the continuum of childbirth, where the baby is conceived in the womb of the mother. Naturally, the entirety of the focus, both physical and emotional, lies on the growing foetus in the expectant mother’s uterus. The fear of child birth is also extremely prevalent and is usually conceptualised as a form of anxiety. Statistically speaking, about 25% of expectant mothers in Australia suffer from anxiety related to the fear of child birth and the related complications (O'Connell et al. 2017). Naturally, the fear of childbirth manifests as a major barrier towards the emotional well being of a mother during the peri natal period. Chances of miscarriage or losing the baby further play on the mind of the woman, which only goes on to increase the levels of stress and discomfort over time. In addition, excessive emotional distress caused due to the fear of childbirth also results in physical changes in the mother’s body and can even result in premature deliveries and babies with dangerously low birth weights (Ionio et al. 2016).

In terms of an enabler, the meaningfulness associated with being a mother is one of the most prominent factors that play in the mind of the expecting woman. The process of childbirth is extremely tedious and can be filled with challenges and difficulties. However, the process is arguably the most valuable for a woman when looked at from an emotional perspective as being a mother leads to an unprecedented amount of joy and contentment that cannot simply be compared to any other human experience. Bélanger-Lévesque et al. (2016) argue that several women also witness a higher degree of spiritual well being when going through the process of childbirth, especially in terms of a successful delivery and coming out of the process together with the father. Furthermore, studies carried out by Bäckström et al. (2018) show that expectant mothers feel the most amount of joy during the first six months of being pregnant, where family support and other mechanisms lead to reduction in the feelings of stress and anxiety.

Discussing how health professionals such as doctors, nurses and midwives can contribute to the emotional well being of expectant mothers, the primary role is related to being well equipped towards the provision of mental healthcare. The key aspects in this regard include the different levels of knowledge and the skills of how emotional care can be given to expectant mothers along with the willingness (Mirzakhani et al. 2020). Strategies could include early screening of mental well being and regular monitoring through follow up checking sessions. Maintaining a positive attitude towards problems associated with mental health and comprehending the different functionalities and working imperatives is extremely critical to ensure that the emotional well being of the mothers are prioritised (Erfina et al. 2019). Counselling skills and delivering professional guidance the women suffering from childbirth related distress positively are major requirements that nurses and midwives should strive to engage in.

Labour and Birth

The process of labour and birth is arguably the most difficult stage when discussing emotional well being of expectant mothers and the continuum of pregnancy. The concept of MFA or maternal foetal attachment has also been discussed extensively, especially when evaluating the emotional well being of expectant mothers during the later stages of pregnancy (Petri et al. 2018). It predominantly comprises of the thoughts and fantasies that mothers tend to have with regards to the unborn baby and acts as one of the major barriers of emotional well being. In addition, pregnancy fatigue and hormonal imbalances tend to reach their peaks, extending added pressure onto the expectant mothers both in terms of their psychological as well as emotional well being. Studies have shown that women tend to be the most vulnerable during this stage and it is very important for the support systems in the forms of the family, husband or partner, medical professionals and others to be supportive towards her vulnerabilities (Rovas, Baltrusaityte & Drupiene, 2017). Chronic stress and depressive symptoms are very common in the later stages of pregnancy, which further hints at the significance of the role of health professionals in ensuring that the emotional well being of the mother is maintained.

Discussing the enablers of emotional well being during labour and childbirth, peersupport has been one of the most widely studies aspects that act as enablers and allow mothers to become more comfortable with the whole process. The lack of social support has been stated as one of the most prominent factors that cause pregnancy stress and other anxieties related to giving birth to the child (Bulgakov et al. 2018). Furthermore, the intensity of the factors is typically higher during the later stages of the pregnancy continuum, when the mother nears the date of delivery. In terms of peer support strategies enabling the emotional well being of expectant mothers, most studies propose that bringing together affected women and providing a safe environment where they are comfortable in sharing their opinions can be extremely beneficial (McLeish & Redshaw, 2017). Physical discomfort is also very common during labour where the joints begin to feel loser and women gain weight. It could lead to further self esteem and self confidence issues that go on to deteriorate the emotional well being and eventually lead to complications in the process of childbirth. Peer support groups allow the mothers to limit the feelings of inadequacy while simultaneously benefitting the process of labour and childbirth through preparation and medical comprehension.

The role of health professionals during the labour and childbirth stage of the pregnancy continuum is largely associated with ensuring that the delivery process is carried out safely and all the threats to the mother and the baby are eliminated to the fullest possible extent. While the process has undergone numerous technological advancements and modern development, a certain degree of risk is always prevalent until the mother and the baby are out of danger (Lundgren et al. 2020). Labour contractions can be extremely significant both in terms of the physical as well as the psychological aspects, and health professionals must be well equipped to respond in the most appropriate manner possible. The process of childbirth can be fairly complicated and requires the assistance of a variety of different health professionals such as dieticians, sonographers, anaesthetists and others. It is imperative that all the professionals involved carry out their duties effectively with diligence and with responsibility.

Post Natal Period

The post natal period can also be extremely stressful and difficult for the mother, especially since the delivery has already taken place and the body has gone through a number of different changes and alterations. Depressive and anxiety symptoms are extremely common within new mothers that have recent given birth. In terms of the barriers to emotional well being, one of the most prominent aspects that have been the subject of several researches and longitudinal studies is the discomfort faced by women when sharing their mental health problems with the health professionals. Reluctance to acknowledge the symptoms is a very common practise and it eventually leads to substantial negative impacts on the woman in the post natal period (Bayrampour et al. 2017). Some of the key factors that contribute to the barrier include the social stigma and pressures that are associated with mental health along with the fear of losing custody of the child. Post natal symptoms of stress have also been linked with the inability to comfortably share mental and emotional well being issues with the doctor or the GP.

However, several enablers of emotional well being also exist in terms of ensuring that women do not suffer from anxiety and stress after having given birth. One of the most prevalent enablers is the aspect of physical exercise, both individuals as well as in support groups or peer programs. Encouraging new mothers to engage in physical exercise can boost both the physiological conditions of the body as well as the emotional well being of the mind (Harrison t al. 2018). The woman’s body goes through severe amounts of stress and discomfort for a long time during the continuum of the pregnancy, thus leading to fatigue and signs of stress. Physical exercise and pregnancy specific programs that work on social support and ensuring that the new mothers feel comfortable with the process of pregnancy are very important. Regular physical exercise post delivery also benefits the mother towards future pregnancies and conceptions.

In terms of the role of the medical and health professionals to assist women with emotional well being during the post natal period of pregnancy, constant guidance along with the provision of post pregnancy well being plans can be extremely effective. Health professionals must constantly maintain a positive attitude and ensure to deliver positive guidance and support to the new mothers. Post pregnancy well being plans has been widely acknowledged within clinical studies as being extremely beneficial for new mothers to combat symptoms of post pregnancy stress and emotional trauma (Spelke & Erika Werner, 2018). Naturally, it is imperative for health professionals to engage in the best practises and ensure every possible form of support to the new mothers to upkeep her emotional well being as well as that of her baby’s.

Conclusion on Prevalence of Tocophobia in Pregnant Women

In conclusion, the different roles and responsibilities of health professionals were evaluated in the context of the emotional well being of expectant mothers during the continuum of pregnancy. The three stages of pregnancy, labour and child birth and post natal period were incorporated in terms of the different enablers and the barriers of emotional well being. The most prominent barriers included discomfort to share mental health issues with health professionals, foetal attachment and the fear of childbirth. Similarly, the key barriers that were identified included peer support programs, physical exercise and the meaningfulness associated with being a mother and giving birth to life. The role of the health professionals was also identified to be extremely significant and included several responsibilities such as engaging in best practises, providing professional care and guidance and prioritising the mother and her unborn baby at all times.

References for Prevalence of Tocophobia in Pregnant Women

Bäckström, C., Kåreholt, I., Thorstensson, S., Golsäter, M., & Mårtensson, L. B. (2018). Quality of couple relationship among first-time mothers and partners during pregnancy and the first six months of parenthood. Sexual & Reproductive Healthcare, 17, 56-64.

Bayrampour, H., McNeil, D. A., Benzies, K., Salmon, C., Gelb, K., & Tough, S. (2017). A qualitative inquiry on pregnant women’s preferences for mental health screening. BMC pregnancy and childbirth, 17(1), 339.

Bélanger-Lévesque, M. N., Dumas, M., Blouin, S., & Pasquier, J. C. (2016). “That was intense!” Spirituality during childbirth: a mixed-method comparative study of mothers’ and fathers’ experiences in a public hospital. BMC Pregnancy and Childbirth, 16(1), 294.

Bulgakov, A. V., Babieva, N. S., Levanova, E. A., Gridyaeva, L. N., Erofeeva, M. A., Sokolovskaya, I. E., & Davidyan, L. Y. (2018). Specific features of psycho-emotional states of working women during pregnancy. Electronic Journal of General Medicine, 15(6).

Erfina, E., Widyawati, W., McKenna, L., Reisenhofer, S., & Ismail, D. (2019). Adolescent mothers' experiences of the transition to motherhood: An integrative review. International journal of nursing sciences, 6(2), 221-228.

Fancourt, D., & Perkins, R. (2017). Associations between singing to babies and symptoms of postnatal depression, wellbeing, self-esteem and mother-infant bond. Public Health, 145, 149-152.

Harrison, A. L., Taylor, N. F., Shields, N., & Frawley, H. C. (2018). Attitudes, barriers and enablers to physical activity in pregnant women: a systematic review. Journal of physiotherapy, 64(1), 24-32.

Ionio, C., Colombo, C., Brazzoduro, V., Mascheroni, E., Confalonieri, E., Castoldi, F., & Lista, G. (2016). Mothers and fathers in NICU: The impact of preterm birth on parental distress. Europe's journal of psychology, 12(4), 604.

Leahy-Warren, P., Newham, J., & Alderdice, F. (2018). Perinatal social support: panacea or a pitfall.

Lundgren, I., Berg, M., Nilsson, C., & Olafsdottir, O. A. (2020). Health professionals’ perceptions of a midwifery model of woman-centred care implemented on a hospital labour ward. Women and Birth, 33(1), 60-69.

McLeish, J., & Redshaw, M. (2017). Mothers’ accounts of the impact on emotional wellbeing of organised peer support in pregnancy and early parenthood: a qualitative study. BMC pregnancy and childbirth, 17(1), 28.

Mirzakhani, K., Khadivzadeh, T., Faridhosseini, F., & Ebadi, A. (2020). Pregnant women’s experiences of the conditions affecting marital well-being in high-risk pregnancy: A qualitative study. International Journal of Community Based Nursing & Midwifery.

O'Connell, M. A., Leahy‐Warren, P., Khashan, A. S., Kenny, L. C., & O'Neill, S. M. (2017). Worldwide prevalence of tocophobia in pregnant women: Systematic review and meta‐analysis. Acta Obstetricia et Gynecologica Scandinavica, 96(8), 907–920. https://doi.org/doi:10.1111/aogs.13138

Petri, E., Palagini, L., Bacci, O., Borri, C., Teristi, V., Corezzi, C., ... & Perugi, G. (2018). Maternal–foetal attachment independently predicts the quality of maternal–infant bonding and post-partum psychopathology. The Journal of maternal-fetal & neonatal medicine, 31(23), 3153-3159.

Rovas, L., Baltrusaityte, R., & Drupiene, I. (2017). The expectations and well-being of mother-to-be. Res Rep Gynaecol Obstet. 2017; 1 (2): 12-16 Res Rep Gynaecol Obstet 2017 Volume 1 Issue, 2.

Spelke, B., & Erika Werner, M. D. (2018). The fourth trimester of pregnancy: committing to maternal health and well-being postpartum. Rhode Island Medical Journal, 101(8), 30-33.

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