1. Mrs.SUBITHA BABU
M.Sc (N)OBG
NURSING

2. INTRODUCTION
• Pregnancy is an experience full of growth, change,
enrichment, and challenge.
• Fears and expectations about becoming parents.
• Emotions in both mother and father.
• Pregnancy and child birth are events that touch
nearly every aspect of human experience.
• Biologic, psychological, social and culture
individual adaptations to child bearing on each of
these levels may be quite different depending on
age, health, socio-economic status and cultural
background of the women and her family.

3. FIRST TRIMESTER A DA PTA TIONS
•Ambivalence
•Introversion or
narcissism
•Acceptance of
pregnancy
Need extra emotional support
from family members

4. AMBIVALENCE
• Most of half of the pregnancies are
unintended and unexpected
• Once the pregnancy is confirmed many
women have conflict feeling is known as
ambivalence.
• Pregnancy cause permanent life changes
for woman
• Primi mothers feel unsure of their ability
to be a good parent
• Multi para may be apprehensive about
pregnancy which will affect her
relationship with her children.

5. INTROVERSION/NARCISSISM
• Many women become increasingly concerned about
heir ability to protect and provide for the fetus.
• Undue preoccupation with oneself is narcissism
• Concentration on the self and body is introversion
• Selecting right foods to eat
• Primi mothers wonder about the infant and looks
baby pictures and eager to hear stories what they
were like as infants
• Multi paras know more about infants but they are
concerned with child's acceptance by siblings

6. A CCEPTANCE OF PREG NANCY
• Accepting the pregnancy isone of
the first changesa women must make
for a successful transition in life style.
• A woman who cannot accept the
pregnancy will find it very difficult to
accept the changes necessitated by
pregnancy, child birth and interaction
with the new born.

7. CONTD.
.
The areas to be assessed in acceptance of
pregnancy
•Extent to which the pregnancy was planned and wanted by the
woman and her partner.
•Amount of time the woman in happy versus depressed using
the pregnancy
•Amount of reported discomfort during pregnancy and the
woman's response to the discomfort
•Extent to which the woman accepts or rejects in her body

8. SECONDTRIMESTER ADAPTATIONS
•Role assumption
•Self image and
body image during
pregnancy
•Maternal role
attainment

9. ROLE ASSUMPTION
•Assuming and adopting to the role of
mother are parts of a long term process.
•The psychological changes a woman
undergone during pregnancy that enable
her assume the maternal role actually
build a life long process of informal
socialization of learning a feminine
identify

10. SELF IMAGE ANDBODY
IMAGE DURING PREGNANCY
• Psychologic change a woman undergoes during
pregnancy are self image and body image.
• Self image and body image will be different,
depending on the woman’s trimester of pregnancy.
• Three interdependent spheres of self that influence
the psychological transition to role of mother
1.the ideal self,
2.the self image, and
3.the body image

11. CONTD…
• Ideal self is composed of all the attributes,
qualities and images a person would like to
have and hope to include the self.
• Self image refers to the more reality oriented
active self, it is the self that interfaces with
real world, here and now.
• Body image during pregnancy has to do the
woman’s perception of her size, how she
moves and her own physical beauty or
ugliness.

12. MATERNAL ROLE
ATTAINMENT
• Maternal role attainment, that acquisition of the
mothering role, is described as process that begins
prenatally and ends with formation of a maternal
identify during the infants first years.
• For first time mothers, it is a process in which the
mother achieves competence in the role and
integrates the mothering behaviours in to her
established role set, so that she is comfortable with
their identify as a mother

13. THIRD TRIMESTER ADAPTATIONS
•Lack of knowledge
and preparation for
maternal role
•Establishing a
relationship with the
fetus
•Fantasy during
pregnancy

14. LACK OF KNOWLEDGE
AND PREPARATION FOR
MATERNAL ROLE
• In modern nuclear family, guidelines for parenting
are confusing and role models less apparent than in
some other family types stressors include the lack of
guidelines for successful parenting.
• Some women may feel they have trouble
concentrating or focussing on learning new material
or skills at this time
• Teaching should be clear and concise to help women
learn most easily.

15. ESTABLISHING A
RELATIONSHIP WITH THE
FETUS
• During the course of pregnancy and
the transition to a new life style and
the maternal rolesa motherneedsto
establish a relationship with the infant
to be.
• The relationship with fetusisthrough
to be the first stage in establishing a
relationship with the new-born and
then the child.

16. DREAMS/FANTACIES
DURING PREGNANCY
• Experience strange dreams about childbirth, new born
baby, and life as a new mother.
• Baby's sex and nightmares .
• Fantasy is an important factor in assumption of the
maternal role and transition in to the life style of women
and child.
• Fantasies during pregnancy allow a women to have a
“dress rehearsal” for labor and delivery and mothering
of an infant.
• Realistic fantasies of potential problems that might
occur during pregnancy and labour and delivery can
help the women prepare herself to cope with these
problems or complications, should they occur

17. CULTURAL ASPECTS
I
N PREGNANCY
• DIET:-Cultures encourages the pregnant
women to maintain a diet to generally
considered a normal one for that is generally
considered a normal one for that culture.
• Food taboos are common, usually reflecting a
cultural belief that certain foods are unclean
or fears that ingesting certain food will
produce undesirable physical characteristic in
the new born.

18. CONTD…
• For example pregnant women avoid eating chicken
crab, eggs drank, rabbit and blemished fruits as
those may harm baby’s appearance some cultures
that subscribe to hot and cold theory of illness such
as the Hindus, view pregnancy as a hot state
• So cold goods such as milk and milk products sour
foods and vegetables are encouraged. Hot foods
such as chillies, ginger and animal products are
believed to cause miscarriage and fetal abnormalities

19. ACTIVITY ANDREST
• Must cultures encourage a pregnant women
to maintain normal activities, excluding
strenuous works, although some encourage
more rest during pregnancy.
• Norms for sexual activity during pregnancy
are more variable ranging form no change to
strict prohibition of sexual intercourse
through the second half of pregnancy

20. CONTD….
• Postpartum period is characterized by more
restrictions on maternal activity. Most cultures
encourage a period for rest. Some as long as 40
days, during which time the mother is confined
to her home, often to her bed.
• Some cultures regard the post partum woman as
unclean and prohibit her participation in
religious activities when this is the case, there is
usually provision for a ritual cleansing for both
mother and infant at the end of the confinement
period

21. PREPARATION FOR BIRTH
• Preparations for the actual birth may include
intensive preparation of the house and actual
physical preparations of the mother through specific
exercises, religious practices or diet.
• Some cultures view preparation in advance of the
event as potentially dangerous. Advance preparation
or even referring to the fetus by name may be seen
as tempting fate and making the mother and fetus
vulnerable to evil influences.

22. CULTUR A L A SSESSMENT
• Question to help the nurse understand the family belief
about appropriate care during pregnancy include..
❖How will you and your family prepare for the baby.
❖What concerns do you have about the pregnancy
❖What would provide the greatest assistance
❖Where do you obtain most health care information
❖What foods are encouraged or discouraged?
❖Who will be with you during labour and birth of the
baby?
❖Who will help you at home during pregnancy and after
birth?

23. CULTU R A L NEG OTIATION
•Cultural negotiation also
involves sensitivity to specific
concerns.
•Eg nurses must be aware about
Islamic law governing modesty
when caring Muslim women.

24. CONCLUSION
•psychological changes that occur
during pregnancy will help both
expectant mothers and expectant
fathers to understand themselves
and their partners better.

25. THANK YOU