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The Prenatal Period: Understanding Relationship Development

The Prenatal Period: Understanding Relationship Development. Priscilla Tait, MS, CNM, IMH-E. The Formation of Maternal Identity: Supporting Women in their Transition to Motherhood. Maternal Tasks of Pregnancy. Safe Passage Acceptance of Others Binding-in to the Child Giving of Oneself.

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The Prenatal Period: Understanding Relationship Development

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  1. The Prenatal Period: Understanding Relationship Development Priscilla Tait, MS, CNM, IMH-E

  2. The Formation of Maternal Identity:Supporting Women in their Transition to Motherhood

  3. Maternal Tasks of Pregnancy • Safe Passage • Acceptance of Others • Binding-in to the Child • Giving of Oneself

  4. 1st Trimester • Safe Passage Safety of self is more important than the baby

  5. 1st Trimester • Acceptance of Others The woman is realigning with the “idea” of being pregnant

  6. 1st Trimester Binding-in to the Child • Very little binding-in to the child • “Binds-in” to the idea of the pregnancy itself

  7. 1st Trimester Giving of Oneself • The Child is still an abstraction • She weighs the risks and benefits: What may be given with what may be taken away

  8. 2nd Trimester Binding-in to the Child • Quickening • All tasks are undertaken more seriously after movement is felt • Fetal movement transforms the baby to personhood

  9. 2nd trimester Safe Passage • Begins to be more protective of her unborn child

  10. 2nd trimester Acceptance of others • Progresses to focus on “the child” rather than the pregnancy

  11. 2nd trimester Giving of Oneself • Directly explores the meaning of the act of giving and of being given to

  12. 3rd Trimester Safe Passage • Concern is for self and baby • Seeks out information to ensure safe passage in labor and birth

  13. 3rd Trimester Acceptance of Others • Conditional vs. unconditional acceptance of others

  14. 3rd Trimester Binding-in to the Child • Grows tired of being pregnant • She loves the child but hates the pregnancy

  15. 3rd Trimester • Giving of Oneself • Gives and is given to • Begins the act of giving • Receives from others as a symbol of giving and receiving

  16. Adolescent Pregnancy • Relationship with the father of the baby is important • Social support • Knowledge of Infant Development • Maternal confidence

  17. Stern’s Motherhood Constellation • Life/Growth (concern for G&D) • Primary Relatedness (emotional engagement) • Supporting Matrix (support systems) • Identity Reorganization (transformation of self-identity)

  18. Questions: • “Will I be able to keep my infant protected and alive?” (Life/Growth) • “Will I be able to love my infant in a special way so that she/he will become ‘my baby’ and not just any baby?” (Primary Relatedness) • “Will I be helped in this task?” (Support Matrix) • “How will this experience shape my life?” (Identity Reorganization)

  19. Signs of difficulty with the maternal tasks: • Little or no prenatal care • High-risk health behaviors • Nothing prepared for the baby at term • Refers to fetus in negative terms

  20. High Risk Historical Factors • Unplanned/Unwanted pregnancy • Short interconceptional period • Previous traumatic birth • Previous pre-term birth

  21. High risk factors, cont. • Previous pregnancy or newborn loss • Previous loss of own mother (death, adoption, abandonment) • Current or past abuse • Depression • Substance Use/Abuse

  22. Maternal/Fetal Attachment Behaviors • Interacting with the fetus • Giving of self • Identifying the fetus(gender,naming) • Fantasizing or Attribution of characteristics

  23. Role of the IMH Specialist/Home visitor • Skillful screening and history taking • Empathic listening • Therapeutic use of self • Have a thorough knowledge of community resources for referral

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