Sunday, 26 June 2016

Contemplations on the Tasks of Motherhood: 1976 - 2016

Rita H. Pickler, Editor

In the first volume of the Journal of Advanced Nursing, author, researcher, theorist, and educator Reva Rubin wrote:
Pregnancy is more than a period of gestation, growth and development of the fetus…Pregnancy is also a period of identity reformulation, a period of reordering interpersonal relationships and interpersonal space, and a period of personality maturation (Rubin 1976).
Still true.

Rubin, whose work often seems overshadowed by that of her student, mentee, and fellow theorist, Ramona Mercer (i.e. Mercer & Ferketich 1990), introduced the concept of Maternal Role Attainment in the late 1960’s. She described the maternal role as a complex cognitive and social process that is learned, reciprocal, and interactive. Rubin developed her theory through a series of case studies over her many years as nurse and teacher. She observed how mothers used their senses to become familiar with their infants. She was an early proponent of “rooming-in” and other strategies to keep mother and baby together after birth. As a nursing student in the 1970’s, I remember reading, discussing, and applying Rubin’s work to my clinical practice.

But times change and theories, and ideas, go out of style and use. And in fact, much has changed about what we know happens physically, psychologically, and socially to women during pregnancy. We know much more than we did about how a woman’s well-being affects the fetus and her child. We know that what happens during pregnancy, and even before pregnancy, can have long-lasting effects on both mother and child.

Poor pregnancy outcomes throughout the world continue to exact a toll in terms of prematurity, congenital illness, and lifelong risk for poor health. So, we might be wise to rethink Rubin’s “tasks” as important to the repertoire a pregnant woman needs in order to traverse the gap to motherhood. As a nurse long interested in promoting healthy birth outcomes, this re-reading of Rubin’s paper from 30 years ago has given me fresh ideas about ways to facilitate the work of maternal role attainment. For although the language and yes, some of the ideas need refreshing, most certainly the general notion that promoting maternal health and well-being will lead to improved health and well-being for the world’s children will never be out of style.


References

Mercer, R.T, & Ferketch. (1990) Predictors of parental attachment during early parenthood.
Journal of Advanced Nursing, 15, 268–280, DOI: 10.1111/j.1365-2648.1990.tb01813.x

Rubin, R., (1976) Maternal tasks in pregnancy. Journal of Advanced Nursing, 1, 367-376.



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