4.2 Adjustments of Family Members and Significant Others

The Father

Men undergo far less social preparation than women do for parenthood. With a close, supportive family relationship, the father can receive help in his adjustment if needed. Essentially, there is nothing to prepare him for pregnancy per se. There are no doctor's appointments, baby showers, or the physiologic changes of true pregnancy, although some men have expressed having some of the physical discomforts.

Introduction comes with the actual confirmation of the diagnosis of pregnancy, focusing more on impending fatherhood rather than the immediate state of pregnancy. Accepting the fact of pregnancy can raise excitement versus denial, that is, is it really his? This may cause guilt feelings over the discomforts his partner may be experiencing and may develop a new image of himself and his altered responsibilities.

The father is busily reworking the family budget to afford a child.

He may need encouragement to participate in the preparation for parenting. Encourage him to accompany his partner on prenatal visits. These visits can allow him to listen to the fetal heart tones (FHT). The growth and development of the fetus should be explained to him. He should also be included in office visits. Encouraging him to participate in classes on natural childbirth, parenting, and childcare are all important. Allow the father to participate in the labor and delivery process if he expresses a desire to participate.

Single Mothers

a. Reasons for Single Mothers.

(1) Unmarried. Several reasons contribute to the woman being unmarried. There may have been an unplanned pregnancy and a decision was made not to marry the father of the child. Pregnancy could be the result of a rape and the patient decided not to terminate the pregnancy. A patient just may desire a child without the commitment of a marriage.

(2) Widowed.

(3) Divorced. There may have been a planned pregnancy in an effort to save a marriage and it did not work. It may have been totally unplanned and the patient decided to continue with the divorce and the pregnancy.

(4) Separation. The father may be imprisoned, may be on military duty, or just separated from the mother.

(5) Surrogate mother. A woman who carries the fetus of the infertile woman's husband and then relinquishes the child to the couple for rearing. This is usually done for couples that have difficulty with delivering a viable fetus.

b. Counseling. Most single patients need counseling regardless of their age. This counseling is done to:

(1) Aid her to make realistic plans for her child's future.

(2) Provide assistance to help her cope with emotional stress especially during labor. If at all possible, have the patient find a friend to go through labor with her.

(3) Provide sources of counseling to include whether to have an abortion, keep the child, or put the child up for adoption.

(4) Inform her of community agencies that may help her financially with childcare and other responsibilities.

(5) Provide mechanisms to help her cope with loneliness.

c. Pregnant Teenager--Married or Not.

(1) The teenager is still growing. She needs a specialized nutritional nursing care plan. The diet should be adjusted to what and where she normally eats.

(2) There is a high mortality and morbidity for mothers under 20 years of age and their infants. Because of the lack of prenatal care, she may try to hide the pregnancy.

(3) The teenager lacks compliance with instructions and lack of physical and psychological maturity. She has not yet achieved physical and psychological maturity.

Factors Influencing the Role of the Unwed Father

a. Economic--Can He Support a Child. Does he have a job? Is he married with another family to support? What is the age of the father? If a teenager, is he still in school?

b. Social Implications. These implications indicate the reaction of the news by his peers. Will the pregnancy force an early marriage? If married to someone else, how will this affect that relationship?

c. Psychological Response.

(1) May question whether he is the father.

(2) May experience a sense of loss or grief if he cannot be involved with the child. In some states, adoption without his consent may be allowed.

(3) May experience anger from the girl, her or his parents.

(4) May affect his relationship with another female.

Factors Affecting the Parents of the Unwed Mother and Father

The parents of the unwed mother and father are also important. They may be concerned with the following reactions/emotions:

a. Rejection or neglect from family or friends.

b. May feel exposed to judgmental attitudes of medical and nursing personnel over how they could have let this happen.

c. May feel guilty for what happened.

d. May face financial burden, especially if they decide to keep or adopt the child.

e. May face a permanent loss of a grandchild if the child is given up for adoption.

f. May face loss of relationship with their child as a result of the decision made.

Special Needs of Siblings

The response of siblings to pregnancy varies with age and dependence needs. Open communication with siblings will be very beneficial. Inform the parents to:

a. Prepare children for the arrival of the newborn.

(1) Consider ages and personalities when talking with children.

(2) Inform older children first, but do not leave out the younger ones. Children understand far more than you may think.

(3) Emphasize that the baby is not replacing anyone but is an addition to be loved by all.

b. Make physical changes to the home if necessary.

(1) Changes should be made well in advance, especially if it means changing siblings room or bed arrangements.

(2) Include children in the changes and adjustments.

c. Prepare children for the separation from their mother during the delivery.

(1) Evaluate hospital sibling visitation policies in advance.

(2) If available, let siblings go meet the newborn and see their mother in the hospital.



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