Elsevier

JOGN Nursing

Volume 8, Issue 3, May–June 1979, Pages 164-170
JOGN Nursing

Principles and Practice
The High-Risk Mother Viewed in Relation to a Holistic Model of the Childbearing Experience

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The high-risk antepartal mother is, first, a woman facing the experience of childbearing and, second, a woman for whom this experience is defined as high risk. Too often, health professionals concentrate on the latter almost to the exclusion of the former. In this article a holistic model of the experience of childbearing, common to all women, is proposed. It takes into account relevant social, cultural, and psychological as well as physiological factors. The model is then related to specific problems that may threaten the successful outcome of pregnancy. Appropriate implications for nursing are also discussed.

Section snippets

A MODEL FOR THE CHILDBEARING EXPERIENCE

Rubin has emphasized that we must view childbearing as a multidimensional experience.2 She points to physiological, societal, psychological, and cultural factors that must be considered if a comprehensive, realistic view of childbearing is to be achieved. Yet when working with an individual mother, it is sometimes difficult for the nurse to take all of these factors into account. Therefore, a model incorporating these factors should prove useful as a framework within which the nurse can view

THE HIGH-RISK MOTHER

A basic assumption of the above model is that childbearing is a normal experience, that the pregnant woman and those related to her define the trajectory of childbearing in relation to common expectations of an uncomplicated pregnancy culminating in a healthy mother/baby pair. The Frisbee of a given pregnancy will land at a known location, at a known time, after traveling a known course; and behaviors of most of those related to this childbearing experience will be determined in terms of those

IMPLICATIONS FOR NURSING

The purpose of a conceptual model is descriptive. As such, it is not intended to be a prescription for how we should behave. Rather, it should help us, as professionals, to more fully describe the reality of the child-bearing experience and to organize our observations into a meaningful whole. Such knowledge, then, should form a sound base upon which we can intelligently build professional practice.

The use of the nursing process with high-risk mothers demands first that we accurately assess the

CONCLUSION

The ultimate effectiveness of nursing intervention depends on the way in which the woman accomplishes her childbearing task. A pregnancy culminating in a physically healthy infant and mother is desired. However, our aim must be to help each mother cope effectively with her particular childbearing experience, whatever its physical outcome. For, the way in which she copes with a current high-risk situation will profoundly affect her ability to function adequately in the maternal role throughout

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