Trinity University of Asia - Graduate School

EFFECTIVENESS OF FATHERS CLASS IN PRE-NATAL CARE

OF PRIMIGRAVID TEENAGERS

Submitted by:
PARADA, Rodrigo Antonio J.

OBJECTIVES
By the end of this study, the researcher will be able to:
-

Identify the different effects of Fathers cooperation in prenatal care of

teenage mothers.
Distinguish the coping mechanisms fathers use in the cycle of pregnancy.
Compare the effects of fathers class from mothers class in prenatal care.

SIGNIFICANCE OF THE STUDY

Pregnancy is

the

an embryo or fetus,

in

development
a

of

one

woman's uterus.

or

more

It

is

offspring,
the

known

common

as

name

for gestation in humans. A multiple pregnancy involves more than one embryo or fetus
in a single pregnancy, such as with twins.
Childbirth usually occurs about 38 weeks after conception. In women who have a
menstrual cycle length of four weeks, this is approximately 40 weeks from the start of
the last normal menstrual period (LNMP). Health authorities recommend that women
not artificially begin delivery with labor induction or caesarean section before 39 weeks
as this amount of time is considered "full term" for the child to develop. Human
pregnancy is the most studied of all mammalian pregnancies. Conception can be
achieved through sexual intercourse or assisted reproductive technology.
An embryo is the developing offspring during the first 8 weeks following
conception, and subsequently the term fetus is used until birth. In many societies'
medical or legal definitions, human pregnancy is somewhat arbitrarily divided into three
trimester periods of three months each, as a means to simplify reference to the different
stages of prenatal development. The first trimester carries the highest risk
of miscarriage (natural death of embryo or fetus). During the second trimester, the
development of the fetus can be more easily monitored and diagnosed. The third
trimester is marked by further growth of the fetus and the development of fetal fat
stores. The point of fetal viability, or the point in time at which fetal life outside of
the uterus is possible, usually coincides with the late second or early third trimesters;

babies born at this early point in development are at high risk for having medical
conditions and dying.
In the United States and United Kingdom, 40% of pregnancies are unplanned,
and between a quarter and half of those unplanned pregnancies were unwanted
pregnancies. Of those unintended pregnancies that occurred in the US, 60% of the
women used birth control to some extent during the month pregnancy occurred
Teenage pregnancy is pregnancy in human females under the age of 20 at the
time that the pregnancy ends. A pregnancy can take place after the start of
the puberty before first menstrual period, but usually occurs after the onset of periods.
In well-nourished girls, menarche usually takes place around the age of 12 or 13.
Pregnant teenagers face many of the same obstetrics issues as other women.
There are, however, additional medical concerns for mothers aged under 15. For
mothers aged 1519, risks are associated more with socioeconomic factors than with
the biological effects of age. Risks of low birth weight, premature labor, anemia,
and pre-eclampsia are connected to the biological age itself, as it was observed in teen
births even after controlling for other risk factors (such as utilization of antenatal
care etc.).
In developed countries, teenage pregnancies are often associated with social
issues, including lower educational levels, higher rates of poverty, and other poorer life
outcomes in children of teenage mothers. Teenage pregnancy in developed countries is
usually outside of marriage, and carries a social stigma in many communities and
cultures. By contrast, teenage parents in developing countries are often married, and
their pregnancies welcomed by family and society. However, in these societies, early
pregnancy may combine with malnutrition and poor health care to cause medical
problems.
Teenage pregnancies appear to be preventable by comprehensive sex
education and access to birth control. Abstinence-only sex education does not appear
to be effective.

Mothers classes are intended for new mothers to learn more about parenting
and motherhood. Some of the topics tackled include the convention of the right of the
child, indigenous cooking practices, and healthy food. The mothers are also involved in
discussions on child diseases and health and child abuse. The mother-participants also
discuss their situation with their children at home with other concerns.
Volunteer Barangay Health Workers (BHW) facilitate all the classes which are
held in one Purok of the barangay for a given period of time. They make sure that the
topics are discussed properly and thoroughly for the benefit of the mothers.
These volunteer BHWs are mostly women who are residents of the barangay.
According to Santos, the Mother Class helps not only the mothers in the community but
also the BHWs. She admits, that they too, learn and get additional information on how
to handle and raise their kids in terms of what to feed them and what to do when they
get sick.
The researcher will conduct this study because the researcher would want to
look for ways to decrease the number of teenage pregnancies or if not decrease it, be
able to educate not only teenage mothers but also the teenage fathers.
The target respondents of the study are the teenage mothers and fathers of 5
barangays in Paranaque who go on regular check-ups in health centers, lying-ins, and
Ospital ng Paranaque.

Maternal Attainment Role Theory (Ramona Mercer)

First proposed in 1991 by nursing theorist Ramona Mercer, a pediatric nurse

manager, educator and clinician with extensive experience in maternal child health, the
Maternal Role Attainment Theory is a model that describes the processes through which
a woman develops maternal identity and bonds with her child. Mercer first developed
the theory as a framework for implementing the nursing process in the care of nontraditional mothers, such as adoptive or foster mothers or those who were unexpectedly
thrust into a mothering role (for example, through the illness or death of a family
member.) However, the model also is a useful framework through which nurses can
assess, prioritize and address the needs of all new mothers, especially those who are
dealing with unusual stressors, such as a sick infant, personal health issues, financial
difficulties, postpartum depression or a lack of psychosocial support.
Concepts
The primary concept in Mercers theory of Maternal Role Attainment (revised to
Becoming a Mother in her 1995 book Becoming a Mother: Research on Maternal
Identity from Rubin to the Present) is that motherhood is a developmental and
interactional process through which the mother and child bond over time. She describes
four distinct phases in the process, the names of which she revised in 2004.
1. Commitment, Attachment and Preparation (formerly the Anticipatory Stage)
During this initial stage the mother-to-be begins to adjust to the anticipated
realities of her new role. This stage includes learning the social expectations
associated with motherhood, adapting to the physical and physiological changes
of pregnancy, fantasizing about motherhood and dealing with health concerns,
including pre-natal care and preparation for childbirth.
2. Acquaintance, Learning and Physical Restoration Stage (formerly the Formal
Stage) The stage immediately after childbirth, adoption or bringing a new child
into the home, this is the stage during which the new mother adapts to her role
by modeling learned behaviors and conforming closely to social and family
norms.

3. Moving towards a New Normal (formerly the Informal Stage) This is the period
in which the mother begins to develop her own maternal identity and becomes
more comfortable with her decision-making and mothering skills.
4. Achievement of Maternal Identity (formerly the Personal Stage) This final
stage, which typically occurs at about four months after birth, is the point at which
the new mother has successfully integrated prior learning with personal
experience. She feels confident, competent, and accomplished in her role and
begins to fully experience the joy of motherhood and secure attachment to the
child.
Mercer theorized that these stages are sequential, but that each woman moves through
them at her own pace. Additionally, she believed that maternal identity and attachment
cannot exist independently of each other: that is, maternal identity develops
concurrently

and

in

tandem

with

attachment

to

the

child.

1. Influences - Mercer describes multiple factors that influence women as they

move through the process of attaining maternal identity. These can be broken
down into four primary areas: birth experience, social stressors, self-concept and
health status.
2. Birth experience - Although a positive birth experience contributes to and
strengthens the mother-child bond, many new mothers feel disappointment, guilt
or inadequacy when the birth experience fails to live up to their expectations or
what they perceive to be the norm. Prematurity, an unplanned Caesarean birth or
other medical complications can negatively impact the new mothers attitude
towards her infant and limit her ability to bond with the child.
3. Social Stressors -Social support is an important factor in the development of
maternal identity. New mothers who receive appropriate guidance and

information, emotional support and appraisal of their parenting skills feel

competent and confident. Conversely, a lack of social support can lead to
feelings of inadequacy, confusion, resentment and guilt, all of which have an
adverse effect on maternal attachment and identity.
4. Self-concept -This is a broad term that includes factors such as self-esteem,
self-worth and the mothers perception of her abilities as a caretaker for her child.
Issues such as changing body image and sexual desirability can profoundly
affect a womans self-concept immediately after giving birth. Additionally, role
conflicts, such as the desire to go back to work versus the desire to be a good
mother often surface at this time.
5. Health Status - The health status of both the mother and the infant are essential
components of developing maternal identity. For the new mother, issues ranging
from episiotomy pain to postpartum depression can have an impact on her ability
to care for and relate to her child. Conversely, a sick or disabled infant who is
confined to the neonatal ICU is both physically and emotionally isolated from the
mother, which can pose a significant barrier to attachment during the first days
and weeks of the childs life. Furthermore, a childs temperament or ability to
respond to maternal cues can negatively, albeit unconsciously, impact the
mothers emotional response and attachment to the child.

Nursing Implications

In more than two decades since Ramona Mercer first published her theory on Maternal
Role Attainment, much has changed in our understanding of maternal-child health.
Nevertheless, Mercers basic premise and its implications for nursing practice remain
sound. As the health care practitioners who are most closely aligned with women in the
pre-natal and post-natal periods, nurses are uniquely equipped to assess, prioritize and
address the needs of women who are striving to meet the demands of motherhood in an
increasingly complex andin many waysincreasingly isolated world. Applying the
nursing process to any of the factors that influence the new mothers adaptive processes
is one of the professions most enduring challenges and one of the most important, for
the future of our children and our planet depend to a very great extent on our ability to
foster the essential bond between mother and child.