A concept analysis of maternal role in pregnant adolescent

Abstract

Objective

The purpose of this study is to clarify the concept of maternal role in pregnant adolescent.

Method

The Walker and Avant's concept analysis (2005) was used in this study.

Results

The attributes are accepting pregnancy at young age, bonding and getting attached with their unborn baby, taking care of unborn baby, recognizing risk related to their pregnancy, dealing with emotions, and preparing for labor. The antecedents included: personal factor, environmental factors, and psychological factors. The consequences are improving adolescent health during pregnancy, increasing confidence, reducing the high risk of pregnancy at a young age, and giving birth safely. Empirical references to maternal roles of pregnant adolescent include their responsibility of the pregnancy, protecting unborn baby from harm, knowledge about pregnancy, changing behavior, and emotional well-being.

Conclusions

This concept analysis will help the author for developing instrument about the ability of pregnant adolescent to perform the maternal role during pregnancy.

Introduction

The issue of adolescent pregnancy is still a major issue worldwide¹ as there is high prevalence of the condition in many countries. Consequently, there is need for more attention from government and health care providers.

Identify uses the concept of maternal role

This aspect will explain the definition of maternal role from literatures and its theoretical perspectives.

Definition of maternal role from review of literatures

These are maternal role definition from the review of the literature. Naphapunsakul² defined the maternal role as a mother's behaviors and feelings in infant care which include confidence in providing care to the infant, having a mother–infant relationship, and satisfaction in the maternal role. Then Mercer³ defined it as an interaction and developmental process between mother and baby in childbearing. Pregnant women should be confident in performing the motherly roles with their infants.⁴ Also, Rubin⁵ defined maternal role as the tasks of a mother in preparing for the motherly role during pregnancy and one month after birth. And in short, a maternal role can be defined as a mother's ability to take the responsibility as an impending mother and roles performed to be healthy during the pregnancy and for the unborn baby.

Theoretical perspective of maternal role

In 1986, Ramona Mercer came up with a nursing theory, known as the Theory of Maternal Role Attainment. This theory has to do with maternal–child health and mothers’ role to the children. It explains how mothers develop to the role of babies’ keepers and this came on the premise that the roles played is based on the mother's experience which might be going on for years. More so, Mercer applied the role acquisition theory in developing this maternal role attainment theory through four progressive phases, which are: the anticipatory phase, the formal phase, the informal phase, and the role identity phase.⁶

The theory of maternal tasks in pregnancy by Rubin,⁵ also talks about maternal role. Rubin explained about the role expectations of mother and how to explore it long enough to develop a sense of playing the role, while also selecting the behavior to come up with while performing it. The theory also talks about how a mother can solve the problems that may arise during pregnancy. Rubin described that the psychological work of pregnancy is divided into four domains and these are: safe passage, acceptance by others, binding into the child, and giving of oneself.

Differentiating the concept of maternal role from other closely related concept

Many concepts are used in the theory of Maternal Role Attainment and this makes its uses practical in different academic disciplines but more importantly in the nursing profession. There are so many concepts of maternal role but the two major ones identified and most closely related to its understanding are maternal role attainment and maternal identity.

And these two were defined by Alligood and Tomey⁷ as follows.

Maternal role attainment is an interactional and developmental process taking place over a period of time, during which the mother becomes attached to the infant, acquires the needed competence in the care-taking tasks involved in the role, and expresses pleasure and gratification in it.

Maternal identity is defined as “having an internalized view of the oneself as a mother”.⁷

And understanding these two concepts, as defined above, is integral to understanding the basis of Mercer's work.

Determining defining attributes

Attributes are those characteristics associated with the concept of maternal role which include: (a) accepting pregnancy at young age, (b) bonding and attachment with the unborn baby, (c) taking care of the unborn baby, (d) recognizing risk related to the pregnancy, (e) dealing with emotions, and (f) preparing for labor.

Identifying antecedents and consequences

There are three antecedents related to the concept of maternal role and these are explained as follows.

Personal factors: The component of personal factors include: pregnancy condition, wanted or unwanted child, and knowledge/beliefs/culture.

Pregnancy condition: During this pregnancy period, most women usually experience nausea and often vomit. And this will decrease the woman's appetite for food. A study by Sohail and Muazzam⁸ found out that gestational age has a correlation with nausea during pregnancy and influences the behavior of these women.

Wanted or unwanted child: Pregnancy is a normal thing for a married couple but that is not the case for teens who are into open relationships. In South Africa, nearly one-third of the women were reported as having had a pregnancy in adolescent age, and most of these pregnancy were unwanted.⁹

Knowledge: Knowledge is one factor that affects the action to make a decision.¹⁰ Adolescents’ knowledge are limited when it comes to the role of mother during pregnancy.¹¹

Environmental factors: The environmental factors include social support and social economics.

Social support: Some studies showed that social support functions can boost the mother's confidence in performing the maternal role during pregnancy till the point of birth.¹² According to Turnage and Pharris,¹³ social support is an important aspect for these adolescents while transiting into the new role of motherhood.

Social economics: A number of pregnant adolescents are living in low social economic conditions and come from the poorest countries with low social status.¹ This in a way affects the important decisions made in such families.

Psychological factors: The psychological factors include stress and anxiety.

Stress and anxiety: Having a baby for adolescents when pregnant means an overall life change in terms of responsibilities from that stage to motherhood, and this period will cause them stress.⁹ However, the consequences are improving adolescent health during pregnancy, increasing confidence, reducing the high risk of pregnancy at a young age, and giving birth safely.

Constructing a model case

A model case includes all attributes of the concept and illustrates such¹⁴

Mrs. Rn is a 17 years old Indonesian, married, in 32 weeks gestation, and living with the husband, a 22 years old young man, in the parents’ house. This young woman regularly visits the health center for check up due to the love for the unborn baby. According to this pregnant woman, the regular taking of healthy food and vitamin was a priority and already prepared to deliver the baby in a private clinic.

Analysis

All attributes of maternal role illustrated by this case showed that Mrs. Rn was confident, had an understanding of the roles of prospective mothers and did not fail in taking proper care of the pregnancy.

Development of additional cases

Borderline case

Mrs. Dn is a 16 years old Indonesian, married, in 34 weeks gestation and living with the husband, a 21 years old young man in a rented house. This pregnant women attended clinic for medical check-up once three times all through. This young woman was happy with the pregnancy, took good food but did not take vitamin because of its nauseating effect and yet to pick the clinic for the delivery of the baby.

Analysis

This illustration relates to maternal role, but it does not represent all the attributes. Mrs. Dn takes care of the pregnancy but does not follow some of the suggestions of the health care provider and yet to pick the clinic for the delivery.

Contrary case

Mrs. An is 16 years old, married, also an Indonesian in 28 weeks gestation, living with the husband, a 20 years old young man, in a rented house. The husband works as an office boy with the government in a different town form their parents. This would-to-be mother only attended antenatal care once. Also, this young woman did not know how to take care of the pregnancy and had limited knowledge on it before coming for antenatal care in the community health center.

Analysis

Mrs. An felt had no knowledge on how to take care of the and so was unconfident to be a mother to the coming baby.

Defining empirical reference

The final step of Walker and Avant's method of concept analysis has to do with the empirical references. This talks about how the concept is to be measured or what the observation should look like in reality. This is the event that demonstrates the existence of the concept.

Empirical references to maternal roles of pregnant adolescent include the responsibility to the pregnancy, protecting the unborn baby from harm, having knowledge about it, changing behavior, and the emotional well-being.

Conclusions

Conclusively, the concept of maternal role was selected for this analysis because pregnant adolescents have been recognized as serious issues in terms of carrying out the motherly roles during pregnancies. And the various studies considered also present evidence of the consequences of unprepared maternal role. The desire of the authors is that the analysis of maternal role be beneficial for nurses and other health care providers in gaining a better understanding of the concept and implementing it in appropriate nursing activities so as to assess the pregnant adolescent role.