Understanding maternal development was Re: Re: postpartum service line.

[Guest guest]

Margaret, you raise many good points. I agree that new mothers need to be nurtured in their mothering role, not have their mothering role taken over by others. I've seen similar things happen with breastfeeding: the mother can breastfeed in the clinic where others get the baby latched, but cannot breastfeed outside the clinic because she has not been taught the skills of how to do so. How long will a mother breastfeed under such circumstances?

The nature of maternal development (e.g., the "formal" stage") often makes it difficult or impossible for a new mother to be able to stand up to others (Mercer 1981, 1985; Rubin 1984). And, a mother's particular place in the spectrum of "women's ways of knowing" (e.g., silence, received knowledge) can also make it difficult or impossible for her to be able to question the authority of others, experiment, and make her own choices (Belenky, Clinchy, Goldberger & Tarule 1986). If lactation consultants, other health care providers, postpartum doulas, nannies, etc. don't understand and respect these developmental processes, they will not be able to provide the support that mothers need and deserve as they learn to take on the maternal role (Good Mojab 2005).

Belenky, M., Clinchy, B., Goldberger, N., and Tarule, J. Women’s Ways of Knowing: The Development of Self, Voice, and Mind. New York: Basic Books, 1986.

Good Mojab, C. The women behind the breasts: The context of infant feeding issues. Western Kentucky Breastfeeding Coalition 2005 Conference, "Raising Awareness: Current Issues in Lactation." Bowling Green, Kentucky, USA. August 26, 2005.

Mercer, R. (1981). The nurse and maternal tasks of early postpartum. Maternal Child Nursing Journal, 6, 341-345.

Mercer, R. (1985). The process of maternal role attainment over the first year. Nursing Research, 34(4), 198-204.

Rubin, R. (1984). Maternal identity and maternal experience. New York: Springer.

-- Good Mojab, MS clinical psychology, IBCLC, RLC, CATSM LifeCircle Counseling and Consulting, LLC Website: www.lifecirclecc.com Phone: Email: admin@... Ammawell Website: http://home.comcast.net/~ammawell Announcement only email list: ammawell-subscribe

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It would be wonderful to have more postpartum helpersavailable who focus on "mothering the mother" andhelping with meals, housework and errands. Becausewhat I tend to see is someone who comes in and takesover the baby-care so mother can "rest" and therebykeep her from getting comfortable in her new role. I'm sure you're aware of how loosely and incorrectlythe term "doula" is being used out there.I recently had a long visit with a mother with *zero*confidence in her abilities to breastfeed or deal withthis baby at all, and a two-week-old who wasn'tgaining well. During the two hours, the baby wasbeing changed, carried in a sling, soothed, etc, bythe doula, except when I would specifically get motherand baby together for breastfeeding, after which she'dhand the baby off again. The doula was very nice,obviously loved babies (who are infinitely moreappealing than housework, granted) and an expertbaby-soother -- but this baby didn't need to besoothed, she needed to be with her mother more. Ireally tried to stress the skin-to-skin, early cues,etc. and brought the doula into the conversation abouthow she could clear the decks and help the motherfocus on this -- but it's hard to say if anythingregistered.Of course it's different when someone hires a "babynurse" or worse yet, a "sleep trainer" specifically totake over baby-care at night. Recently a mother oftwins mentioned that the "night doula" was givingfortified breastmilk. Since the twins were born a bitearly, I assumed this was some hold-over from thehospital's use of fortifier (which sometimes goes onlonger than necessary). But it turned out that this"night doula" was adding powdered formula to the EBMso the babies would sleep longer, and "learn" to sleepthrough the night. Arrgghh! I then explained thatany fortification had to be done very carefully so asn

ot to overtax immature kidneys or upset the baby'sdelicate fluid balance, and that she shouldimmediately discuss this with her pediatrician (whoI'm glad to say was quite strong in her response, andthe mother fired the "night doula" (who unfortunatelyis still out there for the hiring.) I think thismother was uncomfortable with this arrangement anyway,or she wouldn't have asked.Sorry this has turned into a long rant. Mothers needsomeone to provide the space and time so they can getbreastfeeding off the ground and learn their new job. (That great book, "Breastfeeding Made Simple" explainshow in traditional societies provide a designated timeof rest and seclusion for new mothers and babies --that would be an excellent book to include indoula-training). I think mothers also need to beeducated on what they ask from their employees (somenew mothers are very deferential to the "baby nurse"),and be ready to def

end their own mothering turf. I wonder if somehow you could tap into the labor poolavailable among retirees, who might be trained asdoulas -- maybe advertising in one of those "betterthan 55" communities. A lot of vigorous women intheir late 60s or early 70s might appreciate this kindof flexible, part-time work with cute babies, whichwould come in short 1-3 week stints that would stilllet them travel, etc. as needed. A calm, older womanwho's a good cook might be a great helper. Margaret Wills__________________________________________________