6.08 Phases of the Restorative Period of Maternal Behavior Following Delivery

The restorative period is the postpartal period/time of delivery to the four to six week stabilization point.

The phases are referred to as the taking-in phase, taking-hold phase, and letting-go phase.

a. Taking-In Phase.

During this phase the mother is oriented primarily to her own needs. She primary focuses on sleeping and eating. She may be quite passive and dependent. The mother is reacting to the intense, physical effort expended during delivery and the intense, emotional effort required of her during labor. The mother does not usually initiate contact with the infant. This is not out of disinterest. It may result from her own immediate dependency. Nevertheless, she is taking-in information that helps her to identify the infant. She may use her finger-tip to touch her infant. This serves as one of the first steps in the identification process. She holds the baby facing her so they can explore each other’s face (in the face position). The mother relives the delivery experience which allows her to integrate it fully with reality, fully realized her baby is born, and to identify her infant as being outside and separate from her. This phase, taking-in phase, may last for a day or two. The nurse should plan activities so that the patient can rest as much as possible because failure to allow the patient to receive the necessary and earned rest may yield a “sleep hunger” which may be manifested by irritability, fatigue, and general interference with the normal restorative process. The father’s role is primarily being supportive of his wife and his family.

b. Taking-Hold Phase.

During this phase the mother strives for independence and autonomy, she becomes the “initiator.” She is concerned about her ability to control her bodily functions (that is, bowels, bladder, and if breast-feeding, concerned about adequate amount and quality of milk). She takes an active part in trying to control these functions. She is concerned about her ability to take care of her newborn. This phase is associated with a great deal of anxiety (especially by a new mother). She may have several mood swings. The mother might be involved in a lot of activity trying to accomplish tasks. Fatigue and exhaustion may occur if the mother is not helped to set realist expectations and limits for herself. The nurse is responsible to allow the mother to actually perform infant care tasks, reinforce all positive actions (do not impose yourself), and provide guidance, instruction, and demonstration, as necessary. Reassurance and explanation about infant care are especially needed in this phase. This phase lasts for about ten days (most of this phase is accomplished at home).

c. Letting-Go Phase.

Generally, this phase occurs when the mother returns home. The mother must accomplish two separations during this phase. The separations are to realize and accept the physical separation from the baby and to relinquish her former role of a childless person. The mother must adjust her life to the relative dependency and helplessness of her child. If she quits work, she must adapt (even if only temporarily) to less freedom, less autonomy, and less social stimulation. If she continues to work, she must handle the additional strain of finding sitters and meeting additional workload. The mother may experience a let-down feeling, which is called postpartal, or baby, “blues.” This is a form of depression that is usually temporary and may occur in the hospital.

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