psychological and cultural aspect of pregnancy

nsg

1. MITTAL COLLEGE OF NURSING AJMER PSYCHOSOCIAL AND CULTURAL ASPPECT OF THE PREGNANCY MRS. SNEHLATA PRASHAR PRESENTED BY (LECTURER OBG) MS. POOJA CHOUHAN MCN BSC. NURSING (IV YEAR)

2. THE SINGLE MOTHER :- REASONS FOR SINGLE MOTHERS:- UNMARRIED :- several reasons contribute to the women being unmarried, there may have been an planned pregnancy a decision was made not to marry the father of the child. Pregnancy could man the father of the child. There may have been an unplanned pregnancy and a decision was made not to be terminate the pregnancy .a patient just may desire a child the commitment of a marriage. Widowed:- The focus is on loss immediate kin – spouse, child, parent and sibling in addition for a widow who did not work outside the home a husband absence leave no subject. D IVORCED :- there may be have been a planned pregnancy in an effort to save the marriage and it did not work. It may have been totally unplanned and the patient decided to continue with the divorce and the pregnancy.

3. SEPARATION :- the father may be in imprisoned may be on military duty, or just separated from the mother. SURROGATE MOTHER:- a women who carries the fetus of the infertile woman’s husband and than relinquishes the child to couple for rearing. This is usually done for couple that have difficulty with delivering a viable fetus.

4. Counseling Most single patient need counseling regardless of there age. This counseling is done to . Aid her to may realistic plans for her child future. Provide assistance to help her cop with emotional stress especially during labor. If at all possible, have the patient find a friend to go thought labor with her.

5. 3. Provide sources of counseling to include whether to have an abortion, keep the child, put the child up for adoption . 4. Inform her of community agencies that may help her financially with child care and other responsibilities . 5. Provide mechanisms to help her cop with loneliness .

6. PREGNANT TEENAGER- MARRIED AND UNMARRIED The teenager is still growing . She needs a specialized nutritional nursing care plan . The diet should be adjusted to what and where she normally eats . There is a high mortality and morbidity for mother under 20 years of age and there infants. Because of the lack of prenatal care, she may try to hide the pregnancy . The teenager lacks compliance with instructions and lack of physical and psychological maturity.

7. About 16 million girls aged 15-19 years give birth annually. 90% of them are in developing countries The characteristics of young mothers are common across the regions of the world: Little education, Rural dwelling, Low income

8. Babies born to adolescent mothers face higher risks Adolescents are at an increased risk for pre-term labour & delivery, compared to older women. Babies born to adolescent mothers are more likely to be of low birth weight. Babies born to adolescent mothers are at an increased risk of prenatal & infant mortality.

9. Potential risks to the adolescent mother's life prospects On the other hand, an unmarried pregnant adolescent may be driven away by her family, or abandoned by her partner & be left with no means of support.

10. UNWED MOTHER Unmarried mothers are of concern to people in very many societies partly because their behavior threatens the almost universal norm of bearing children only within a marital relationship and also because they pose a complex problem for the medical and social services. Despite this concern and the fact that many agencies, both social and medical, cater for their needs, little of what is known about unmarried mothers.

11. FACTOR INFLUENCING THE ROLE OF THE UNWED FATHER ECONOMIC - Can he support a child. Does he have a job? Is he married with another family to support? What is the age of the father? If a teenager, is he still in school? B. SOCIAL IMPLICATION – these implication indicate the reaction of the news by his peers. Will the pregnancy force and early marriage? If married to someone else how will this affect that relationship.

12. C. PSYCHOLOGICAL RESPONSE May question whether he is the father . May experience a sense of loss of grief if he cannot be involved with the child. In some states, adoption without consent may be allowed. May experience anger form the girl, her of his parents. May affect his relationship with another female.

13. Factor the parents of the unwed mother and father The parents of the unwed mother and father are also important. they may be concerned with the following reactions/emotions. Rejection or neglect from family or friends. May feel exposed the judgmental attitudes of medical and nursing personnel over how they could have let this happen. May feel guilty for what happened, may face financial burden specially if they decide to keep or adopt the child. May face a permanent loss of a grandchild if the child is given up for adoption may face loss of relationship with there child as a result of the decision made.

14. Domestic Violence Domestic violence is serious social problems, as its negative impact on both victim and members of her/his family, especially on children Studies have show the effects not only have immediately impacts but also have long- term effects. E.g. Abuse as a risk factor for sleep problems in adulthood

15. Domestic Violence during Pregnancy Studies found that about 4-8% of pregnant women experience some form(s) of IPV (including physical, psychological and sexual abuse), ranged from 1 to 20% Based on Fragile Families data: Physical abuse: 6% Psychological abuse: 29%

16. Effects of Domestic Violence Studies have shown physical violence has negative effects on maternal mental health and parenting skills (e.g. unable to provide warmth and engage with children) How about psychological abuse and economic abuse?

17. Violence During Pregnancy Overall Child health: both physical and emotional abuse were significant and negative predictors Child temperament: emotional abuse significantly affected child temperament, while physical abuse has no effects Emotional and psychological abuse is important factor of well-being

18. RISK FACTOR Thorough risk factor vary, some characteristics seems to increase the likelihood of violence. A. Individual:- A personal attributes associated with higher risk of violence include limited education, a young age, lower economic status, a history of abuse and substance use, and for partner violence negative attitude about women .

19. B. Family and relationship:- Within families, risk of violence increases with marital conflicts, male dominance, economic stress and poor family functioning. C. Community:- Within communities, the risk of higher there is gender inequality, and lack of community resources. D. societal :- on a broader level , higher risk is found in societies with traditional gender norms or a lack of autonomy for women , and where there are restrictive laws on divorce and ownership and inheritance of property , or when there is social break down due to conflicts or disasters.

20. PHYSICAL EFFECT OF VIOLENCE DURING PREGNANCY:- Insufficient weight gain Vaginal/cervical/kidney infection Vaginal bleeding Abdominal tenderness Hemorrhage Complication during labour Delayed prenatal care Miscarriage Low birth weight Rupture membranes Abruption placenta Uterine infection Death

21. HEALTH EFFECT BY VIOLENCE INJURY- Physical and sexual abuse by partner associate with injury DEATH :- Killed by family, suicide etc. SEXUAL AND REPRODUCTIVE HEALTH:- The violence against women is associate with sexually transmitted infection. Like Hiv -aids RISKY BEHAVIOUR :- Sexual abuse as a child is associate with higher rate of sexual risk taking (such as first sex at early age, multiple partners and unprotected sex). MENTAL HEALTH :- Violence and abuse increase risk of depression, post traumatic stress disorder, sleep difficulties eating disorders and emotional distress.

22. PREVENTION Improve educational status of the women and girls. Increase the opportunities for the girls or women . Provide sexual education at the early age to the girls Improving their self esteem and negotiating skills Reducing gender inequality Aware the girls and women about there rights and power Encourage women to fight against violent activities.

23. TEENAGE PREGNANCY Teen Pregnancy is defined as a teenage girl within the years of 13 - 19 becoming pregnant ● Teen Pregnancy Prevention is important to the health and quality of life for youth ● Engaging in sexual risk behaviors such as having sex at an early age, having more than one sex partner, and not using condoms or contraceptives can lead to unintended pregnancy, STD’s, and HIV infection

24. Prevention Abstinence Protected sex (condom use, birth control, IUD, etc.) Talking to teens about outcomes and risk factors of pregnancy Comprehensive sex education.

25. Risk Factors Low birth weight ● Premature birth ● Pregnancy induced high blood pressure (preeclampsia) ● Higher rate of infant death ● 38% of teen girls who have a child before 18 get a high school diploma by age 22 ● 30% of teen girls who have dropped out of high school say pregnancy is a reason ● 67% of teen mothers who moved out of their families’ house live below the poverty level ● Children born to teen mother score significantly worse on math & reading tests

26. Signs & symptoms It depends on how far along in the pregnancy: Missing a period ○ Nausea and vomiting ○ Breast changes (tenderness, enlargement) Urinating more often ○ Baby movement If you are experiencing symptoms, call your healthcare provider. ○ Write down a list of questions and do not be afraid to ask!

27. DIAGNOSIS Pregnancy urine tests ○ Detects if human chorionic gonadotropin ( H CG) is present to indicate pregnancy ○ Home pregnancy tests are more than 97% accurate ○ Always best to do with the first urination in the morning ○ If unsure, retest again! Blood tests ○ Also detects if human chorionic gonadotropin ( H CG ) ○ More expensive and used only for early diagnosis

28. THANK YOU