Melissa Pickett and Dr. Lynn C. Callister, College of Nursing

Introduction and Literature Review

The College of Nursing expects students to provide care for patients globally in other cultures as well as patients in our own country. Learning how to meet the mothers’ needs from Argentina will inform health care professionals how to provide the best care to mothers whose newborns are in the NICU. The purpose of this qualitative descriptive study was to gain understanding of the experiences of Argentine mothers who gave birth to newborns who were receiving care in the neonatal intensive care unit.

Women around the world all need support during the transition to motherhood. I hypothesize mothers will experience better outcomes as they are given more support through education of the condition of their neonates. As nurses develop knowledge about the experiences of childbearing women, it will help them to provide quality health care to these women and their families. According to Callister, “Nurses should demonstrate respect and care for women of all cultural heritages and aim for culturally competent care through the acquisition of attitudes, knowledge, and skills to support culturally congruent [nursing care]. ” Gaining an understanding of the perceptions of Hispanic women living in Argentina who have given birth to a compromised newborn has the potential to improve the knowledge and skills of nurses caring for culturally diverse and often vulnerable childbearing families.

Methods

A convenience sample of eleven women giving birth in an Argentine hospital, La Maternidad de La Senora Mercedes in the city and province of Tucuman to newborns who were currently being cared for in the NICU. The mothers asked to participate were those who either stayed in the Casa de Las Madres which is a house where mother’s whose babies are in the NICU, are able to stay for without charge while their babies are in the NICU. Some of the mothers were interviewed in the Casa de Las Madres while others were interviewed in a secluded hallway in the NICU, in a separate room, or in a hallway on another floor in the hospital. Compensation for participating in the research was a photograph of the mother and her baby. This compensation was provided because most families do not have the funds to print photographs of their children.

After the interviews were recorded, two bilingual translators assisted in transcribing and translating the interviews from Spanish to English. The interviews were analyzed as appropriate for qualitative inquiry by the investigator and her mentor, who is an experienced qualitative nurse researcher.

Results

Mothers who participated in the research ranged in age from 20-40 years of age, with the majority in their twenties. Marital status included women who were single, engaged, living together in a committed relationship, and married. Most of them are homemakers, two are students, and, one is a nurse. Their first prenatal visit varied from four weeks to 27 weeks gestation, prenatal visits 2-14 times. The number of pregnancies varied from 1-6 between all the mothers. All gave birth at La Maternidad de la Sra Mercedes in Tucuman, Argentina. Support persons included no support person, mother, sister, and father of baby. Physicians and nurses attended their births. Only three women had childbirth education classes. Eight mothers had cesarean births. There were 6 female newborns and 6 male newborns (one set of twins).

Discussion

These mothers who had given birth to compromised newborns receiving care in the NICU were more concerned about the health of their infant than their own health and well being or the quality of their birth experience. One of the mothers described her feelings as follows, “Never have you thought that you will love somebody as you will love the babies…Every experience is different and in reality the most beautiful…That is what makes you stronger, to see them.” Giving birth in a large maternity hospital in the poorest province in Argentina, women know that the infant mortality rate is very high and that there is a possibility that their newborn may not survive. These women learned child birth is often very different than what they expected it would be. Another mother commented, “I am suffering and I feel desperate and I don’t know how I can help him…I feel like it is a bad dream I have been living…I have been living with a lot of emotions…I see him here so little, with all this stuff that they put on him. I feel his suffering.” Mothers feel more confident and are prepared when they are educated about the possible risks and potential complications. Mothers also appreciate all the emotional support from nurses and others while they care for their babies in the NICU and negotiate making the transition to motherhood with a vulnerable infant.

Implications for Nursing Practice

Gaining an understanding of the perceptions of childbearing women with an ill newborn has the potential to enhance the knowledge of nurses regarding the needs of these women and their families. These mothers focused on the care of their children rather than meeting their own personal needs. Providing support to these women at a critical time in their lives is essential, through education, listening to mothers and answering their questions, providing education about their child’s current condition and how to promote the health and well being of their newborn.

This project has taught me importance of providing the most holistic care for patients through education, support, and listening to all of their needs, and not only the needs we as nurses think are the patients’ most important needs. I recently graduated and plan to apply the research I learned into my practice with patients on a daily basis.

References

• Callister, L.C. (2001). Culturally competent care of women and newborns: Attitudes, knowledge, and skills. Journal of Obstetric, Gynecolopgic, and Neonatal Nursing, 30(1), 209-215.
• Translators included native Spanish speakers agreed to keep confidentiality for research purposes. They included Marta Perez and Laura Black.