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The Irreality of Postpartum: Observations on the Subjective experience
facts and opinion
The Irreality of Postpartum: Observations on the Subjective bxperience n
0
S H I R L E Y E . CARLSON, R N , BSN, M N E d
Postpartal maternal behavior is described as very meaningful and reflective of the subjective experience of early motherhood. Consideration of a variety of dimensions of the early postpartum suggests that this particular phase of the maternity experience is disorienting for new mothers and that they are extremely busy working their way out of bewilderment and confusion toward mastery of a new reality. In acknowledging the new mother's efforts to rearticulate disrupted dimensions of her life, nurses can renew exploration for meaningful nursing care.
28
The behavior of a new mother, particularly the primipara, during the early postpartal period suggests that there are a variety of phenomena peculiar to this phase of the maternity experience and that these phenomena are unexpected and disorienting. Yet, in spite of this disorientation, the new mother is expected to adapt very quickly to sudden and permanent changes in her life situation. The experience of pregnancy holds many surprises in terms of both body image changes and emotions. However, the day-to-day physiological changes of pregnancy are subtle and the accommodative demands are gradual and cumulative. The pace of psychological adaptation is also usually gentle and slow. However, within the context of change and adaptation to it, labor and delivery constitutes a bridge between the subjective maternal experiences of pregnancy and postpartum and is very rapid and abrupt when perceived from the vantage point of the life changes it precipitates. The delivery of a newborn portends a variety of new experiences for the mother. First, the newborn, regardless of how he has been anticipated and awaited during pregnancy, realistically confronts his mother as an unknown entity, a stranger with whom she must become acquainted, who she must now nurture, who she must accept as her own regardless of sex, size, or condition, and who by his very existence represents to her a lifelong commitment and awesome responsibility. Many new mothers observe that, to their great surprise, they have a dearth rather than an abundance of maternal feelings in the early postpartal period. As in all love relations, the true maternal-child love relationship will evolve only through mutual learning and shared experiences. True, there is intense maternal pleasure and pride in the early postpartal period, but the source of such feelings seems to be the now
proven capacity to create and produce a child and the preciousness of his existence rather than real love for the infant itself. Antithetical to the pleasure and pride of the early postpartal period is a pervasive sense of bewilderment and confusion which is clearly reflected in the behavior of the new mother. This bewilderment is not a simple disorientation which focuses only in her feelings in response to the birth of the baby; it seems to involve at least three interwoven aspects of her experience following delivery. These three aspects may be delineated as difficulty in perceiving this newborn infant as really her own, surprise at the dramatic changes that have occurred in her body in a very short span of time, and a confused sense of just how she should behave and function in the role of new mother. Accepting the Newborn During pregnancy, particularly the latter trimesters, expectant mothers do indeed fantasize, plan, and prepare for the forthcoming baby. The content of the fantasy vascillates from a wished-for, beautiful, perfect baby, to a feared, ugly, and defective monster. According to Deutsch, the representation of the fantasy is the best, as opposed to the worst, reincarnation of self in one's offspring. Following the birth of the baby, transformation from the world of fantasy to reality, and along with that, reconciliation to reality, must be achieved. The idea that any viable baby will please a mother is unrealistic; mothers do have their preferences and expectations. A wishedfor girl baby may turn out to be a boy, and from the standpoint of beauty, it is debatable that the term is even applicable to the newborn, except perhaps, in its relative physical perfection. Most mothers do achieve acceptance of their infants, but time, effort, and cognitive-emotional adaptation are involved. Cognitive-emotional Septemher/October 1976 JOCN Nursing
adaptation encompasses discrctc and slowly, hut from the rnaterrial perdiscriminating identification by the spective they have also hcen anticimothcr of just who this infant is as an pated. Every woman knows that inindividual with particularistic and creasing girth is the experience of unique physiognomy and behaviors, pregnancy, and the presence of a arid more than this, incorporating moving, kicking baby within both this infant into herself as hw-s and justifies a n d explains size and body thus c~stablishirig a relatioriship o f sensations whether thvy are pleasmutuality a n d love. Inherent in this urable o r uncomfortable. Hokvcver, difficult adjustment process may be during the carly postpartal period, ovrrcoming disappointments related the new niothcr’s behavior strongly t o deviation of the baby from what suggests that therc has been little ans h e may have expected or wished for. ticipation of what the body experience will be beyond the event of dcFacets of the cognitive-cmotional Prirniparas, particularly, adaptation to the reality of the baby livery. arv cltw-ly demonstrated in tht. early express surprise at the trauma and postpartal pcriod. While mothers d o discomforts that are s e q w l a e of the knou, intellectually that they have birthing process. As one primipara liirthcd a baby, really assimilating tearfully expressed her feelings, “It’s the idea of the baby as their own so diffrwnt from what I cxpectcd. All seems best achicwd through touch- the pictures show new mothers walking c,xpcriences and repeated op- ing around, holding their babies, and portunitic:~to interact with the baby. 1 can’t cvcri turn over. This morning N o t e the surprise a ricw mother con- I faintvd just trying to go to the kiathveys cach time her baby is brought to room. I thought when delivery was her. T h e oft repcatcd verbal ex- ovcr you were all right.” pression, “ I can’t believe it’s really I’atierits disnia), focuses on particmine.” is eloquent. O n e must doubt ularistic as well as gross body dysthat t h r idea of the baby as her own function. Some mothers must cope is truly assimilated within the time with unrxpected painful, large, ugly s h c spends on the postpartal unit in hemorrhoids; others with voiding or t h e hospital. Her behavior suggests bowel problems; rnost with the painotherwise. All new mothers, in spite ful cbpisivtomy incision; others with of the anxiety inherent in assuming burgeoning, engorged breasts; and rcsponsibility for care of the infant, all with dramatic change in body voldemonstrate, a sense of urgency to ume and metabolism. N o matter take their babies home, to bed them what thc particular focus or combiclown in their “own” cribs, to dress nation of foci for the individual t h t m in their “own” clothcs, and to patient, the disorientation is exfeed thrm with their “own” bottles. pressed as, ‘‘Is this normal?”, Will The maternal expression which ac- it go away?”, “ W h y a m I so dizzy?”, companies this push to get the baby or the more graphic, “This is sure into an environment familiar to her riot what I expected.” Tolerance of is, “ T h e n I’ll know it’s really mine.” discomfort, reorientation to her body and its function, and assimilation of Body Changes body change are components of the Coupled with t h e new mother’s experitwce of early postpartum that beuilderments a n d feelings at the the new mother must endure. confrontation o f the reality of her However, for some mothers, the baby IS another bewilderment result- body trauma of labor and delivery ing from t h e sudden a n d dramatic seems gross enough to almost totally body change5 brought by delivery incapacitate her for a period of time. Looking for a moment in retrospect, Some of these mothers become alone r c d i l y attests t o the fact that the most l d r i d d e n , confining thembody changes of pregnancy occur sr:lves to the immediate environment “
of their rooms, refusing such things as bathroom or shower privi1cagc.s and sometimes avoiding contact with their babies becausc this seems more than they can cope with at this time. The major focus of the early postpartal period for thew mothers seems t o be the mutilation, function, and sensations of their hodirs. Observation of thcse patients further suggests that as sum i n g mot he ring activities in relation to their babies is difficult arid delayed. ln fact, for them, the whole postpartal recovery process is prolonged.
The Burden of Responsihility The third aspect of disorientation manifested by a new mother in the early postpartal pcriod focusrs on her feelings as she endeavors to assumc the mothering activities esscntial t o the care and nurturing of her new baby. The btthavior of new mothers leaves little doubt that they have difficulty perceiving themselves in thc new role. Most n e w mothers are surprised by how incompetent they feel in interaction with their babies and are frightened and awcd by the burden of responsibility stidtlenly thrust upon theni. N o one knows better than the n w mother that she is very unready to really mother t h e baby she has liirthed. However, the upheaval of thc early postpartal period seems to serve as an impetus to gain perspcctive, coritrol, and competence in the new and disorienting experiericc. Very characteristic of maternal behavior during this period is an intensive scarch for inform at ion, t he purpose of which seems to 1)e t o achieve perspective and stability i n this disorienting experience. T h e focal point of thc information search is liifurcated in that they search both within themselves for reaffirmation of their capacities and for renewed meaning of past life experience and outside themsrlves for verification of capacity to function effectively in a new and demanding way. Search arid review of past life
experience seems to help consolidate and vcrify thc reality of the present at Icast within the context of her pcrsonal perspective and what shc feels are h e r capacities to handle t h r present. Listening to a new mother review the pc,rtinent events of her past lifc, o w rcalizes that her vcrbalization is not idle social conversation to be summarily dismissed, but that it has focus and purpose. It is as though thc peiidrilum of her thought must swing full circle through the past and prcscnt and on to tentatively assay the futurr in order t o more clearly deliricate and achieve meaning a n d clirthction of lifr and function in this d i ffi cu It period. C o u p l t ~ lwith this dimension of search u.ithin herself is that of search withiti thc irnmcdiate cnvironment for nicwiingful responses from others to h c r stuclicd attcrripts to function in n c n ways. ‘10 her infant, she looks for personal accrptancc, particularly in t h r fwding situation. An infant which ferds wt.11, thrives, and is comfortcd b>- her ministrations reflects on her conipctcncc as a beginning mothrxr. To nurses, she looks for support, guidance, and help, but more important than this, f o r feedback which verifies h c r success in mothcririg. Of cqual significance may be the information s h r receives i n measuring her accomplishments in relation t o thosf, of h c r immediate postpartal pccrs. Hesponse to her search for information is not always positive; it rilay critical. H o w e v e r , i n dications that shc is less than perfect
in early endeavors, unless they infer total incompetence, seem to further motivate h c r toward success. Conclusion
Rc.solution of bewilderment, disruption, and disorientation is surely not accomplished during thc brief postpartal period in the hospital. It seems important, however, to analyze and understand the extent of thc dcniands on a new mother during this critical period. In acknowledging the new mother’s efforts to accommodate the new dimensions of her lifc, nurstxs can tailor nursing care to help facilitatc thv mother’s acceptaricr of her new role. Bibliography
t’syc/iiatry 101(14):141-148, 1944 childer‘s Theory of the Sociology of the 13ody Iniagc.” MatCliild N u r s J 1(2):lOI-l12, 1972 h c h l i r i , G. : Griefs aiid Discontents. Hoston, Little, Hrown, 1969 liuhin, H. : “I’mic Maternal 13ehavior.” Xurs Outlook, 9:683-686, 1961 Kubin, K . : “The N e o m a t t m d Period.” In C;urreiit C‘oncepts in Clinical Nursiiig, (dited b y 8. Hergeson, et a1. St. Louis, C. V . Mosby, 1966, 388-391 Kuhiri, K . : “Body Image and SelfEsteem.” Nurs Out look 16(6 ) : 20-23, 1968 Iiubin, I{.: ‘‘ Fantasy and Ohject Constancy iri hlaternal Kelationships.” M u - O ‘ ~ i i k / Nurs J 1(2):1O1-112, 1972 Address reprint r q u e s t s to Shir\ey E Carlson, HN, 1036 Wayne Place, Eau Claire, WI 54701.
‘I. Henrdek (Editors): 1’circ.ntliood: I t s I’sycliology aiid Psyclropcitliology. h s t o n , tittle, H r o w n , 1970 Dcsutsch, [I. : l’sycliology of W’onien. N e w York, <;rune arid Stratton, Sliirley Curlson i s 1945 an Associate Proi;cstingcr, L. : .A Tlirwry of (:ogniticc fessor i i i the DeIlissoriutlcc. Stanford, Stanford Uni- partrnent of M a vcrsit). Press, 1957 ternal Ileal t li (;oldrnan, (;,, and 1). hiilman (Editors): Nursing at State .Ifotle rii M’on iuri : 11 r Ps ycIiolog~4uiid University of New Sexuality. Springfield, Charles C. I’ork at t?u.alo. ’l’honias. 1969 She i s also tlie MaGrirrian. R. : 1’s) cliological and Social jor Advisor for the b‘actors i n l’regnancy, 1)elivt.r)- antl Mutrrnd tiealtli Outconic,.’’ in Cliildbraring: I t s Social component of the uncf Psycltologicd :\sprcts, edited b y Graduate Program S . Iiicliardson arid A . Guttmachcr. in iVursing. ller undergraduate degree Haltitriore, \\’illianis a d Wilkiiis, 1967, is from (:olunibia [Jniversity, and her p p 1+2 M N E d is f r o m tlie University of PittsLinderiian. E, : “Syni~-’tomatc,logy and hurgli. Slir is a meniber of NAACOG,
i l n t h o r i ~ ,J . , and
I ‘
Obstetric Anesthesia Conference The 6th Obstetric Anesthesia Conference, sponsored by the Los Angeles Obstetrical and Gynecological Society, will be held in Los Angeles on March 25-27, and then continue for Part 11, which will be at Del Webb’s Kuilima resort hotel on the North Shore of Oahu, Hawaii, March 28-31, 1977, where the meetings are planned for the late afternoon, leaving the rest of the day free. This year’s speakers include Drs. John J. Bonica, John G. P.Cleland, Roger K. Freeman, Charles P. Gibbs, Bradley E. Smith, Richard 6. Clark, Watson Bowes, Toshio Akamatsu, and John S.McDonald. Lectures are planned with the total perinatal period emphasized from the obstetric, anesthesia, and pediatric viewpoints. A complete program or further information can be obtained by calling (209) 251-4833, ext. 2228, or writing John S. McDonald, MD, Obstetric Anesthesia, P.O. Box 7632, Fresno, CA 93727.
30
Septernber/October 1976 JOCiV Nursing
The Irreality of Postpartum: Observations on the Subjective bxperience n
0
S H I R L E Y E . CARLSON, R N , BSN, M N E d
Postpartal maternal behavior is described as very meaningful and reflective of the subjective experience of early motherhood. Consideration of a variety of dimensions of the early postpartum suggests that this particular phase of the maternity experience is disorienting for new mothers and that they are extremely busy working their way out of bewilderment and confusion toward mastery of a new reality. In acknowledging the new mother's efforts to rearticulate disrupted dimensions of her life, nurses can renew exploration for meaningful nursing care.
28
The behavior of a new mother, particularly the primipara, during the early postpartal period suggests that there are a variety of phenomena peculiar to this phase of the maternity experience and that these phenomena are unexpected and disorienting. Yet, in spite of this disorientation, the new mother is expected to adapt very quickly to sudden and permanent changes in her life situation. The experience of pregnancy holds many surprises in terms of both body image changes and emotions. However, the day-to-day physiological changes of pregnancy are subtle and the accommodative demands are gradual and cumulative. The pace of psychological adaptation is also usually gentle and slow. However, within the context of change and adaptation to it, labor and delivery constitutes a bridge between the subjective maternal experiences of pregnancy and postpartum and is very rapid and abrupt when perceived from the vantage point of the life changes it precipitates. The delivery of a newborn portends a variety of new experiences for the mother. First, the newborn, regardless of how he has been anticipated and awaited during pregnancy, realistically confronts his mother as an unknown entity, a stranger with whom she must become acquainted, who she must now nurture, who she must accept as her own regardless of sex, size, or condition, and who by his very existence represents to her a lifelong commitment and awesome responsibility. Many new mothers observe that, to their great surprise, they have a dearth rather than an abundance of maternal feelings in the early postpartal period. As in all love relations, the true maternal-child love relationship will evolve only through mutual learning and shared experiences. True, there is intense maternal pleasure and pride in the early postpartal period, but the source of such feelings seems to be the now
proven capacity to create and produce a child and the preciousness of his existence rather than real love for the infant itself. Antithetical to the pleasure and pride of the early postpartal period is a pervasive sense of bewilderment and confusion which is clearly reflected in the behavior of the new mother. This bewilderment is not a simple disorientation which focuses only in her feelings in response to the birth of the baby; it seems to involve at least three interwoven aspects of her experience following delivery. These three aspects may be delineated as difficulty in perceiving this newborn infant as really her own, surprise at the dramatic changes that have occurred in her body in a very short span of time, and a confused sense of just how she should behave and function in the role of new mother. Accepting the Newborn During pregnancy, particularly the latter trimesters, expectant mothers do indeed fantasize, plan, and prepare for the forthcoming baby. The content of the fantasy vascillates from a wished-for, beautiful, perfect baby, to a feared, ugly, and defective monster. According to Deutsch, the representation of the fantasy is the best, as opposed to the worst, reincarnation of self in one's offspring. Following the birth of the baby, transformation from the world of fantasy to reality, and along with that, reconciliation to reality, must be achieved. The idea that any viable baby will please a mother is unrealistic; mothers do have their preferences and expectations. A wishedfor girl baby may turn out to be a boy, and from the standpoint of beauty, it is debatable that the term is even applicable to the newborn, except perhaps, in its relative physical perfection. Most mothers do achieve acceptance of their infants, but time, effort, and cognitive-emotional adaptation are involved. Cognitive-emotional Septemher/October 1976 JOCN Nursing
adaptation encompasses discrctc and slowly, hut from the rnaterrial perdiscriminating identification by the spective they have also hcen anticimothcr of just who this infant is as an pated. Every woman knows that inindividual with particularistic and creasing girth is the experience of unique physiognomy and behaviors, pregnancy, and the presence of a arid more than this, incorporating moving, kicking baby within both this infant into herself as hw-s and justifies a n d explains size and body thus c~stablishirig a relatioriship o f sensations whether thvy are pleasmutuality a n d love. Inherent in this urable o r uncomfortable. Hokvcver, difficult adjustment process may be during the carly postpartal period, ovrrcoming disappointments related the new niothcr’s behavior strongly t o deviation of the baby from what suggests that therc has been little ans h e may have expected or wished for. ticipation of what the body experience will be beyond the event of dcFacets of the cognitive-cmotional Prirniparas, particularly, adaptation to the reality of the baby livery. arv cltw-ly demonstrated in tht. early express surprise at the trauma and postpartal pcriod. While mothers d o discomforts that are s e q w l a e of the knou, intellectually that they have birthing process. As one primipara liirthcd a baby, really assimilating tearfully expressed her feelings, “It’s the idea of the baby as their own so diffrwnt from what I cxpectcd. All seems best achicwd through touch- the pictures show new mothers walking c,xpcriences and repeated op- ing around, holding their babies, and portunitic:~to interact with the baby. 1 can’t cvcri turn over. This morning N o t e the surprise a ricw mother con- I faintvd just trying to go to the kiathveys cach time her baby is brought to room. I thought when delivery was her. T h e oft repcatcd verbal ex- ovcr you were all right.” pression, “ I can’t believe it’s really I’atierits disnia), focuses on particmine.” is eloquent. O n e must doubt ularistic as well as gross body dysthat t h r idea of the baby as her own function. Some mothers must cope is truly assimilated within the time with unrxpected painful, large, ugly s h c spends on the postpartal unit in hemorrhoids; others with voiding or t h e hospital. Her behavior suggests bowel problems; rnost with the painotherwise. All new mothers, in spite ful cbpisivtomy incision; others with of the anxiety inherent in assuming burgeoning, engorged breasts; and rcsponsibility for care of the infant, all with dramatic change in body voldemonstrate, a sense of urgency to ume and metabolism. N o matter take their babies home, to bed them what thc particular focus or combiclown in their “own” cribs, to dress nation of foci for the individual t h t m in their “own” clothcs, and to patient, the disorientation is exfeed thrm with their “own” bottles. pressed as, ‘‘Is this normal?”, Will The maternal expression which ac- it go away?”, “ W h y a m I so dizzy?”, companies this push to get the baby or the more graphic, “This is sure into an environment familiar to her riot what I expected.” Tolerance of is, “ T h e n I’ll know it’s really mine.” discomfort, reorientation to her body and its function, and assimilation of Body Changes body change are components of the Coupled with t h e new mother’s experitwce of early postpartum that beuilderments a n d feelings at the the new mother must endure. confrontation o f the reality of her However, for some mothers, the baby IS another bewilderment result- body trauma of labor and delivery ing from t h e sudden a n d dramatic seems gross enough to almost totally body change5 brought by delivery incapacitate her for a period of time. Looking for a moment in retrospect, Some of these mothers become alone r c d i l y attests t o the fact that the most l d r i d d e n , confining thembody changes of pregnancy occur sr:lves to the immediate environment “
of their rooms, refusing such things as bathroom or shower privi1cagc.s and sometimes avoiding contact with their babies becausc this seems more than they can cope with at this time. The major focus of the early postpartal period for thew mothers seems t o be the mutilation, function, and sensations of their hodirs. Observation of thcse patients further suggests that as sum i n g mot he ring activities in relation to their babies is difficult arid delayed. ln fact, for them, the whole postpartal recovery process is prolonged.
The Burden of Responsihility The third aspect of disorientation manifested by a new mother in the early postpartal pcriod focusrs on her feelings as she endeavors to assumc the mothering activities esscntial t o the care and nurturing of her new baby. The btthavior of new mothers leaves little doubt that they have difficulty perceiving themselves in thc new role. Most n e w mothers are surprised by how incompetent they feel in interaction with their babies and are frightened and awcd by the burden of responsibility stidtlenly thrust upon theni. N o one knows better than the n w mother that she is very unready to really mother t h e baby she has liirthed. However, the upheaval of thc early postpartal period seems to serve as an impetus to gain perspcctive, coritrol, and competence in the new and disorienting experiericc. Very characteristic of maternal behavior during this period is an intensive scarch for inform at ion, t he purpose of which seems to 1)e t o achieve perspective and stability i n this disorienting experience. T h e focal point of thc information search is liifurcated in that they search both within themselves for reaffirmation of their capacities and for renewed meaning of past life experience and outside themsrlves for verification of capacity to function effectively in a new and demanding way. Search arid review of past life
experience seems to help consolidate and vcrify thc reality of the present at Icast within the context of her pcrsonal perspective and what shc feels are h e r capacities to handle t h r present. Listening to a new mother review the pc,rtinent events of her past lifc, o w rcalizes that her vcrbalization is not idle social conversation to be summarily dismissed, but that it has focus and purpose. It is as though thc peiidrilum of her thought must swing full circle through the past and prcscnt and on to tentatively assay the futurr in order t o more clearly deliricate and achieve meaning a n d clirthction of lifr and function in this d i ffi cu It period. C o u p l t ~ lwith this dimension of search u.ithin herself is that of search withiti thc irnmcdiate cnvironment for nicwiingful responses from others to h c r stuclicd attcrripts to function in n c n ways. ‘10 her infant, she looks for personal accrptancc, particularly in t h r fwding situation. An infant which ferds wt.11, thrives, and is comfortcd b>- her ministrations reflects on her conipctcncc as a beginning mothrxr. To nurses, she looks for support, guidance, and help, but more important than this, f o r feedback which verifies h c r success in mothcririg. Of cqual significance may be the information s h r receives i n measuring her accomplishments in relation t o thosf, of h c r immediate postpartal pccrs. Hesponse to her search for information is not always positive; it rilay critical. H o w e v e r , i n dications that shc is less than perfect
in early endeavors, unless they infer total incompetence, seem to further motivate h c r toward success. Conclusion
Rc.solution of bewilderment, disruption, and disorientation is surely not accomplished during thc brief postpartal period in the hospital. It seems important, however, to analyze and understand the extent of thc dcniands on a new mother during this critical period. In acknowledging the new mother’s efforts to accommodate the new dimensions of her lifc, nurstxs can tailor nursing care to help facilitatc thv mother’s acceptaricr of her new role. Bibliography
t’syc/iiatry 101(14):141-148, 1944 childer‘s Theory of the Sociology of the 13ody Iniagc.” MatCliild N u r s J 1(2):lOI-l12, 1972 h c h l i r i , G. : Griefs aiid Discontents. Hoston, Little, Hrown, 1969 liuhin, H. : “I’mic Maternal 13ehavior.” Xurs Outlook, 9:683-686, 1961 Kubin, K . : “The N e o m a t t m d Period.” In C;urreiit C‘oncepts in Clinical Nursiiig, (dited b y 8. Hergeson, et a1. St. Louis, C. V . Mosby, 1966, 388-391 Kuhiri, K . : “Body Image and SelfEsteem.” Nurs Out look 16(6 ) : 20-23, 1968 Iiubin, I{.: ‘‘ Fantasy and Ohject Constancy iri hlaternal Kelationships.” M u - O ‘ ~ i i k / Nurs J 1(2):1O1-112, 1972 Address reprint r q u e s t s to Shir\ey E Carlson, HN, 1036 Wayne Place, Eau Claire, WI 54701.
‘I. Henrdek (Editors): 1’circ.ntliood: I t s I’sycliology aiid Psyclropcitliology. h s t o n , tittle, H r o w n , 1970 Dcsutsch, [I. : l’sycliology of W’onien. N e w York, <;rune arid Stratton, Sliirley Curlson i s 1945 an Associate Proi;cstingcr, L. : .A Tlirwry of (:ogniticc fessor i i i the DeIlissoriutlcc. Stanford, Stanford Uni- partrnent of M a vcrsit). Press, 1957 ternal Ileal t li (;oldrnan, (;,, and 1). hiilman (Editors): Nursing at State .Ifotle rii M’on iuri : 11 r Ps ycIiolog~4uiid University of New Sexuality. Springfield, Charles C. I’ork at t?u.alo. ’l’honias. 1969 She i s also tlie MaGrirrian. R. : 1’s) cliological and Social jor Advisor for the b‘actors i n l’regnancy, 1)elivt.r)- antl Mutrrnd tiealtli Outconic,.’’ in Cliildbraring: I t s Social component of the uncf Psycltologicd :\sprcts, edited b y Graduate Program S . Iiicliardson arid A . Guttmachcr. in iVursing. ller undergraduate degree Haltitriore, \\’illianis a d Wilkiiis, 1967, is from (:olunibia [Jniversity, and her p p 1+2 M N E d is f r o m tlie University of PittsLinderiian. E, : “Syni~-’tomatc,logy and hurgli. Slir is a meniber of NAACOG,
i l n t h o r i ~ ,J . , and
I ‘
Obstetric Anesthesia Conference The 6th Obstetric Anesthesia Conference, sponsored by the Los Angeles Obstetrical and Gynecological Society, will be held in Los Angeles on March 25-27, and then continue for Part 11, which will be at Del Webb’s Kuilima resort hotel on the North Shore of Oahu, Hawaii, March 28-31, 1977, where the meetings are planned for the late afternoon, leaving the rest of the day free. This year’s speakers include Drs. John J. Bonica, John G. P.Cleland, Roger K. Freeman, Charles P. Gibbs, Bradley E. Smith, Richard 6. Clark, Watson Bowes, Toshio Akamatsu, and John S.McDonald. Lectures are planned with the total perinatal period emphasized from the obstetric, anesthesia, and pediatric viewpoints. A complete program or further information can be obtained by calling (209) 251-4833, ext. 2228, or writing John S. McDonald, MD, Obstetric Anesthesia, P.O. Box 7632, Fresno, CA 93727.
30
Septernber/October 1976 JOCiV Nursing