Community Nursing Article Review

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Community Nursing

While developing classes and teaching classes to expectant mothers, the community nurse in this paper is made aware of the fact that many women in the class are over 30 years of age and are going through their first pregnancy. In addition, some (if not many) of the attendees are having a struggle over their commitments to their careers because they would like to stay home and raise the child rather than use day care and let someone else care for their very young child. What kind of class would be appropriate to relate to those concerns? This paper delves into that topic and other issues regarding the choices that a new mother has available.

The Literature on Stay-at-Home Mothers vs. Continuing One's Career

Understanding the Transition from Career to Motherhood

In The American Journal of Family Therapy the authors suggest that there has not been sufficient research done on "fulltime motherhood" (stay-at-home mothers); and much of the existing research focuses on the needs of the child rather than the needs and future of the mother (Vejar, et al., 2006, 17). The fact that research tends to zero in on the child's growth "…detracts attention from the developmental strides embarked upon by the mother" (Vejar, 18). Hence, there is a need to launch into greater research on the mother's challenges in this genre.

This article uses qualitative research based on a study of four women, and it points out that there have been huge expectations "…placed on women" throughout the 20th century, it has come down to a matter of women having to juggle their responsibilities (Vejar, 18). Those responsibilities include keeping up with household responsibilities (cooking, cleaning, etc.), and simultaneously "juggling the demands of career pursuits" (Vejar, 18). There is no doubt that there are substantial benefits a mother receives from having a career and being employed; a woman's "…mental, physical, and relational well-being" are all enhanced when she is able to continue working (Vejar, 18).

Vejar and colleagues interviewed four women (ages 31 to 34) for this research paper; each of the four had achieved at least a bachelor's degree and had been working in a position that was "…professional, educational, or managerial" prior to the delivery of a child (19). But during the interview process, all four women were stay-at-home moms, where they lived with husbands and at least one biological child. The questionnaire covered: a) their "sense of self"; b) their familial influences; c) their philosophies on parenting and childhood; d) their support systems and personality descriptions; e) their personal needs and their families' personal needs; f) media influences on working vs. fulltime mothers; g) negatives and positives of working and raising a child; h) how the women see the future for their families; and i) advice they share with "potential fulltime mothers" (Vejar, 20).

Using a SAHM (Stay-at-home-mothers) model (in three stages) for this research, the authors learned that each of the four full-time mothers observed "traditional value structures" while their husbands provided the incomes (SAHM Stage 1). All four had "tidy households," disciplined lifestyles, well-thought-out daily routines and husbands that provided "both emotional and financial support" towards their wives decision to become fulltime mothers (Vejar, 24).

In SAHM Stage II the authors' research indicated that all four women had "traditional values" and believed that their roles as mothers would help their children grow up to be "…happy, healthy members of society" (Vejar, 25). Those traditional values offered "comfort and support" to the women, and each woman was found to be reliant on "…her inborn sense of structure as she compartmentalized her day" to be certain all the important issues relating to her family were completed. In SAHM Stage III has to do with the four mothers' future roles when the children grow older; also, if a woman had a good experience in SAHM I and II, she enters Phase III in a positive way, Vejar continues (25). The conclusion reached by the authors is that fulltime motherhood is a role that should not be viewed "…with doubt or disregard"; in addition, the research reveals that since women tend to go though "…extensive preparation for obstacles and rewards" that are linked to "other life roles," such as being a mother rather than a professional in an office (Vejar, 28).

The Motherhood Career Slide

An article in Nursing Standard asserts that was based on quantitative findings shows that in terms of gender and nursing career progression, women's career trajectories "…put them at a disadvantage" (Watt, 2012).

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Motherhood, in fact, has a "…detrimental effect on women's career progression," and moreover, women who have babies and take a break of more than two years "…see their careers depressed and restricted," Watt explains (62).

"Nursing cares for others…" yet it "discriminates against its own for being working mothers," Watt continues. In fact a woman's "perceptions of parenthood" has a direct impact on women's access to additional training. Moreover, the expectation that female nurses with children will "…prioritize family over work" comes in conflict with the perception that nurses should be nurses first and mothers second, Watt reports on page 62. The authors put forward the idea that when healthcare facilities have to train new nurses to replace those nurses that became mothers and are now at home, there are expenditures associated with that situation; sadly, motherhood can work to "devalue" the woman's abilities which leads to fewer career opportunities once her child is old enough to be looked after in day care (Watt, 63).

TWO & THREE: Critique of Changes in Maternal Characteristics in Nova Scotia

This article points to changes in maternal age, parity, smoking, pre-pregnancy weight, delivery weight and pregnancy weight gain among all women who had babies in Nova Scotia between 1988 and 2001.

What type of study is it? This was a quantitative / statistical study and the data was taken from the Nova Scotia Atlee Perinatal Database (NSCPD). The NSAPD is a reliable source of data because virtually all deliveries of babies in Nova Scotia are recorded in this database. Trained healthcare personnel use standardized forms and hospital records to assure accurate reporting of data. The results show there were 151,268 deliveries in Nova Scotia in the above-mentioned years, and the average maternal age at delivery in 1988 was 27.1 years while the average age in 2001 jumped to 28.9 years (Fell, et al., 2005, 234). In 1997, about 30% of births in Nova Scotia were to women 30-34 years of age, a 58% increase since 1981; a decrease of 19% was found in the deliveries by women less than 20 years of age; and as to pre-pregnancy weight, it increased from 61.8 kg in 1998 to 69.6 kg in 2001 (Fell, 236).

Are the findings consistent with information/knowledge that you have? Do the reported relationships make sense? Some of the findings match other data I have accessed; for example the Human Resources and Kills Development Canada website shows that in 2009 (a more recent data than the Fell article reports) the average age of mothers giving birth in Canada was 29.4 years (an increase over the previous thirty years) (HRSDC, 2010). What is being shown by the statistics is that women are giving birth at more advanced ages, and fewer young women (under 20) are having babies. Indeed, the HRSDC reports that "half of all mothers who gave birth in 2009" were at least 30 years of age, and in 1974 there were 30 babies per 1,000 teenage mothers but by 2009 that number shrank to just 12 babies per 1,000 teen mothers (HRSDC). In the Society of Obstetricians and Gynecologists of Canada website it reports that women age 30 to 34 years of age are having "…more children than any other age group" and women 35 years and older account for "11% of first-time mothers" (sogc.org). How strong is the observed association? The relationships do make sense because the trend throughout Canada is that women are giving birth at ages older than in the recent past, and the association between the data presented in the Fell article and the other data from Canadian sources is remarkably similar.

Would you report the findings of this study into your community health nursing practice or recommend the study to others? Certainly I would use the data that Fell and colleagues put together on the changes in maternal characteristics. Moreover, I would use information from the peer-reviewed articles referenced in this paper to show the women in my class that if they truly want their children to grow up as well-balanced, healthy, happy, and morally strong adults, they need to take the responsibility of staying at home and creating the best possible emotional, psychological, and social environment for them that is possible.

Of course I would emphasize that women are having babies at an older age, and that becoming.....

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