Birth Places a Tremendous Emotional

¶ … birth places a tremendous emotional and physical strain on a woman. Postpartum teaching can alleviate many of the stressors associated with motherhood, and help the new mother ease her transition from the hospital to home. Moreover, postpartum teaching can help a mother prevent many problems ranging from constipation to postpartum depression.

Postpartum teaching consists of multiple levels of learning: cognitive, affective, and psychomotor. This report will address postpartum teaching on each of these three main levels. The following teaching project will include assessments of the learner, the teacher, and the resources required for the session. Also, the teaching project will include a thorough teaching plan detailing cognitive, affective, and psychomotor learning objectives. A subject and content outline plus a rationale for the teaching strategies used for the project are also included. Finally, an evaluation of the learner, the teacher, and the resources completes the teaching project.

The following teaching project lasts one hour. The learner is a 30-year-old female who gave birth two days before the session. The birth was without complications. The primary goals of the current teaching project are to teach the learner about the most common postpartum physical and psychological symptoms and therefore prepare her was well as possible for postpartum symptoms. The new mother will ideally be able to manage most postpartum symptoms according to what she learns during the teaching session.

Assessment of the Learner

One of the most important factors in learner assessment is an acknowledgement of diversity: diversity of background and also a diversity of learning styles. Stilborne & Williams (1996) point out the unique features of adult learners: including motivation, self-directedness, circumstances, and personal learning styles. Taking into account the wide range of worldviews held by mothers may be one of the most important foundations for the teaching project. A teacher can help a student learn best by respecting individual differences. Assessment of the learner therefore begins by determining (a) the learner's cultural background, medical history, and prior experience with childbirth; (b) the learner's attitude toward motherhood; - the learner's attitude toward health care; and (d) the learner's learning style. It is also important to determine what postpartum symptoms, if any, the new mother has experienced to date.

This 30-year-old female is Caucasian and from a Christian family. She has never given birth before, and has no serious medical issues. When asked, the learner admitted to being constipated since giving birth. Her main concerns with postpartum issues include weight loss and learning how to breastfeed properly. The new mother is not on medications of any sort, and has expressed interest in breastfeeding her newborn. The learner is in reasonably good spirits, although she is a single mother. Her sister, her parents, and a few close friends frequently visit her in the hospital and therefore offer emotional support to the new mother. The learner is a professional who does not seem overly concerned with the financial issues that might affect her ability to raise her child by herself. Her attitude toward health care is optimistic and positive and she demonstrates a high degree of compliance and willingness to learn.

When examined in light of Kolb's model of learning styles, the new mother exhibits strengths in the Doing and Watching categories. Kolb suggested four "combinations of perceiving and processing" that amount to learning preferences more than learning styles, per se (Clark 2000). Reflective observation, or simply watching, provides a major source of input for a learner like the new mother. Also, the new mother has demonstrated a predilection for active experimentation as opposed to abstract conceptualization. Therefore, the best way to approach the teaching session is to have the new mother practice whatever is being taught to her, after she observes the teacher performing a certain action. Accommodating learner needs is tricky but will enormously help the new mother understand how to avoid common postpartum health problems, both physiological and psychological ones.

Assessment of the Teacher

The teacher has minimal experience in a professional nursing environment but has considerable past experience working in a teaching environment. A frequent volunteer, the teacher also has a penchant for helping others and is patient. The teacher is a single mother who has experienced postpartum depression as well as physiological issues associated with childbirth. Therefore, she is passionate about helping other women minimize the stressors that do occur after childbirth. Her experience with childbirth allows her personal insight into what the new mother must be going through and can address the learner's needs personally as well as professionally. Especially because the learner prefers to watch and then follow for herself, the teacher will be an ideal aide for addressing postpartum issues. The teacher is comfortable holding newborns and can make the new mother feel safe while she learns how to breastfeed. As a mother, the teacher can help the learner minimize any awkwardness.

Assessment of Resources

Several books and pamphlets are available for the learner to read on her own time. For example, the British Columbia Ministry of Health publishes a handbook available in PDF format called "Baby's Best Chance." The publication is addressed to new parents and includes an informative postpartum section called "Parents Best Chance." However, the "Your Body After Pregnancy" chapter is the one that most directly addresses the postpartum issues in this teaching project. For example, the chapter includes information on vaginal discharge, discomfort and bleeding. Because of the sensitive nature of health issues related to childbirth and its aftercare, the new mother will probably enjoy reading the "Baby's Best Chance" handbook in her own leisure time at home. However, the learner is self-directed and interested in direct observation and learning by doing. The teaching project will supplement pamphlets such as "Baby's Best Change" and any other reading materials the new mother might have acquired. Because the learner is a single parent, she should pay attention to the section of the "Baby's Best Chance" guidebook that addresses single parenting issues. Many of the learner objectives outlined in the teaching plan below are derived from "Baby's Best Chance." The learner can also read several Web sites with information on breastfeeding techniques, postpartum depression, and postpartum weight loss. For example, the United States Department of Health and Human Services publishes a helpful Web site for female health issues with an in-depth section on breastfeeding.

Teaching Plan

Overall Learner Goal

To understand and recognize postpartum symptoms and know what to do to minimize discomfort (cognitive).

To be able to breastfeed comfortably and lose weight in a healthy way (psychomotor).

To accept the vicissitudes of being a mother to a newborn and to become comfortable with new stressors that may arise (affective).

Cognitive Objectives

Name at least six physiological postpartum symptoms including cramps, vaginal discomfort, vaginal bleeding, difficulty urinating, constipation, hemorrhoids, and weight gain (knowledge).

Name at least six symptoms of postpartum depression including extreme fatigue, loss of interest in hobbies or daily life, difficulty concentrating, feelings of low self-worth, suicidal thoughts, difficulties sleeping, and irritability (knowledge).

Name at least six risk factors that might exacerbate postpartum depression including personal or family history of mood disorders, financial strain, having a baby with health problems or having health problems of one's own, unstable home life, physical or emotional abuse, death in the family, or job loss (knowledge).

Describe what she would do if she experiences vaginal discomfort or pain (comprehension).

Describe what she would do to alleviate constipation (comprehension).

Describe what she would do to prevent or treat hemorrhoids (comprehension).

Describe how she intends to change her diet and exercise habits to facilitate postpartum weight loss (comprehension).

Describe how she intends to deal with symptoms of postpartum depression (comprehension).

List the practical issues including paperwork for maternity leave, finding child care, arranging for medical insurance, and alterations to her living will that she will need to address upon discharge from the hospital (knowledge and comprehension).

Psychomotor Objectives

Bring baby to breast, tickling the baby's mouth to trigger him or her to open widely while supporting the base of the baby's neck (manipulation, precision).

Breastfeed efficiently and painlessly by positioning the baby's tongue around the nipple and areola, supporting the breast by hand if necessary and monitoring baby's lips and jaw (precision).

Operate a manual, a cordless, and an electric breast milk pump, first by observing on a model breast and then by practicing on herself (manipulation, precision, imitation).

Observe teacher performing simple stretching exercises with focus on abdomen and performing the exercises in tandem (imitation).

Affective Objectives

Express feelings about motherhood, if necessary by writing down her feelings in a personal journal and sharing them later (valuing).

Express any concerns or worries about motherhood or any postpartum issues including breastfeeding (valuing).

Demonstrate interest in networking with other single parents, if possible through organized groups (responding).

Subject Content Outline

What does the term postpartum refer to?

What are the most common physiological symptoms experienced by new mothers immediately after childbirth and within the first few months of giving birth?

What are some of the postpartum symptoms to be concerned about, and which ones should cause no worry?

What are some of the psychological symptoms associated with being a new mother?

What is postpartum depression?

What are the risk factors associated with postpartum depression?

How can postpartum depression be prevented or managed?

What are some of the specific issues singles mom face?

What is an ideal postpartum diet and exercise regime?

Breastfeeding techniques.

Breast pumping techniques.

Introduction to Internet and print resources for new mothers.

Introduction to social networking and support groups for new mothers in her area.

Teaching Strategies Used and Rationale

The teacher and learner will have a high degree of privacy in the hospital room during the teaching project. Therefore, lessons on breastfeeding will be comfortable and cause little embarrassment for the learner. Having privacy will help the learner feel relaxed and willing to breastfeed in front of the teacher. Also, the private setting will help the learner express her emotions.

Having determined that the learner prefers to observe and then act, the teaching strategies used for the project will include demonstrations and imitation. The learner's positive attitude directly suggests her high level of motivation to learn. Also, her cultural background and tendency to be compliant with hospital standards and procedures imply that the learner is likely to be highly motivated. Motivation is a prerequisite for adult learning (Silborne & Williams 1996). As Lieb (1991) notes, adult learners are autonomous, self-directed, goal-oriented and practical. Postpartum teaching enables the learner to capitalize on her own wealth of knowledge derived from her interactions with friends and family who have children. Also, the learner is excited about reading books and online materials related to postpartum issues and so the teaching project is tailored for a self-directed, motivated adult learner. The teaching project is also goal-oriented and practical, with specific learner objectives that include psychomotor mastery of basic breastfeeding techniques. Beger & Cook (1998) found that mothers prefer teaching methods that focus on physical needs. Those needs are squarely and thoroughly addressed in this project. Breastfeeding properly is the main psychomotor learning objective, and learning how to mitigate postpartum physical discomfort via cognitive understanding is one of the main cognitive objectives of the teaching project.

Other teaching strategies used in the current project include a strong emphasis on observational learning. Although Bandura's theory of observational learning was designed for child learners, observational learning remains one of the major preferred adult learning styles. Kolb, for example, showed how adult learning styles might include a preference for observation and imitation. The learner in this project did express her wishes to watch the breastfeeding model before trying breastfeeding techniques for herself. Lieb (1991) also points out the importance of life experiences to the adult learner. Allowing the learner to incorporate breastfeeding techniques or simple advice given to her by friends and family members will aid her motivation in incorporating the practices introduced in this project.

Materials Used and Rationale

The learner will be offered several online and print resources as suggestions for further reading. The government of British Columbia's guide called "Baby's Best Chance" is a well-written and relatively comprehensive handbook that includes plenty of practical information that is related to what the new mother can expect in terms of physical and psychological symptoms. However, the handbook lacks thorough information on breastfeeding and breast pumping. Therefore, the learner will be given a list of Web sites and books she can read on her own time. During the teaching project, the learner will be introduced to proven breastfeeding and breast milk pumping techniques suggested by reputable sources including the American Food and Drug Administration and other government agencies. Web sites that are sponsored by medical establishments, government-sponsored Web sites, and educational Web sites all provide reliable information that the new mother can trust. Any and all of the Web sites listed in the References section of this report will be offered to the new mother.

Evaluation of Learner

According to the American College of Healthcare Executives (nd), "evaluation should be integrated and consistent, not simply accomplished only at the conclusion of training." In other words, the teacher should continually observe and evaluate the learner before, during, and after the session. The teacher's responsibility to the learner is to make sure that any and all teaching strategies used during the current project are effective. If the learner does not respond to or responds negatively to any strategies employed during the teaching project then it is the teacher's responsibility to change his or her approach. During the teaching project, I observed the learner thoroughly, taking into account her background as well as her interactions with friends, family members, and the newborn. After determining that the learner preferred to learn by doing and observing, the current project was designed to accommodate her needs.

The learner remained enthusiastic during the entire lesson. She smiled readily and seemed appreciative of the information and techniques that the teacher brought to the lesson. Therefore, the learner remained highly motivated. Her high level of motivation in turn ensured concentration and retention of material. She was more than able to meet the learning objectives listed in the project report. In fact, the learner surpassed the teacher's expectations in terms of her ability to name postpartum physiological and psychological symptoms and their remedies. The learner at first seemed hesitant about breastfeeding but after observing various techniques of breastfeeding and breast pumping on the model, she was quickly able to imitate and practice on her own newborn baby.