The development of the maternal looking guide: a clinical tool for midwives to assess mothers’ interactions with their newborns
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Date
2017
Authors
O’Rourke, Patricia Mary
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Advisors
Jureidini, Jon
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Theses
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Abstract
The healthy physical, cognitive and social development of infants depends on nurturing relationships. The earliest relationship is usually between the mother and her infant, and mother-infant gaze plays a crucial role. This thesis examines maternal looking—the unidirectional looking by a mother at her newborn baby over the first hours and days post birth—as a precursor to bi-directional mother-infant gaze. Maternal looking allows the mother time to adjust to her actual baby, which may be pivotal for the mother-infant relationship. Midwives work closely with mothers and their babies perinatally. They are well placed to identify those mothers who struggle to look at their babies and respond with an appropriate intervention to support the crucial but vulnerable mother-newborn relationship. However, they have not had specific tools to assist them to do this. The research explores how the more subtle features of a mother’s looking at her newborn may mirror the meaning she makes of that newborn. By identifying or characterising these features, midwives can recognise mothers at risk and help them to look at their babies. Two studies were conducted. Study 1 used video to examine how mothers look at their newborns. Using an iterative design, intensive analysis identified and categorised patterns of looking and looking-related behaviours. This resulted in a typology of looking, which in turn generated a one-page clinical tool for midwives. Study 2 subjected the tool to inter-rater reliability testing using midwives as multiple raters. The results of this study show that the tool has moderate reliability. The tool, which has subsequently been named the Maternal Looking Guide, enables the assessment of mothers’ looking behaviour over six constructs and then allocation to one of three overall categories of looking: comfortable, uncomfortable, and worrisome. These categories distinguish women who are doing well (comfortable), those who need a referral to an expert perinatal service (worrisome) and those to whom midwives could offer something extra (uncomfortable). It is this third intermediate group, the uncomfortable mothers, that the research aims to help midwives identify. The Maternal Looking Guide is a practical, reliable tool that can be used for early assessment and decision-making about the mother-infant relationship. This research raises the profile of infant mental health in the midwifery profession. Implications of the research and ways that it may stimulate further research in the field of infant mental health are identified.
School/Discipline
Adelaide Medical School
Dissertation Note
Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2017.
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Copyright material (Film) removed from digital thesis. See print copy in University of Adelaide Library for full text.
This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals
This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals