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Twin Pregnancies-Impact on the family



hunnybun39 10 / 26  
Oct 21, 2008   #1
Hi,
I am having really hard time liking this essay, I'm just not sure how it is sounding so far, I am all essayed out :(

Any feedback would be appreciated. Thanks (oops forgot to add it is not completed yet, only half way through!)

The birth of twins can be a challenging experience for the family. Raising twins poses a unique set of challenges the family must overcome, including fatigue caused by multiple demands placed on the parents; managing the physical care of infants while meeting their individual needs; and experiencing a strain in the marital relationship due to the time consuming task of parenting twins. Nurses can play an integral role in assisting these families by conducting thorough assessments and implementing relevant interventions.

Caring for twins is a more difficult and physically demanding task than caring for one child; this often leads to parental fatigue. Forty four percent of parents of twins report fatigue or high levels of fatigue throughout the first two months after delivery (Williams, Medalie, 1994). Fatigue is often caused by the difficulties in coping with unsynchronized sleeping, feeding, and crying patterns of two infants (Taubman-Ben-Ari,Findler, Bendet, Stanger, Ben-Shlomo, Kuint, 2008). This fatigue is heightened when one parent must return to work, leaving the other parent to take on all the care-giving and household responsibilities. Often when the working parent returns from work, care-giving responsibilities are taken up again, leaving little or no time for rest for either parent. When raising singletons with two parents, parents receive half the time off, raising twins with two parents, parents receive little to no time off usually each parent being assigned to an infant. Studies show that by the time infant twins are six months old, seventy percent of parents complain of inadequate sleep (Williams, Medalie, 1994). Fatigue has negative effects on physical and mental status with regard to energy, motivation, and cognitive state (McQueen, Mander, 2003). Fatigue combined with the multiplicity of demands on parents with twins adds to stress, precipitating physical and mental exhaustion.

Parents of multiples found that managing the daily needs of infant twins was an all consuming task, taking twice sometimes three times as long as care-giving singletons (Holditch-Davis, Roberts, Sandelowski, 1999). Consequently parents of multiples had less time to spend in non-care-giving interactions with their infants. The logistics of caring for more than one infant dictated that the multiple birth infants were left alone more, received less care by both parents simultaneously, and received more care by someone other than the parents when compared to singletons (Holditch-Davis et al, 1999). Multiple birth infants were also looked at, talked to, and held less often (Holditch-Davis et al, 1999). Parents felt torn between the physical care of their infants and meeting each infant's individual needs. This can lead to parent detachment from their infants, or alternatively developing a bond with only one infant (Holditch-Davis et al, 1999).

The postpartum period following the birth of twins, poses time constraints on the parents leading to an increase in marital problems. Most parents of twins report diminished time for and quality of their relationship with their spouse during the first year of caring for infant twins (Williams, Medalie, 1994). Attempting to respond to overwhelming and competing demands placed by twin infants, parents felt a loss of control over personal time (Williams, Medalie, 1994). Couples considered it mentally healthy to have down time and or alone time but caring for multiples eliminated this extra time (Holditch-Davis et al, 1999). Since multiples filled these parents time, they reported feeling tied down and confined (Holditch-Davis et al, 1999). Degree of social support was found to be an important predictor of spousal conflict (Taubman-Ben-Ari, 2008). Decreased marital satisfaction can have significant impacts on the family, the most detrimental being divorce.

OP hunnybun39 10 / 26  
Oct 21, 2008   #2
Please help me shorten this paragraph, is it possible? My biggest problem is staying within the page limits, is there anything i can condense or eliminate?

Parents may quickly become fatigued and or overwhelmed with caring for multiple infants. The nurse should start off by assessing the each parent's ability to perform activities of daily living. Fatigue can limit the person's ability to participate in self-care and perform his or her role responsibilities in the family. Assess the family's emotional response to fatigue. Anxiety and depression are the more common emotional responses associated with fatigue. These emotional states can add to the person's fatigue level and create a vicious cycle. Assess the family's nutritional intake and evaluate sleep patterns. Assess the families expectations for fatigue relief, willingness to participate in strategies to reduce fatigue, and level of family and social support. Prenatally the nurse should provide anticipatory guidance about the likelihood of fatigue during the postpartum period; this is an important step which can ensure a successful transition to parental roles. Nurse can teach about continuing supplemental iron and prenatal vitamins during the postpartum period as a strategy that can help alleviate fatigue. Recommending prenatal vitamins along with a well balanced diet and getting adequate rest, can be instrumental in relieving postpartum fatigue. The nurse can provide strategies for the whole family to decrease the amount of work after their multiples arrive home. Examples include making charts to monitor eating, sleeping, and elimination patterns; freezing meals for later use; and taking advantage of help and food offered by friends and family. Nurse can assist and encourage the couple to start building a support system around them that will help meet their need in the early months, ideally this should begin prenatally.


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