Six Weeks Is Too Long to Wait: Using Mercer's Becoming a Mother Theory to Argue for a Nurse Contact Within Three Days of Postpartum Discharge
[Student Name]
University of Phoenix
NSG/415: Theory-Based Nursing Practice
Week 5 Assignment
[Instructor Name]
[Date]
The hospital, unit and data are a composite written for a model paper.
On a composite hospital's mother-baby unit, most first-time mothers go home about 48 hours after a vaginal birth. Their next planned contact with a clinician is the infant's newborn visit, usually at three to five days, and their own postpartum visit, often at six weeks. Discharge teaching is thorough but compressed into the last hours before leaving, when mothers are exhausted. A review of calls to the unit's help line found that first-time mothers most often called between days two and five at home, about breastfeeding, sleep, bleeding and whether their feelings were normal. The hospital's contact with new mothers ends at exactly the point when their questions begin. This paper uses Mercer's theory of becoming a mother to argue for a nurse contact within three days of discharge.
The Practice Problem
The early days at home are a period of physical recovery, sleep deprivation, feeding challenges and emotional change. Warning signs of postpartum complications, such as hypertensive disorders, infection and depression, can appear during this time. National obstetric guidance treats the months after birth as a period needing continuing care instead of one checkup: it calls for contact with a maternal care provider in the first three weeks, care tailored to the woman after that and a full visit by twelve weeks (American College of Obstetricians and Gynecologists [ACOG], 2018). The unit's current practice leaves a gap between discharge and that first contact.
Mercer's Theory of Becoming a Mother
Mercer (2004) revised her earlier theory of maternal role attainment and proposed replacing that term with becoming a mother, to emphasize an ongoing, lifelong process rather than an endpoint. She described four stages: commitment, attachment and preparation during pregnancy; acquaintance, learning and physical restoration in the first weeks after birth; moving toward a new normal in the following months; and achievement of a maternal identity. The process occurs within nested environments: the family, including the partner and the infant; the community, including health care; and the wider society. Mercer emphasized that the partner's support, the infant's characteristics and the mother's own health and self-confidence influence how smoothly a woman moves through these stages.
What the Theory Explains About the Problem
The theory identifies the first weeks after birth as the acquaintance, learning and physical restoration stage, in which the mother learns her infant's cues, gains confidence in caregiving and recovers physically. Success in this stage builds competence and confidence, while difficulties, such as painful breastfeeding, conflicting advice from relatives or unaddressed anxiety, can undermine a mother's sense of herself as capable. The current practice discharges mothers at the start of this stage and removes professional support until the stage is nearly over. In Mercer's terms, the health care system, part of the community environment that should support the mother, withdraws when its support is most useful.
The theory also explains why the calls cluster where they do. Breastfeeding difficulties typically peak around days three to five as milk volume increases; sleep deprivation accumulates; and emotional changes, including the common baby blues, emerge. These are the challenges of acquaintance and learning.
Evidence That Early Contact Helps
Evidence supports nurse contact in the early postpartum period. Dodge et al. (2019), in a randomized trial of a universal postpartum nurse home visiting program in which a nurse visited families about three weeks after birth to assess needs and connect them with community resources, found that the program was associated with greater connection to community resources and improvements in several maternal and infant outcomes. ACOG (2018) also supports early contact, including telephone contact, to address concerns and identify complications. Together, the professional guidance and trial evidence indicate that early nurse contact is feasible and beneficial.
The Proposed Change
Three linked components make up the proposal, and each answers to the theory.
1. A nurse telephone call within 48 to 72 hours after discharge for all first-time mothers and any mother identified as at risk. The call, made by a mother-baby nurse using a structured script, asks about feeding, sleep, bleeding, blood pressure symptoms, pain, mood and support at home. This supports the acquaintance and learning stage when questions peak.
2. A home visit by a nurse within the first week for mothers with specific needs identified during the stay or on the call, such as breastfeeding difficulty, limited support, hypertension or signs of depression. This addresses Mercer's attention to the family environment, allowing the nurse to see and involve the partner and family.
3. Coordination with the infant's pediatric visit and the mother's obstetric provider, with the nurse sending a brief summary of concerns, so that the health care system acts as one supportive environment rather than separate appointments.
Implementation and Resources
The unit would begin with telephone calls, using nurses scheduled on light-census shifts, and add home visits in partnership with the hospital's home health agency. The structured script and documentation template would be built with the unit practice council, and staff would be trained in a one-hour session. Partner education about the early weeks would be added to discharge teaching, reflecting the theory's emphasis on the partner's role.
Evaluation
Measures would include the percentage of eligible mothers reached by phone within 72 hours; maternal confidence scores before discharge and at two weeks; breastfeeding continuation at two and six weeks; emergency department visits by mothers and infants within 14 days; and depression screening completion. Comparing six months before and after implementation would show whether the change supports the process the theory describes.
Conclusion
Mercer's theory of becoming a mother identifies the first weeks after birth as a stage of acquaintance, learning and physical restoration in which support shapes a mother's confidence and identity. The current practice withdraws professional support at the start of that stage. A nurse telephone call within three days, targeted home visits and coordinated care, supported by professional guidance and trial evidence, would place nursing support where the theory says it matters most and give first-time mothers help when their questions begin.
References
American College of Obstetricians and Gynecologists. (2018). ACOG committee opinion no. 736: Optimizing postpartum care. Obstetrics & Gynecology, 131(5), e140-e150. https://doi.org/10.1097/AOG.0000000000002633
Dodge, K. A., Goodman, W. B., Bai, Y., O'Donnell, K., & Murphy, R. A. (2019). Effect of a community agency-administered nurse home visitation program on program use and maternal and infant health outcomes: A randomized clinical trial. JAMA Network Open, 2(11), Article e1914522. https://doi.org/10.1001/jamanetworkopen.2019.14522
Mercer, R. T. (2004). Becoming a mother versus maternal role attainment. Journal of Nursing Scholarship, 36(3), 226-232. https://doi.org/10.1111/j.1547-5069.2004.04042.x
How this NSG 415 Week 5 example is structured
The NSG/415 shelf page describes the final week as carrying the theory into a full practice change argument. The paper builds the argument in the order a reader would need it: the practice problem, the theory that explains why the problem matters, evidence that the proposed change works, the change itself and how it will be evaluated. The theory is not decoration; each part of the proposal is tied to a stage or influence the theory describes. Students search this week as NSG 415 Week 5, NSG415 Wk 5 or NSG/415 Wk 5; all three are the same assignment.
NSG/415 Week 5 questions, answered
What does NSG/415 Week 5 usually ask for?
The course shelf describes the final week as carrying a nursing theory into a full practice change argument. Many sections ask for a paper that identifies a practice problem, applies a nursing theory to justify a change, supports it with evidence and proposes implementation and evaluation.
What is Mercer's theory of becoming a mother?
Ramona Mercer's theory, which revised her earlier theory of maternal role attainment, describes how a woman develops a maternal identity through stages of commitment and preparation, acquaintance and learning, moving toward a new normal and achieving that identity, influenced by the infant, the partner, family and wider social systems.
How do I connect a theory to a practice change?
Show how the theory explains why the current practice falls short and how each part of the proposed change supports a process or outcome the theory describes. Then add empirical evidence, since a theory explains why a change should work but research shows whether it does.
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