# Situation: The nurse from the Rural Health Unit (RHU) makes a home visit to a 20-year-old primipara on the fourth day after a normal vaginal birth. She is breastfeeding her term newborn, and her partner and her mother help at home. In Rubin's phases of maternal adjustment, during which phase is a new mother usually most eager to learn and practice newborn care?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=629582  
> language: ko  
> subject: Nursing Practice II — Maternal and Child Health Nursing

## 문제

Situation: The nurse from the Rural Health Unit (RHU) makes a home visit to a 20-year-old primipara on the fourth day after a normal vaginal birth. She is breastfeeding her term newborn, and her partner and her mother help at home.

In Rubin's phases of maternal adjustment, during which phase is a new mother usually most eager to learn and practice newborn care?

## 보기

1. Letting-go phase
2. Taking-in phase
3. Engrossment phase
4. Taking-hold phase **✔ 정답**

**정답: 4**

## 해설

Rubin described three maternal phases. In taking-in (first 1 to 2 days) the mother is passive and focused on her own needs; in taking-hold (from about day 2 to 3) she becomes more independent and eager to learn infant care, making it the best time for teaching; in letting-go she accepts the new role and relationship changes.

## 심화 해설

Maternal Role Adjustment: Rubin’s Phases

Rubin’s framework describes a predictable progression of maternal behavior in the early postpartum period, and the timing of a home visit on day 4 after a normal vaginal birth places this mother squarely in the phase when teaching is most effective. The three phases are sequential but overlapping, and each carries distinct implications for nursing assessment and education.

Taking-in is the earliest phase, typically dominating the first 1 to 2 days after birth. During this time, the mother is largely passive and dependent. Her focus is inward—on her own physical recovery, sleep, and the need to recount and process the labor and birth experience. She may talk repeatedly about the delivery and appears more interested in being cared for than in actively caring for the newborn. Teaching about infant care is generally not well retained in this phase because the mother’s energy is directed toward restoring her own body and integrating the birth story.

Taking-hold begins around the second to third day and extends into the first week or longer. This is the phase in which the mother shifts from passive recipient to active participant. She becomes more independent, initiates self-care, and demonstrates a clear readiness to learn and practice newborn care. The taking-hold phase is the optimal window for teaching because the mother is both psychologically ready and physically more comfortable, allowing her to focus on mastering infant feeding, diapering, bathing, and interpreting newborn cues. A home visit on day 4 falls within this phase, making it an ideal time for the RHU nurse to provide hands-on teaching and reinforcement.

Letting-go is the final phase, in which the mother accepts the newborn as a separate individual and redefines her own identity and relationships. She relinquishes the fantasy of the ideal child and the previous childless role, and she adjusts to the real infant and the new family structure. This phase is less about acquiring new skills and more about emotional integration and role acceptance. Teaching can still occur, but the intense eagerness to learn care tasks is more characteristic of taking-hold.

Engrossment is not one of Rubin’s phases. It is a term used to describe a father’s intense preoccupation with and absorption in the newborn during the early postpartum period. It is a paternal, not maternal, concept and therefore does not answer the question about a new mother’s readiness to learn infant care.

| Phase | Typical Timing | Maternal Behavior | Teaching Implication |
| --- | --- | --- | --- |
| Taking-in | 1–2 days | Passive, dependent, focused on own recovery and recounting birth | Provide rest and support; defer structured teaching |
| Taking-hold | Day 2–3 onward | Independent, eager to learn and practice newborn care | Best time for teaching and return demonstration |
| Letting-go | Later postpartum | Accepts new role, redefines relationships, sees infant as separate | Support emotional adjustment and role transition |

Key point! The question asks when the mother is *most eager to learn and practice* newborn care. That eagerness is the hallmark of taking-hold, not taking-in or letting-go.

The research evidence supports the clinical relevance of these phases even in contemporary practice. Evans and colleagues demonstrated that both taking-in and taking-hold behaviors are measurable in the early hospital period, with small decreases in taking-in and small increases in taking-hold over the first days after vaginal delivery . This pattern aligns with the observation that a mother on day 4 is moving firmly into taking-hold. However, Martell’s qualitative work cautions that shortened hospital stays of 24 to 48 hours may compress or alter the timing of these phases, meaning that many mothers reach the taking-hold phase at home rather than in the hospital . This makes the RHU home visit on day 4 particularly valuable, because the nurse may be the first professional to assess the mother’s readiness and provide teaching during the taking-hold window. Hadsell similarly emphasizes that postpartum nurses must assess a mother’s psychological readiness before initiating teaching, noting that readiness—not merely the passage of time—determines learning effectiveness . A mother in taking-hold demonstrates readiness through questions, attempts at self-care, and initiation of infant care tasks; the nurse should capitalize on these cues by offering structured teaching and supervised practice.

Watch out! Do not confuse taking-in (passive, self-focused) with taking-hold (active, infant-focused). The word “hold” suggests the mother is taking hold of the caregiving role. Also, engrossment belongs to fathers, not to Rubin’s maternal phases.

## 임상 시나리오

Teaching in Taking-Hold PhaseOptimal window for newborn care education
On day 4 postpartum, a mother is typically in the taking-hold phase. She becomes more independent, initiates self-care, and shows clear readiness to learn infant care.

Prioritize teaching during this phase: feeding techniques, diapering, cord care, and recognizing newborn cues. The mother is psychologically ready and physically more comfortable.

CautionAvoid overloading teaching during taking-in (first 1-2 days) when the mother is passive and focused on her own recovery; information retention is poor.

## 핵심 개념

- **Taking-in phase** — First 1-2 days postpartum; mother is passive, dependent, and focused on her own recovery and birth experience.
- **Taking-hold phase** — Begins around day 2-3 postpartum; mother becomes independent and eager to learn and practice infant care.
- **Letting-go phase** — Mother accepts the new maternal role and adjusts to changes in family relationships.
- **Engrossment** — Term describing a father's intense focus and absorption with the newborn, not a Rubin maternal phase.
- **Rubin's phases** — Framework describing three sequential maternal adjustment phases after birth: taking-in, taking-hold, letting-go.

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