Before I can open this conversation, I feel the need to acknowledge that the COVID pandemic has impacted us all. Our lives have all been touched by this viral bomb in different ways and to various degrees, and we are all adjusting to a new world that we weren’t quite ready for. This journey isn’t over yet, and I hope that people are able to reach out and access the supports and resources they need to get through this incredibly unique and challenging time. I took some time away from my PhD to focus on my family, which I was fortunate to have been able to do. And now I’m lucky enough to be able to come back to it for the final sprint.
I am thankful the OT working in private practice who reached out to me recently after reading this blog. Having a chat with her reminded me that my research is important and needed, and that it’s time to roll up my sleeves and follow my heart again. She reminded me of the pressure that we feel as practitioners to ensure our practices align with research for evidence-based practice confidence, and that the EBP triad elements needs balance. It was the conversational kick I needed. I believe in the role of OT in supporting women during perinatal phases, motherhood transitions and matrescence, and I hope that my research contributes knowledge that can be useful in helping this specialist field to continue evolving with integrity. So, let’s get going…
One of my favourite occupational therapy conceptual framework approaches is Wilcock’s (1998) ‘doing, being and becoming’, which I think so naturally fits into the adjustment process we need to make as human-beings experiencing challenging and/or transformative life transitions. One of my OT colleagues refers to this as the “fake it ’til you make it” philosophy, which always makes me chuckle and nod. OT’s are great at using occupation to help people move and grow through life transitions. For mothers, this also extends to including co-occupations such as play, feeding and bathing for developing a sense of maternal skill acquisition and competence.
In Switzerland there’s a specialist role for occupational therapists titled “Erledigungsblockade”. A few years ago, I was unbelievably lucky enough to have a hallway conversation with the President of the Association of Occupational Therapists Switzerland. She was incredibly generous with listening about my research and shared information about the OT role with me. In now second-hand layman terms, I understand that this OT role is well established and supports people needing to work through “blockades” interrupting their lives so that they can return to their usual self and state of being (Joss, 2011). It conceptually reminds me of the KAWA model approach, however I’ve not yet been able to learn as much about it as I would like.
I think it’s important to mention these when we’re thinking about the OT role in supporting women through their motherhood transitions and with perinatal health issues. The role of OT is culturally defined to some extent, and so too is the way we understand women’s maternal health, well-being, issues and needs. Looking at maternal health from a sociological, development and anthropological perspective through the lens of matrescence brings some good conversation starters for a round-table OT debate.
A quote I read recently which made me laugh and think was from a collection of pivotal anthropological papers addressing motherhood:
Giving birth to a child does not automatically unleash a previously contained flood of maternal behaviour. Nor… does it determine when a woman becomes a mother. The process of matrescence includes a subtle, supportive process of socialization into motherhood. In many cultures and for most women becoming a mother is their most dramatic life crisis (Newman, 1975, p. 9)
I think this quote summed up for me where OT’s have a place in maternal transitions, perinatal health and matrescence. Two articles I read recently by Blair (2000) and Schwartzman (2006) reminded me that OT’s are specialists in supporting people through life transitions, in both the presence and absence of illness, disease and disability. OT’s have a role to play in health promotion, preventing issues and nurturing self-actualisation and personal development by using occupation. It directly applies to perinatal OT practice, but the reality is that OT’s want validation for the practice decisions from directly relevant research about the role of OT in perinatal health.
There are so many resources available to support women with perinatal health issues – including occupational therapy! – but what do we know about the OT role in supporting women through matrescence? Is it even a thing? I think it is. Is it different to the OT role in perinatal health? I’m not sure yet.
Pascoe Leahy & Bueskens (2020) recently published a textbook which has blown my mind. I practically read it from cover to cover in a weekend, and my understanding of matrescence and the role for occupational therapy has never been clearer. I have come to think of it as the missing link in my research which has made everything suddenly make sense. The authors talk about time use for mothers, changes in women’s sense of identity and meaningful engagement, and concepts which I regard as absolutely core to OT practice. Unsurprisingly there is no reference to OT, but they’re speaking our language and it translates easily and naturally. When you couple this with Esdaile & Olsen’s (2004) textbook about mothering occupations and everything we already know about occupational therapy and occupational science, the pieces fit and the OT role and scope of practice potential is clear.
I write this knowing that it may be a difficult to relate to, but exploring the OT role in women’s maternal health is a wonderful academic adventure for me. There’s so much to learn, uncover and unpack, and translating the knowledge into something accessible for OT’s to use in practice is always on my to-do list. I hope someone might be able to read this and feel encouraged to reflect and explore new ways of applying EBP concepts to clarify, measure and evaluate their practice. We’re getting there.
References:
Blair, S. E. (2000). The centrality of occupation during life transitions. British Journal of Occupational Therapy, 63(5): 231-237, doi.org/10.1177/030802260006300508
Esdaile, S. A., & Olsen, J. A. (Eds.). (2004). Mothering occupations: Challenge, agency and participation. F. A. Davis Company.
Joss, B. (2011). Beeinträchtigung im Beruf durch Erledigungsblockade. http://tl.dieergopraxis.ch/tl_files/ergopraxis/dokumente/EB%20Berufliche%20Beeintraechtigung%20.pdf
Pascoe Leahy, C., & P. Bueskens, P. (Eds.), Australian Mothering: Historical and Sociological Perspectives. Cham: Palgrave Macmillan, USA
Newman, L. (1975). Reproduction: Introductory notes. In D. Raphael (Ed.), Being Female: Reproduction, Power, and Change (pp. 7-12). The Hauge: Mouton Publishers.
Schwartzman, A. J., Atler, K., Borg, B., & Schwartzman, R. C. (2006). Fueling the Engines: A Role for Occupational Therapy in Promoting Healthy Life Transitions. Occupational Therapy in Health Care, 20(1), 39-59. https://doi.org/10.1080/J003v20n01_03
Wilcock, A. A. (1998). Reflections on doing, being and becoming. Canadian Journal of Occupational Therapy, 65, 248-256.
Research & evidence-based practice for OTs in perinatal health, motherhood, and matrescence 