Reva Rubin
Theory of Maternal Identity
This presentation is a glimpse of the contributions made
by Reva Rubin to the maternal experience.
• Who is Reva Rubin’s
• What is the Theory of Maternal Identity
• The naturalist model used to research and develop her theory
• A historical look at maternal nursing
• How did her thoughts and observations of the maternal experience
• How did her thoughts and observations changed the nursing experience
• What Rubin’s Theory means to nursing today
• Listening to Reva Rubin discussing the maternal experience
EDUCATION AND BACKGROUND
• Masters Degree from Yale University
• BA in Sociology from Hunter College
• Professor and Director of Graduate
Programs in Maternity at University of
Pittsburgh
• Certified Midwife from Frontier
Nursing Service
• MS from Yale University
• Awarded Fellowships by the World
Health Organization & Rockefeller
Foundation
Reva Rubin
Middle Range Theorist
Scope focused on maternal
nursing and developed concepts
on maternal identity
Awards and Honors
• First Annual Award in Nursing from the National Foundation March of
Dimes
• Distinguished Service Award in Nursing in Maternal – Child Nursing from
the America Nurse Association in 1976
• Honorary Doctorate from the University of Calgary 1992
Reva Rubin’s concept of maternal role attainment,
which ultimately leads to maternal identity was
developed to help women and nurses in the
maternal experience (Rubin, 1984).
By understanding a women’s subjective experience
it can help elevate the skills of health care providers
practicing maternal medicine and lead to enhanced
outcomes for mother’s (Templeton, Edgil and
Douglas, 1988).
The Naturalist Model
Research based on Nature
• Subject in action
• Pregnant women, mother to be
• Situation dictated by nature
• Childbirth/Maternal Experience
• A setting that is natural
• The Nurse as an observer is
• Independent variable
• Nurse
• Dependent variable (subject)
• Mother
natural to the child birth
experience in a helpful and
functional way (Rubin, 1988).
Rubin’s naturalist research included more than 6,000 patients
as subject matter (Rubin, 1984).
Data collection began from the first missed menstrual period
through pregnancy, delivery and the sixth week post partum
(Rubin, 1984).
The primary question asked was “ How does this this women
feel about herself in this situation at this time?” ( Rubin,1984).
Another question posed was “ How do women use nursing
help in each stage of the childbearing experience if nursing is
available and accessible?” (Rubin, 1984).
The subjects verbal and nonverbal experience were recorded
verbatim for analysis.
The History of Maternal Nursing
Pre World War I
Deliveries were done at
home. Mortality for the
mother was high and even
higher for the infant. This
included long labor, poor
sterile technique and forced
deliveries (Rubin, 1975).
A notable change in 1908
prior to WWI was the
introduction of antepartal
care, this nursing practice
was not at first accepted
but gradually accepted
part of maternal care
(Rubin, 1975).
Post World War I
The 1920s brought the
change from home to
hospital deliveries. This
meant 10-14 day
hospital stays, ill
equipped rooms w/
community bathrooms
(Rubin, 1975).
But with hospital stays
came nursing care and
nurses who were able
to care for patients
with bed baths and
back rubs. Patients felt
cared for by nurses
(Rubin, 1975).
Post World War II
Hospitals had access to
antibiotics and plastics which
decreased infections. Rooming
in with infants began and was
established by nurses (Rubin,
1975).
Nurses started parenting
classes.
Stayed with women in labor and
helped guide the labor process.
The rocking chair and on
demand feedings were
established (Rubin, 1975).
Home delivery 1900’s
Image retrieved from
http://birthanarchy.com/roots-repression
Maternity Ward 1915
Image retrieved from
http://librarysocietyfriendsblog.wordpress.com
/2012/07/03/world-war-i-and-its-aftermathcataloguing-the-papers-of-hilda-clark-18811955/
Current Day Hospital
Maternity Suite
Image retrieved from
http://indianapublicmedia.org/news/terrehaute-hospital-unveils-motherbaby-unit47409/
Maternal Identity and the Mother
Prior to Reva Rubin’s theory of maternal identity, maternal care focused on
the physiological and biological aspect of a woman’s care and ignored the
psychological aspect of a women’s care (Mercer, 1995).
Rubin noted, “that the formation of a maternal identity that binds the
women in to this child and to becoming a mother of this child is gradual,
systematic, and extensive” ( Rubin, 1984).
She brought to light a women’s self doubt and fears that may materialize
during pregnancy or after the birth of a child. A newly pregnant mother has
certain expectations of pregnancy and if they do not happen may begin to
have self doubt (Rubin, 1984). A new mother with child that does not feed
as well as in the hospital setting may begin to feel failure.
By observing women throughout the maternal experience Rubin was able to
help guide women and develop understanding of these behaviors.
Maternal Identity and the Mother
Maternal Identity for the mother involves replication in a number of different ways.
The new mother during the many phases of the maternal experience begins looking for
behaviors to model. Rubin discusses this as a “bridge or linkage to each phase of
childbearing” (Rubin, 1984).
They may model socially accepted norms, the environment or information from media like
the newspaper or magazines.
Another model may be the mother of the woman who is pregnant.
Role play is another form of replication (Rubin, 1984). Rubin describes this as a “trying on
of the maternal role” (Rubin, 1984). Samples of this may be babysitting, placing herself in
the role as mother to the child even though it is not her own.
Fantasy is another aspect of maternal identity and is it in this aspect that “a women makes
the child uniquely her own” (Rubin, 1984). Fantasy also incorporates a women’s fears of
labor and the what the outcome may be.
Maternal Identity and the Mother
The different processes and actions observed by Rubin also included
• A woman’s need to address maternal tasks, the task of child bearing, keeping her family
unit intact and a balancing social and work relationships with pregnancy.
• Body image during the maternal experience begins from conception to the post partum
period, women deal not only with the obvious self image of adjusting to weight gain but
also the physical difficulty with movement and everyday tasks (Rubin, 1984).
• Pain can occur during any part of the maternal experience from the early stages of
morning sickness through the post partum period. However, the greatest focus of pain is
in labor and delivery and the subjective aspects of this experience women may
experience (Rubin, 1984).
• Rubin noted that a women’s response to pain was associated with fatigue, isolation, fear
and disorientation in labor (Rubin, 1984).
• After delivery a woman deals with identification and interaction of the child. This
outcome may be determined by a women’s experience during her pregnancy.
Nursing and Maternal Identity
By observing and discussing the psychological experiences of women
through the birth process this opened a better understanding for nurses
and healthcare professionals. Some of these key changes were….
The introduction of mother’s and parent’s classes taught by nurses. These
classes discussed changes that may take place during pregnancy and helped
alleviate some of the fear or anxiousness experienced by new mother’s (
Rubin, 1975).
Rubin noted that with nurses guiding women through the labor process this
decreased the need for medication, fears were alleviated due to the nurse
staying with the mother and not feeling abandoned and left alone (Rubin,
1975).
Interaction between mother and infant increased as well as the father
participation.
A Dialogue of Reva Rubin in her own words
https://www.youtube.com/watch?v=DLLgoxLjAXA
What have we gained from Reva Rubin’s Theory of
Maternal Identity ? The catalyst for …..
• Child birth Classes
• Labor and Delivery recovery suites
• Less sedation
• Father’s participation in delivery
• Early discharge
• Kangaroo care
• Fetal monitoring
• Visits to Neonatal Intensive care units by parents/Grandparents
Reva Rubin is an inspiration to all
nurses in the field of maternity
nursing. Her writings are eloquent
and heartwarming.
Image retrieved from
http://acupuncturepregnancy.com/category/toronto/
References
Birth Anarchy. (n.d.). Retrieved from http://birthanarchy.com/roots-repression
Gay, J. T., RN DSN, Edgil, A. E., RN DSN, & Douglas, A. B., RN MSN. (1988). Reva Rubin Revisited.
JOGNN, 394-398.
Mercer, R. (1995). A Tribute to Reva Rubin. MCN, 20.
Quaker Strongrooms A blog from the Library Society of Friends. (n.d.). Retrieved from
http://librarysocietyfriendsblog.wordpress.com/2012/07/03/world-war-i-and-its-aftermath-cataloguing-the- papers-of-hildaclark-1881-1955/
Rubin, R. (1975). Maternity Nursing Stops Too Soon. American Journal Of Nursing, 1680-1684.
Rubin, R. (1984). Maternal Identity and the Maternal Experience. Springer Publishing.
Terre Haute Hospital Unveils New Mother-Baby Unit. (n.d.). Retrieved from
http://indianapublicmedia.org/news/terre-haute-hospital-unveils-motherbaby-unit-47409/Terr