Therapeutic Interventions

1. Develop healthy eating and lifestyle habits prior to conception. (1, 2)

2. Confirm pregnancy during the early stages. (3, 4)

1. Advise the parents to see a prenatal heath care provider for a preconception health evaluation and to learn about recommended guidelines for initiating a healthy pregnancy (e.g., eat healthy foods, exercise daily, get adequate sleep, take a multivitamin containing folic acid).

2. Caution the parents to eliminate exposure to harmful substances (e.g., cigarettes and second-hand smoke, alcohol, illegal drugs, unauthorized medications, cat litter).

3. Instruct the parents to take an at-home or medically administered

3. Read literature or view videos to prepare for the pregnancy, delivery and care of the infant. (5, 6)

4. Take childbirth education and parenting classes. (7, 8)

5. Develop a family routine, work program, and social pregnancy test at the first sign of pregnancy).

4. Encourage the mother to make and keep appointments with a medical practitioner according to the recommended prenatal schedule (e.g., first 20 weeks one visit every four weeks, 20-36 weeks one visit every two weeks, 36 weeks to birth one visit per week).

5. View The Baby System video with the prospective parents to help them understand the process of pregnancy and birth including fetal development, physical changes of the mother and ways the father can be involved and supportive.

6. Review the weekly changes in the pregnancy with the parents by referring to literature describing the stages of pregnancy (e.g., Your Pregnancy Week by Week by Curtis and Schuler).

7. Assist the prospective parents in choosing a prenatal and birthing class consistent with their preferred type of delivery (e.g., natural, at home, Lamaze, with or without anesthetic and/or pharmaceutical intervention) and encourage them to attend as a couple.

8. Refer the parents to a parenting class (e.g., The Parent Talk System by Moorman and Knapp) to acquire appropriate child management techniques to use with their developing child.

9. Council the parents to adjust their work and social schedules activities supportive of a safe and healthy pregnancy. (9, 10)

Follow medical guidelines recommended by the prenatal health care provider. (11, 12)

Create a plan for developing a loving bond with the new baby. (13, 14)

to a healthier, more family friendly pace or assign the "Creating a Family Friendly Lifestyle" activity from the Parenting Skills Homework Planner (Knapp).

10. Assign the parents to list any of their current habits that may negatively affect the pregnancy, delivery or future health of the child (e.g., an unhealthy diet, use of hot tubs or saunas, taking over the counter medications) and brainstorm methods of replacing the negative habits with healthy behaviors.

11. Review with the parents the nutritional guidelines to follow during the pregnancy and help them plan well-balanced meals and snacks that promote a healthy pregnancy; discuss cravings and normal weight gain.

12. Council the parents to keep regularly scheduled appointments with their health care provider and to submit to any medically recommended tests that are necessary to monitor the status of the pregnancy.

13. Instruct the parents to begin communicating with their unborn infant using loving interactions (or assign the "Bonding with Our Prenatal Baby" activity from the Parenting Skills Homework Planner by Knapp).

14. Council the parents to guard against "gatekeeping" tendencies (e.g., competition for

8. Accept the role assignments that allow for sharing responsibility for the care of the needs of the child, the home, and the family. (15, 16)

9. Commit to a cooperative co-parent strategy for resolving all child- and family-related issues. (17, 18)

10. Create a family budget that allows for the needs and accommodations required by the new baby. (19, 20)

the baby's time, attention, attachment, and affection) by encouraging one another to develop a positive and loving relationship with the infant. (See Touchpoints by Brazelton.)

15. Brainstorm with the parents a list of their parental responsibilities and assist them in assigning these obligations so that both parents engage equitably in providing for the infant's physical, financial, and emotional needs.

16. Encourage the couple to predict how their spousal roles will change as the marriage and family evolves (or assign the "Our Evolving Marriage and Spousal Roles" activity from the Parenting Skills Homework Planner by Knapp).

17. Advise the parents of the importance of forming a cooperative alliance when addressing all child management issues and instruct them to consult one another on all child- and family-related decisions.

18. Instruct the parents to keep conflict away from the infant by discussing their differences privately, coming to an agreement that both can support, and then forming a loving, united front when interacting with the infant.

19. Review the importance of prenatal health care with the parents and ask if there are personal or family resources or insurance to cover the recommended medical care.

11. Seek assistance for unmet financial needs from extended family, church, community organizations or social service agencies. (21, 22)

12. Plan for the pediatric care of the infant. (23, 24)

13. List and arrange to provide for the initial needs of the newborn. (25, 26)

20. Assign the parents to create a family budget that lists available income and additional expenses incurred by the pregnancy (e.g., loss of mother's income, medical expenses, child care) and brainstorm methods of reducing costs while adequately providing for the needs of the child.

21. Instruct the expectant parents to list the resources and financial support available from their extended family and brainstorm additional solutions for housing, medical care, living expenses, education, and employment.

22. Assist the expectant parents to obtain needed financial support by applying for community assistance (e.g., child and family services, Medicaid, food stamps, State Department of Social Services).

23. Advise the couple to select a pediatric health care provider for the infant and schedule an appointment for both parents during the seventh month of pregnancy.

24. Instruct the couple to create a list of questions to discuss with the pediatrician during the first predelivery appointment (e.g., whether to circumcise, nurse or bottle feed, eating and sleeping schedule).

25. Council the parents to work together to plan and prepare a safe and comfortable environment for the baby in their home (e.g., quiet sleeping area, diaper

14. Involve the siblings in the prenatal process through age appropriate discussions and involvement. (27, 28, 29)

15. Involve close friends and extended family in prenatal plans and expectations. (30)

16. Complete a personalized birth plan. (31, 32)

changing table, comfortable nursing chair).

26. Brainstorm with the parents the steps necessary to prepare for the baby's birth (e.g., plan ahead for the trip to the hospital, select a pediatrician, acquire an approved infant car seat).

27. Instruct the parents to lovingly introduce the expected birth of the baby to their other children by providing basic details and answering questions by giving positive, truthful, and age-appropriate information.

28. Council the parents to include the siblings in planning for the baby by actively listening to their ideas and inviting them to assist with preparing the new baby's area in the home.

29. Assign the parents to use verbal affirmations, hugs, smiles, and quality time to reassure the siblings that they are loved unconditionally and hold an irreplaceable place in the family.

30. Instruct the parents to encourage the participation of family and friends in the birth celebration according to family and cultural customs (e.g., taking pictures of the newborn, bringing gifts, preparing food, attending the baptism or other birth ritual).

31. Assign the parents to talk with their prenatal health care provider about their specific treatment wishes during the delivery and immediate afterbirth

17. Gather information about parenting an infant from video, books, and Internet resources. (33, 34)

care of the mother and baby (e.g., place of delivery, use of anesthetic, people in delivery room).

32. Instruct the parents to complete a personalized birth plan (available from their hospital, health care provider or iVillage the Internet for Women: /pregnancy/birthplan) that outlines their specific directions for medical care and interventions during the delivery and immediate aftercare.

33. View the video Expect More Than a Baby! with the expectant couple to develop an awareness of issues that concern new parents of infants (e.g., sleep deprivation, shift in family dynamics, volatile emotions, postpartum depression, time management).

34. Assign the parents to access web sites that give helpful information to young parents about their infants (e.g., the Gerber Web site:, the Similac Formula Web site,, or the Enfamil Formula Web site

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