Critical Review of Theory-Maternal Role Attainment
Theory Review
Mercer’s (1984) Maternal Role Attainment (MRA) theory was built upon Rubin’s (1967) earlier work on attainment of the maternal role. Maternal role attainment is defined as “a process in which the mother achieves competence in the role and integrates the mothering behaviors into her established role set, so that she is comfortable in her identity as a mother” (Mercer, 1984, p. 198). Mercer has extensively studied the process of MRA with a focus on mothers of normal newborns.
Purpose of Article
According to Miles, Holditch-Davis, Burchinal, and Brunssen, (2011), one of the purposes of their study was to identify the most important maternal and infant behaviors in measuring the components of MRA in mothers of medically fragile infants. Another purpose was to examine the impact of specific maternal and infant qualities on the components of MRA over the first year of life (Miles et al., 2011). Finally the authors hoped to “contribute to nursing science about MRA with this rare population of infants” (Miles et al., 2011, p. 21) as there has been little research regarding the process of MRA in mothers of medically fragile infants.
Critical Elements of the Theory
The authors assumed that maternal identity would be delayed because of difficulty in taking on parental roles with infants requiring high levels of care (Miles et al., 2011). They also surmised that maternal presence would decresase as the infants became older and health increased (Miles et al., 2011). And finally competence would increase as the mother learned how to meet the health-related needs of her infant and was able to participate more fully in care activities (Miles et al., 2011). The assumptions regarding presence and competence were proven correct according to study results; however, maternal identity was not delayed in the study participants.
The major concepts related to this study include maternal identity, maternal competence and maternal presence. The authors identified characteristics of the infant system as functional maturity and severity of the child’s illness. Characteristics of the maternal system included illness-related distress, satisfaction with family, marital status, educational level, and ethnicity (Miles et al., 2011). Characteristics of the infant and maternal systems impact mother-infant interactions.
According to the study, maternal identity was influenced only by worry. Maternal presence was only influenced by infant alertness. However maternal competence was related to infant alertness, parental role alteration stress during hospitalization, education and marital status (Miles et al., 2011). Referents include maternal confidence in role, the amount of participation in care activities for the infant, physical closeness to the infant, the quality of care given and interaction with the infant.
Theoretical Definitions and Empirical Referents
Maternal identity is defined by the authors as “the mothers’ perceptions and feelings of self as the mother of her infant” (Miles et al., 2011, p. 22). The authors defined maternal competence as “the quality of her parental caregiving and interaction” and maternal presence as “the amount of caregiving and physical closeness displayed with or felt towards her infant” (Miles et al., 2011, p. 22). Empirical referents include Maternal Identity Scale: Critically ill infant (MIS), Maternal interview rating, naturalistic observations of mother-infant interactions and the home observation for measurement of the home environment (HOME) (Miles et al., 2011).

References
Mercer, R. T. (1984). The process of maternal role attainment over the first year. Nursing Research, 34, 198-204.
Miles, M. S., Holditch-Davis, D., Burchinal, M. R., & Brunssen, S. (2011). Maternal role attainment with medically fragile infants: Part 1. Measurement and correlates during the first year of life. Research in Nursing & Health, 34, 20-34.
Rubin, R. (1967). Attainment of the maternal role: Part 1. Processes. Nursing Research, 16, 237-245.
Rubin, R. (1967). Attainment of the maternal role Part 2. Models and refferants. Nursing Research, 16, 342-351.