Ramona T. Mercer

Nurse, professor

• Born: October 4, 1929
• Died: August 10, 2023

• Education: St. Margaret's School of Nursing; University of New Mexico; Emory University; University of Pittsburgh
• Significance: Ramona T. Mercer developed a theory of nursing known as Maternal Role Attainment. This theory helps explain how mothers bond with their children following birth and become competent in their new roles as parents over time. Mercer originally designed this theory to provide strategies that nurses could use to help nontraditional mothers gain confidence in their new identities as parents.

Background

Ramona T. Mercer was born Ramona Theime on October 4, 1929. She attended St. Margaret's School of Nursing in Montgomery, Alabama, graduating in 1950. Mercer then spent ten years working as a nurse. She held various positions during her early career, including that of head nurse and instructor in pediatrics and obstetrics. Mercer returned to school in 1960, enrolling at the University of New Mexico in Albuquerque. Two years later, she earned her bachelor's degree in nursing.

Mercer had a strong interest in maternal and pediatric care. This interest continued as she pursued several advanced degrees. Mercer attended Emory University in Atlanta, Georgia, where she earned her master's degree in maternal-child nursing in 1964. She remained at Emory as a teacher for five years before moving on to earn her doctorate degree.

Mercer then attended the University of Pittsburgh in Pennsylvania. It was there that she met Reva Rubin, who became her professor and mentor. Rubin's own research and ideas played an enormous role in Mercer's development of the theory that would make her well known throughout the nursing field. Mercer received her doctorate in maternity nursing from the University of Pittsburgh in 1973.

Maternal Role Attainment Theory

After graduate school, Mercer moved to California, where she joined the faculty at the University of California, San Francisco (UCSF). Mercer would remain with UCSF for the rest of her career, serving in different professorial roles over time.

During the late 1970s, Mercer wrote several books. Her first book, Nursing Care for Parents at Risk, was published in 1977. Her second book, Perspectives on Adolescent Health Care, was published in 1979. This book focuses on her research on teen mothers and examines how they handle the first year of motherhood. Whereas her mentor Rubin's research focused on the maternal role from pregnancy to about one month after birth, Mercer was interested in examining women's experiences with motherhood for longer periods. Early on, she specifically focused on mothers who had nontraditional experiences, such as mothers of children with birth defects or teen moms. She wanted to research how these women attain their maternal roles.

Mercer's Maternal Role Attainment theory developed as she investigated how women in three specific age groups (fifteen to nineteen, twenty to twenty-nine, and thirty to forty-two) grew into their roles as mothers during the first year of their children's lives. By 1986, she had published First-Time Motherhood: Experiences from Teens to Forties, which included her Maternal Role Attainment theory. Mercer's theory argues that while most women have an easy time transitioning into the role of mother, others struggle due to a variety of factors. New mothers' abilities to bond with their children and successfully carry out their maternal responsibilities can be influenced by their past, their environments, and their interactions with their children and the other important people in their children's lives. Such variables can include the mother's age at the child's birth, the child's temperament, and the mother's marital status.

In Mercer's theory, it is the healthcare provider's responsibility to help women achieve the final stage of maternal role attainment, at which point the mother feels bonded to her child and has developed confidence in performing the necessary tasks to take care of the infant. For example, Mercer notes that the transition to the maternal role occurs at the biological, psychological, and social levels. Because of this, it is important for healthcare providers, such as nurses, to advise women to seek care if they have any issues in these areas. For instance, failure to recover completely from the physical strains of childbirth can have physiological and social effects on a woman that prevent her from attaining the final stage of maternal development.

During her career, Mercer continued to develop her theory. In 2004, she argued for a change in the title of the theory, proposing that it be called Maternal Role Attainment—Becoming a Mother to address other aspects of how women transition into the role of motherhood. The theory has also been used to provide support for adoptive and foster mothers and women who become mothers unexpectedly, such as an aunt raising a niece or nephew following the death of a sibling.

Impact

Mercer's work had a significant influence on the nursing field. Her theory helped provide specific interventions for nurses to assist in the transition to motherhood. Mercer believed that nurses play a unique role in this process, as they are often the healthcare providers who have the most contact with new mothers throughout the maternity cycle and into the woman's first year of motherhood. She believed that it is critical for nurses to provide education and support to women as they become mothers and gain confidence in their child-rearing skills.

For her contributions to nursing, Mercer received many honors and awards. The University of New Mexico recognized her with its Distinguished Alumni Award. The American Academy of Nursing named Mercer as a living legend in 2003. She was a professor emeritus at UCSF, and her name appears on the university's Wall of Fame.

Personal Life

Mercer married Lewis Mercer on New Year's Eve in 1971. Lewis Mercer was an engineer and a plant manager. The two met on a cruise in the Caribbean. They were married for nearly forty years before Lewis Mercer passed away in 2009. Mercer died on August 10, 2023, at the age of ninety-four. She was survived by her two children and four grandchildren.

Bibliography

Alligood, Martha Raile. "Ramona T. Mercer Maternal Role Attainment—Becoming a Mother." Nursing Theorists and Their Work. Elsevier, 2018, pp. 432–36.

Bryar, Rosamund, and Marlene Sinclair, editors. "Ramona T. Mercer: Theories of Antepartum Stress and Maternal Role Attainment." Theory for Midwifery Practice. 2nd ed. Palgrave Macmillan, 2011, pp. 69–71.

"In Memoriam: Missionary Emeritus Ramona Mercer." International Mission Board, 22 Aug. 2023, www.imb.org/2023/08/22/in-memoriam-missionary-emeritus-ramona-mercer-1928-2023/. Accessed 9 Oct. 2024.

"Lewis P. Mercer." San Francisco Chronicle, 9 Aug. 2009, www.legacy.com/obituaries/sfgate/obituary.aspx?n=lewis-p-mercer&pid=131103443. Accessed 9 Oct. 2024.

"Maternal Role Attainment Theory." WhyIWanttoBeaNurse.org, 2011, www.whyiwanttobeanurse.org/nursing-theories/maternal-role-attainment-theory.php. Accessed 9 Oct. 2024.