THE THEORY OF ATTAINMENT OF THE MATERNAL ROLE IN ADOLESCENCE: A REFLECTION FOR THE PRACTICE A TEORIA DA CONSECUÇÃO DO PAPEL MATERNO NA ADOLESCÊNCIA: UMA REFLEXÃO PARA A PRÁTICA TEORÍA DE ADOPCIÓN DEL ROL MATERNO EN LA ADOLESCENCIA: REFLEXIÓN PARA

Objective: to reflect on becoming a mother in adolescence based on some concepts from Ramona Mercer's theory of attainment of the maternal role. Method: a theoretical-reflective study based on Ramona Mercer's theory of attainment of the maternal role. The concepts related to the process of becoming a mother during adolescence were selected and presented in a guiding axis. Results: a low maternal age can affect coping, generating feelings that impact on self-esteem and self-concept, already weakened in the phase of adolescence. The tension of the role can worsen, with social support being an important factor involved in the maternal role. Its absence generates feelings of fear, insecurity, and depression. Paternal absence, in turn, is common and can weaken the attainment of the maternal role, given the father's contribution to reducing tension in the mother and child dyad. It is up to the nurse to identify factors that may impact on the development of the maternal role and offer support and care for the development of this maternal identity. Conclusion: the reflections made on the concepts involved in becoming a mother in this period allowed understanding the changes in its various spheres. The concepts addressed also have a strong interrelationship with each other and directly impact pm the care construct, and it is up to nurses to align their care practice with the real needs of pregnant adolescents.


INTRODUCTION
The attainment of the maternal role is a mid-range Nursing theory, described by Ramona Mercer. This theory addresses an interactive and evolutionary process between the mother and the child to build a maternal identity and involves changing the mother's personal state, which develops confidence and competence in the performance of the maternal role. 1 At any age, motherhood is related to several physical and emotional changes that culminate in an ambiguous experience of becoming a mother, involving feelings and emotions that affect the woman's identity, being considered the greatest developmental transition throughout the life cycle. 2 Adolescence, in turn, is a special phase of development that is also related to physical and hormonal changes that impact on emotions, identity, and social relationships. Thus, motherhood in adolescence refers to two moments of intense changes, which generate ambivalent feelings, with the onset of fear, anguish and rejection, which can evolve to positive feelings with the acceptance of pregnancy and when the bond with the maternal role occurs. 3 Motherhood in adolescence is a public health problem that, in addition to biological complications such as spontaneous abortion and maternal death, encompasses physical and emotional immaturity that impacts on the care provided to the child, which makes the process of becoming a mother more difficult. 4 Among the professionals involved in the care of pregnant women and adolescents, nurses play an essential role in building a care plan based on real needs, individualized and effective, to achieve results in the health of the woman and, consequently, of the child. 3 The present study aimed to reflect on becoming a mother in adolescence based on some concepts of Ramona Mercer's theory of attainment of the maternal role.

METHODS
This is a reflection study based on the interpretation of the literature and on the reflective impressions of the authors regarding the theme addressed, being presented in a guiding axis: "The attainment of the maternal role in adolescence".
This study used some of the concepts of the theory of attainment of the maternal role related to the process of becoming a mother during adolescence, namely: maternal age; self }-esteem; self-concept; tension of the maternal role; social support; anxiety; depression; mother-father relationship. Such concepts were selected because they present some particularities in relation to this audience, allowing for a better understanding about the epistemology of care when becoming a mother in adolescence, from the approach of this Nursing theory.

The attainment of the maternal role in adolescence
The theory of attainment of the maternal role described by Ramona Mercer follows a four-phase process for its attainment, namely: a) commitment and preparation phase, which occurs from the beginning of pregnancy and includes social and emotional adaptations; b) knowledge and physical restoration phase, which begins with birth and encompasses learning and developing the maternal role; c) standardization approach phase, which involves how the woman deals with the new role and determines the best care for her child; and d) personal or maternal identity phase, in which the woman recognizes motherhood with security and confidence. 5 The maternal identity is attained when the woman acquires a new identity from the redefinition of the self to incorporate motherhood, in which she is in internal harmony as to her maternal role and her expectations. Becoming a mother in adolescence can be influenced by the mother's chronological and developmental diretamente no construto cuidado, cabendo ao enfermeiro alinhar sua prática assistencial com as reais necessidades das gestantes adolescentes.

RESUMEN
Objetivo: reflexionar sobre cómo convertirse en madre en la adolescencia a partir de conceptos de la teoría de adopción del rol materno (ARM) de Ramona Mercer. Método: estudio teóricoreflexivo basado en la teoría de adopción del rol materno de Ramona Mercer. Los conceptos relacionados con el proceso de convertirse en madre durante la adolescencia fueron seleccionados y presentados en un eje guía. Resultados: la poca edad de la madre puede afectar el proceso, generando sentimientos que tienen influencia en la autoestima y el autoconcepto, ya debilitados en la adolescencia. La tensión puede empeorar y por ello el apoyo social es un factor importante en el rol materno. Su ausencia genera sentimientos de miedo, inseguridad y depresión. La ausencia paterna, a su vez, es común y puede debilitar la adopción del rol materno, dada su contribución a la reducción de la tensión en la díada madre e hijo. Le corresponde a la enfermera identificar los factores que pueden afectar el desarrollo de la función materna y ofrecer apoyo y atención para desarrollar su identidad. Conclusión: las reflexiones sobre los conceptos involucrados en ser madre en esta etapa de la vida han permitido entender los cambios en sus distintos aspectos. Los conceptos enfocados también se relacionan entre sí e impactan directamente en la construcción de los cuidados. La práctica asistencial de enfermería y las necesidades reales de las adolescentes embarazadas deben estar alineadas. be highlighted because the psychological and emotional conditions are affected in adolescence, and social support is essential to assist in this transition. 4 The vulnerability related to the absence of support or to abandonment by the child's father, the adolescent's parents and the family, in addition to the interruption in leisure activities and school drop-out caused by the new role, has consequences in attaining the maternal identity. 7 In addition, the judgment and preconception of society, family members, and health professionals intimidate the adolescent and impact on her acceptance of pregnancy and on her performance of the maternal role. 3,4 Anxiety and depression are stress-generating factors that can be present through absence or poor social support, which hinders the attainment of becoming a mother, in addition to influencing the child's growth and development. 9 The abrupt break in the social life of adolescent who has a child and the absence of social support generate feelings of fear and insecurity which, associated with the intensive care demand that a newborn requires, reflect overload, tiredness, and irritation. And it requires an individual look at this context to prevent worsening the anxiety and depression levels that can affect both women and newborns. 4,7 The mother-father relationship is defined by Mercer as a perception of the couple's relationship that encompasses the intended values and objectives. 1 Motherhood and paternity in adolescence involve low quality perceptions regarding the child's health and education, which can influence the quality of care for the child's growth and development. 4 In adolescence, paternal absence is common, which can weaken the attainment of the maternal role, given its contribution to reducing tension in the mother-child dyad.
It is up to the nurse to identify factors that may impact on the development of the maternal role and offer support and care for the development of this maternal identity. Support to the mother can be carried out through a dialog to listen and understand the environment in which she is inserted and to identify her demands, in addition to encouraging the mother and child bond for the construction of her maternal identity. 10 The young maternal age can affect the coping and the responsibilities of conceiving and caring for a child, creating ambiguous feelings that impact on self-esteem and self-concept which, in the adolescence phase, tend to be weakened. The tension of the role can worsen dependence on the child and the maternal transition, with social support being an important factor involved in this tension. It is the concept most interconnected to the others, since its absence associated with the judgments faced by the adolescents and to the interruption in the common activities of this phase harms the maternal role. This is associated with anxiety and depression resulting from all these changes and from the fathermother relationship, often absent in this audience, as illustrated in Figure 1.
age, anxiety, and depression, in addition to the social support received and to family functioning. 2 The transformations and changes in the lives of adolescents who become mothers, associated with the young chronological age to face the responsibilities of motherhood, can lead them to perceive this new context as difficult and unsatisfactory, generating feelings of rejection, sadness, and anguish, in addition to the impact on their psychological lives caused by unwanted pregnancies, which makes it difficult to acquire the stages to attain the maternal role. 2,6 Self-esteem is the perception of people on how others see them. And the self-acceptance of perceptions, when impaired, affects both maternal construction and physical restoration. 1 The organic and aesthetic changes of adolescence, such as rapid growth, sexual characteristics, personality development and socialization, added to the intense changes of pregnancy and postpartum, significantly alter the body image and, consequently, the woman's self-esteem, mainly for the time of biological adjustment that extends months after delivery. 7 Self-concept is the global perception of oneself, including self-satisfaction, self-acceptance, self-esteem, and the relationship between oneself and one's ideal. 1 Pregnancy in adolescence is marked by the interruption of plans such as the completion of studies and the insertion in the labor market, which impacts on the self-concept of the adolescent, who has her global perception of herself changed, from adolescent to mother. This transition also affects her self-acceptance and self-esteem. 6 The tension in the role of motherhood encompasses apprehension, conflict, and difficulty in terms of skills in the face of the new role, the unknown and abstract, and uncertainty about the ability to respond effectively to social expectations. 1 The tension of the role affects the commitment and preparation phase for attaining the maternal role, in which it is challenging in the first pregnancy, mainly in adolescence, due to the difficulty of the transition from becoming a mother due to the lack of previous experience, which requires intense psychological, social, and physical development. This can be aggravated by the socioeconomic reality, the health status of the woman or of the child, and the very demanding behavior of the child. 7,8 The health care context can relieve the tension of the role. From the assistance and care received from the health services, the adolescent may have her doubts clarified and be able to perform her role as a mother in caring for her child, thus developing her autonomy, confidence, and appreciation of her protagonism, essential feelings for her to adapt to motherhood and assume it. 4 Social support refers to the help received and to the satisfaction with that help, and can be subdivided into emotional support, informational support, physical support, and appreciation support. 1 Social support affects the attainment of becoming a mother, favors daily care for the child, and improves coping with motherhood, providing confidence and understanding. This concept deserves to DOI Ramona Mercer's theory has guided the practice in the provision of a more complete care, allowing for planning, implementation, and evaluation of Nursing care and promoting more individualized and complete assistance. The concepts have been mentioned in many Obstetrics manuals and also used in other disciplines, covering diversity of populations in the maternal and child scenario, thus breaking paradigms in Nursing care and becoming a pillar in Nursing work. 11,12 The present study contemplates limitations regarding the existing particularities of different panoramas of pregnant adolescents, but it is considered extremely important to guide future research studies on this theme, in addition to its elucidative character regarding Nursing care for pregnant adolescents. Therefore, it is of fundamental importance to reflect on the concepts involved in the process of becoming a mother, in order to contribute to the improvement of comprehensive actions and interventions that address the real needs of this population.

FINAL CONSIDER ATIONS
Motherhood in adolescence is a period of constant and intense changes, in which becoming a mother is a challenge. The reflections made on the concepts involved in becoming a mother in this period allowed understanding the changes in its various spheres. The concepts addressed have a strong interrelationship with each other and allow understanding the dimensions faced in this challenge, which directly impact on the care construct, and it is up to the nurses to align their care practice to the real needs of these adolescents.
The theory of attainment of the maternal role allows nurses to identify factors that may influence the process of becoming a mother in adolescence, and provides a basis for the elaboration of care plans and appropriate interventions for strengthening the mother and child dyad, as well as it reinforces self-esteem and selfconfidence in the performance of the maternal role.
In summary, this reflection refers to the expressive contribution of Ramona Mercer's theory to support the practice of nurses, requiring further studies that address the scientific bases of Nursing, with a focus on strengthening and consolidating the care provided, the discipline of Nursing, and better results in caring for this specific population.