Influence of Various Modes of Delivery on Mother-infant Bonding: A Prospective Observational Study

Abstract

Background: Mother-infant bonding has tremendous implications for the child's future development. The difficulties that some mothers have in establishing an emotional bond with their newborns often referred to as impaired bonding or bonding failure are an essential focus in the postpartum period. Therefore, it is important to identify predictive factors for bonding failure and to intervene at an early stage for the better mental health care of mothers as well as infant. Objective: To determine the effect of various modes of delivery on the mother-infant bonding. Methods: Prospective observational study performed on low-risk singleton pregnancy who delivered at term. Mother-to-Infant Bonding Scale (MIBS; Taylor et al., 2005), a validated self-report test was used to measure mother's feelings towards her baby within three days of delivery and at the end of six weeks postpartum period. Total score ranges from 0 to 24. A total MIBS score of ≥ 2 is established as cut-off indicating “poor bonding”. MIBS score of 0 and 1 is considered as “good bonding”. The mean bonding score among the 3 groups was compared. Results: Elective cesarean delivery group had 112 participants, 115 were Emergency cesarean group and 107 were vaginal delivery group. Immediately after the delivery (MIBS 1), the proportion of women with poor bonding among Emergency cesarean group was 34.8% when compared to proportion of women with poor bonding among Elective cesarean (11.6%) and Vaginal delivery (13%). This was statistically significant (p-value 0.01). When we followed up these mothers at 6 weeks post-partum checkup, the MIBS scoring (MIBS-2) consistently improved among the three groups. However, proportion of women with poor bonding still remained high at 16.5% among the Emergency cesarean group. Conclusion: Mode of delivery has a significant impact on MIBS. In this study, unplanned cesarean delivery was associated with a high incidence of poor mother to infant bonding. Poor bonding was commoner in this group even at 6 weeks post-partum, compared to those undergoing a successful vaginal delivery and a planned elective cesarean delivery.