Abstract
BackgroundCo-morbidity is prevalent in women with fear of birth. Depressive symptoms and lack of prenatal attachment might influence the postpartum bonding between the mother and the new-born.AimTo examine the underlying dimensions of the Postpartum Bonding Questionnaire and to investigate associations between depressive symptoms, prenatal attachment and postpartum bonding in women with fear of birth.MethodsA longitudinal study comprising 172 women with fear of birth. Data were collected by questionnaires in mid- and late pregnancy and two months after birth. The Edinburgh Postnatal Depressive Scale, Prenatal Attachment Inventory and Postpartum Bonding Questionnaire were investigated.ResultsTwo factors of the Postpartum Bonding Questionnaire were identified: Factor 1 mirrored caring activities and the women’s perceptions of motherhood, whereas Factor 2 reflected negative feelings towards the baby. The Postpartum Bonding Questionnaire was negatively correlated with the Prenatal Attachment Inventory and positively with The Edinburgh Postnatal Depressive Scale.Women with fear of birth and depressive symptoms both during pregnancy and postpartum showed the highest risk of impaired bonding after birth. Primiparity and being single were also associated with impaired bonding.ConclusionA focus on women’s mental health during pregnancy is necessary in order to avoid the negative effects of impaired bonding on the infant. Depressive symptoms could be concurrent with fear of birth and, therefore, it is important to determine both fear of birth and depressive symptoms in screening procedures during pregnancy. Caregivers who meet women during pregnancy need to acknowledge prenatal attachment and thereby influence adaptation to motherhood.
Highlights
Co-morbidity is prevalent in women with fear of birth
Women with fear of birth and depressive symptoms both during pregnancy and postpartum showed the highest risk of impaired bonding after birth
Depressive symptoms could be concurrent with fear of birth and, it is important to determine both fear of birth and depressive symptoms in screening procedures during pregnancy
Summary
Co-morbidity is prevalent in women with fear of birth. Depressive symptoms and lack of prenatal attachment might influence the postpartum bonding between the mother and the new-born. We found that, in this sample of women with fear of birth, that primiparous women were more likely to present with impaired bonding This finding contradicts the results from studies that reported that multiparous women were more at risk of attachment [16] and bonding problems [2], and the latter review suggested that when a woman becomes a mother for the first time, she may have more time and attention for her pregnancy and child, which may positively affect mother-to-infant bonding. We do not know the reason for primiparous women’s higher scores on the PBQ, but one possible explanation could be that women identified with fear of birth might suffer from other traumas Another explanation is that the women were preoccupied with their fear of birth during pregnancy and had not sufficiently processed the prenatal attachment [9]. Another explanation could be that they had not received any help with their emotional well-being, e.g. depressive symptoms
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