Abstract
BackgroundPer UNICEF’s Nurturing Care Framework, early childhood development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship can be partly examined via a series of bonding activities called early stimulation behaviors (ESB). This study describes early stimulation behaviors and the associated correlates among pregnant women in Ghana.MethodsThis cross-sectional study used data from a cluster-randomized trial in two districts of Northern Ghana. A total of 374 pregnant women were enrolled at baseline and administered a pre-intervention survey. Communication-related early stimulation behaviors was the primary outcome which was evaluated using three maternal-fetal bonding activities; did the woman self-report touching and/or talking, singing, and/or talking about family to her belly. A generalized estimating equation modified Poisson model was used for the bivariate and multivariable analysis.ResultsAbout half of the participants reported performing communication-related ESB during pregnancy frequently or sometimes. Bivariate analysis revealed that negative life experiences including higher rates of emotional, physical and sexual intimate partner violence (IPV) and having moderate to severe depressive symptoms were associated with women performing early stimulation behaviors more often. In the multivariable model, physical intimate partner violence remained significantly associated with early stimulation behaviors.ConclusionResearch on early stimulation behaviors is still in a nascent phase. It is unclear why our results revealed an association between intimate partner violence and early stimulation behaviors; this could reflect a coping mechanism for the expectant mother. Further research is needed to better understand this association and explore potential long-term impacts of early stimulation behaviors during pregnancy on child development.Trial registrationClinical Trials # NCT03665246, August 29, 2018.
Highlights
Per UNICEF’s Nurturing Care Framework, early childhood development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development
Most ECD programs begin at birth; evidence suggests that for nurturing care to be most effective, interventions need to begin during pregnancy and be caregiver-centered [3]
There is sparse research on how frequently early stimulation behaviors (ESB) during pregnancy should be performed or what specific behaviors lead to optimal developmental outcomes; some evidence suggests these behaviors may lead to higher maternal-fetal attachment [13]
Summary
Per UNICEF’s Nurturing Care Framework, early childhood development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship, which focuses on interactions and feelings the expectant mother has towards her developing fetus, is one the first opportunities in ECD to create a nurturing relationship between caregiver and baby [2]. This relationship opens a window for pregnant women to begin performing early stimulation behaviors (ESB), like touching and talking to her belly during pregnancy. Most ECD programs begin at birth; evidence suggests that for nurturing care to be most effective, interventions need to begin during pregnancy and be caregiver-centered [3]
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