Maternal-fetal Attachment Research Articles

Age, psychological maturity, and the transition to motherhood among English-speaking Australian women in a metropolitan area.

In the context of the trend toward delayed parenthood, this study examines whether older maternal age is associated with greater psychological maturity and whether greater psychological maturity provides any adaptive benefit during the transition to motherhood. A sample of 240 predominantly English-speaking Australian women in a metropolitan area expecting their 1st baby (mean age = 32.81 years; 41% conceived after fertility treatment) completed measures of psychological maturity (hardiness, ego development, and ego resiliency) and pregnancy adaptation (maternal fetal attachment and formation of a maternal identity) in the 3rd trimester of pregnancy and a measure of postnatal adjustment at 4-6 months postpartum. Structural equation modeling showed age was positively associated with a latent construct of psychological maturity, and psychological maturity was associated with more optimal adaptation in pregnancy and early motherhood. Both psychological maturity and pregnancy adaptation predicted positive postnatal adjustment. Age was indirectly related to adaptation through its relationship with psychological maturity. The relationships in the model applied regardless of mode of conception (fertility treatment or spontaneous). Potentially confounding contextual factors associated with older age at motherhood, higher education, and maternal and child health were included in the model. These results suggest that psychological maturity is a benefit of motherhood at older ages.

Maternal–fetal attachment and prenatal diagnosis of heart disease

ObjectiveTo test the hypothesis that there are differences in the level of maternal–fetal attachment before and after fetal echocardiography in the presence or absence of cardiac abnormalities. Study designCohort study in which the mothers responded to a validated Maternal–Fetal Attachment Scale. The study compared a group of pregnant women with diagnosis of fetal heart disease (FHD) with a group without this diagnosis (“no fetal heart disease” – NFHD). Results197 pregnant women were included, 96 FHD and 101 NFHD. Maternal–fetal attachment at the initial and final periods showed no significant baseline differences between groups (p=0.081). At the final period, migration from medium to high level of attachment was significantly higher in FHD (p=0.017). Transition from medium to high levels comparing the initial and final periods was more pronounced in FHD (p=0.009). ConclusionDiagnosis of fetal heart disease increases the level of maternal–fetal attachment.

A comparative study on Maternal Fetal Attachment behaviors of women with and without history of perinatal loss

Abstract Background: Maternal mental health and motherhood adaption behaviors during pregnancy have been paid much attention during recent years. This study aims to compare maternal fetal attachment behaviors of women with and without history of perinatal loss Material and Methods: This was a comparative study on women in two groups of women with and without history of perinatal loss. The participants were recruited using a convenience method of sampling, from prenatal care services affiliated to Shahid Behesti University of Medical Sciences. Tools for data collection included a questionnaire with demographic- and fertility- related questions as well as the Persian version of Cranly ’s MFA questionnaire The MFAS scale included questions in groups including role-taking, differentiation of self from fetus, interaction with fetus, attribution of characteristics to fetus, and giving of self. Data was analyzed by SPSS and using t, ANOVA, regression, Chi square, Pearson correlation and Mann Whitney tests. Results: One hundred women aged years (Mean±SD), with weaks gestational age participated in the study. Finding showed that total mean score for MFA of women with history perinatal loss ( Percent) is not significantly different from the mean score of primigravid women without such a history ( Percent) (p< ). Primigravid women without history of perinatal loss had a significantly higher score for the behaviors related to “differentiation of self from fetus” comparing to women with history of perinatal loss But, two groups were not different regarding to other groups of MFA behaviors (p< ). Conclusion: Maternal-fetal attachment behaviors of women with and without history of perinatal loss were not different. However women with the history of perinatal loss shows lower scores for behaviors related to differentiation of self from fetus. Key word: Pregnancy, perinatal loss, Maternal Fetal Attachment

Determinants of maternal fetal attachment in women from a community-based sample

BackgroundMaternal fetal attachment (MFA) has been found to be an important predictor for the developing relationship between mother and child. During the last decades, research on determinants of MFA has yielded inconclusive and even contradictory results. Until now, a process model in which multiple determinants of MFA are studied concurrently has been lacking. The present study evaluates a process model (based on Belsky’s model of parenting) in which the specific contributions of parental, contextual, and expected child characteristics to MFA were examined.MethodsParticipants, 351 pregnant women from a community-based sample, completed questionnaires concerning their personality, attachment security, partner support, perceived stress, expected child temperament, and MFA at 26 weeks gestational age. Based on Belsky’s model, a set of competing structural equation models were formulated and evaluated with path analysis.ResultsMFA was found to be multiply determined by parental, contextual, and expected child characteristics. These factors explained 19% of the variance in MFA. Pregnant women who were more extrovert, conscientious and agreeable reported having higher levels of MFA. In contrast, those women who perceived more stress and expected having an infant with a dull temperament reported lower levels of MFA.ConclusionThis study demonstrated that the theoretical framework of Belsky’s model is applicable for explaining variations in the quality of the mother–fetus relationship in the pregnancy period. More knowledge of the determinants of MFA could help to identify mothers at risk for developing suboptimal feelings of attachment.

Examen des propriétés psychométriques de la traduction française de la Maternal Antenatal Attachment Scale (MAAS)

Prenatal attachment (PA) is defined as the relationship that develops between a woman and her foetus. Three measurements exist for evaluating PA: the Maternal Foetal Attachment Scale (MFAS), the Maternal Antenatal Attachment Scale (MAAS) and the Prenatal Attachment Inventory (PAI). Of these three, only the PAI has been used in French. The overall objective of the current study was to evaluate the psychometric properties of this second measure of PA: the MAAS. This scale was developed in 1993 by Condon. The MAAS is a 19-item self-report questionnaire which allows for calculating a total attachment score and two subscale scores; one score estimating the quality of the affective attachment experience and the other that estimates the intensity of concern about the foetus. For each item, the future mother provided an appreciation on a 5-point Likert scale (1=absence of feelings for the foetus; 5=very strong feelings for the foetus). The sample was composed of 117 primiparous French females (27.5 ± 4.27 years) in the third trimester of pregnancy (32.84 ± 3.77 weeks of amenorrhea). The study was carried out over a period of 5 months (January-May 2012). Each woman was asked to provide demographic data, a French version of the MAAS, a validated French version of the PAI, and a scale evaluating depressive symptoms (Edinburgh PostNatal Depression Scale, EPDS). The MAAS demonstrated moderately good psychometric properties. Condon's two-factor structure of MAAS was not supported in our sample. Four factors were identified with exploratory factor analysis. Internal consistency was satisfactory for the global scale and for the factor 1 but not sufficiently adequate for the other factors. Concurrent validity was indicated by moderate correlations between the global MAAS scores with the total PAI score. A weak but significant inverse correlation was found between the MAAS and the EPDS suggesting good divergent validity. The authors suggest that additional research be conducted on the measurement before confirming the validity of the French version.

Predictors of Sensitivity in Mothers of 8-Month-Old Infants

This longitudinal study investigated the impact of maternal mental health, including postpartum depression, and of maternal-fetal attachment, on maternal sensitivity when babies were eight months old. The study included 38 mother-infant dyads. The women answered the SRQ-20 and the Maternal-Fetal Attachment Scale in the third trimester of pregnancy, and the BDI, for evaluation of postpartum depression in the first month following birth. Maternal sensitivity was examined through an observation of mother-child interaction when babies were eight months old. The multiple regression model considering the three factors explained 18.6% of the variance in sensitivity, and only maternal-fetal attachment was a significant predictor. The results indicate the importance of interventions to promote the bond of pregnant women with their babies, which may even minimize possible harmful effects of postpartum depression on mother-child interaction.

Violence during pregnancy and its effects on mother–baby relationship during pregnancy

Background: Human beings have an innate need to form close emotional bonds with significant others. Objective: The purpose of this research was to study the effect of domestic violence during pregnancy in the mother–infant relationship. Method: 204 pregnant outpatients (of the Obstetrics and Gynecology Department of the Hospital Pedro Hispano, Portugal) with a mean age of 29 and in their last 3 months of pregnancy were the participants of this study. To assess the violence level during pregnancy, we used the Conflict Tactic Scale 2. The mother–baby relationship was determined using the Maternal Foetal Attachment Scale and the Maternal Adjustment and Maternal Attitudes questionnaire. Results: In our work, we encountered 107 pregnant victims (52.4% of all outpatients) of domestic violence. The results showed that victims of domestic violence had a poor relationship with the foetus (M = 97.4, SD = 8.1), but not to the point of statistical significance. In these same patients, we also detected minor adjustments and attitude shifts towards pregnancy (M = 117, SD = 14.2) and this result was statistically significant when compared with women who did not experience domestic violence. Conclusion: Our results suggest that women who are victims of domestic violence are more likely to have a lower attachment with the foetus when compared with women who do not suffer domestic violence. Additionally, the victims showed more negative attitudes towards pregnancy and the foetus when compared to non-abused women.

Depression and Anxiety During Pregnancy: Clinical Aspects

Depression and anxiety are common during pregnancy. Depression is associated with preterm birth, low birth weight, and intrauterine growth restriction. Risk factors related to depression and anxiety during pregnancy are poor social support, poor quality of intimate relationship, poverty and previous episodes to depression and anxiety. When these mental disorders are untreated, poor health behaviors are observed in pregnant patients including inadequate nutrition, smoking, drug use and failure to attend medical appointments. Inadequate maternal-fetal attachment is developed when mother is depressed. Self-harm is another situation of concern in depressed pregnant women. On the other side associated risks to antidepressant and anxiolytic treatment during pregnancy have to be considered, it has been reported miscarriage, perinatal death, lower birth weight, preterm birth and lower Apgar scores related to psychotropic drug use during pregnancy. Increased risk of malformation is still controversial, as well as developmental effects in children of mothers exposed to of psychotropic drugs. In this review we explore literature related to depression and anxiety during pregnancy to weigh risk and benefits of their treatment in the mother and the baby. Keywords: Depression, anxiety, pregnancy, antidepressants, anxiolytic.

A synopsis of recent influential papers published in psychiatric journals from the Arab world (2012)

This review includes six recent and influential papers that have appeared in the three leading psychiatry journals from the Arab region. The first paper examined the role of personality profile in the motivation to quit smoking and concluded that there is a positive correlation between Novelty seeking (NS), Persistence (P), Cooperativeness (C) and motivation to quit smoking. The second study discussed the prevalence of abuse history in patients with schizophrenia whether physical or sexual, and its impact on their condition and function. The third paper reported that patients with substance abuse problem show more risky sexual behaviors than normal controls. The fourth study high-lighted the similarities regarding complaints about sleep and polysomnographic changes in depression patients and somatoform disorder patients. The fifth paper, investigated the prenatal and perinatal risk factors in autistic disorders. The sixth and final article concluded that poor levels of maternal fetal attachment during the course of pregnancy should be managed in order to optimize fetal and maternal health. Overall, the papers describe a wide spectrum of research initiatives in the Arab world that are likely to have implications for global mental health.

The Relationship Between Maternal–Fetal Attachment and Cigarette Smoking Over Pregnancy

Cigarette smoking during pregnancy is one of the most preventable causes of infant morbidity and mortality, yet 80 % of women who smoked prior to pregnancy continue to smoke during pregnancy. Past studies have found that lower maternal-fetal attachment predicts smoking status in pregnancy, yet past research has not examined whether maternal-fetal attachment predicts patterns or quantity of smoking among pregnant smokers. The aim of this study was to examine the relationship between maternal-fetal attachment and patterns of maternal smoking among pregnant smokers. We used self-reported and biochemical markers of cigarette smoking in order to better understand how maternal-fetal attachment relates to the degree of fetal exposure to nicotine. Fifty-eight pregnant smokers participated in the current study. Women completed the Maternal-Fetal Attachment Scale, reported weekly smoking behaviors throughout pregnancy using the Timeline Follow Back interview, and provided a saliva sample at 30 and 35 weeks gestation and 1 day postpartum to measure salivary cotinine concentrations. Lower maternal-fetal attachment scores were associated with higher salivary cotinine at 30 weeks gestation and 1 day postpartum. As well, women who reported lower fetal attachment reported smoking a greater maximum number of cigarettes per day, on average, over pregnancy. Lower maternal-fetal attachment is associated with greater smoking in pregnancy. Future research might explore whether successful smoking cessation programs improve maternal assessments of attachment to their infants.

A longitudinal study of maternal attachment and infant developmental outcomes

Extant research has demonstrated that compared to adults with insecure attachment styles, more securely attached parents tend to be more responsive, sensitive, and involved parents, resulting in improved outcomes for their children. Less studied is the influence of a mother's attachment style on her attachment to her unborn child during pregnancy and the consequent developmental outcomes of the child during early childhood. Thus, the aim of this prospective longitudinal study was to examine the relationship between maternal-fetal attachment (MFA) during pregnancy and infant and toddler outcomes and the role of mothers' attachment style on early childhood developmental outcomes in an economically disadvantaged sample of women and their children. Gamma regression modeling demonstrated that an avoidant maternal attachment style (b = .98, 95% CI [.97, .98], p < 0.001) and post-partum depressive symptomatology (b = .97, 95% CI [.96-.99], p = 0.03) were significant predictors of early childhood development. Women demonstrating higher avoidant attachment styles and greater depressive symptomatology were more likely to have children demonstrating early childhood developmental delays than those women with less avoidant attachment styles and less depressive symptomatology. Furthermore, women reporting higher MFA during pregnancy had more secure attachment styles, and their children had more optimal early childhood development than those women reporting lower MFA and less secure attachment styles. Findings have implications for enhancing early intervention programs aimed at improving maternal and childhood outcomes. An earlier identification of disruptions in attachment may be beneficial in tailoring interventions focused on the mother-child dyad.

Apego materno fetal em gestantes que vivem com HIV/Aids

Maternal-fetal attachment in pregnant mothers living with HIV/Aids. Pregnancy in the context of HIV/ AIDS is usually accompanied by intense anxiety due to the possibility of mother-to-child HIV transmission. This study investigated the maternal-fetal attachment in pregnant mothers living with HIV/AIDS (n = 88), compared to pregnant mothers without HIV (n = 79), considering their answers to the Maternal-Fetal Attachment Scale. The results showed no differences on maternal-fetal attachment among the participants. However, findings show a peculiar way of maternal-fetal attachment among pregnant mothers living with HIV/AIDS. Mother-baby interactions seem to focus more on the present moment, and the baby health care in pregnancy is linked to the mother HIV treatment. The scale might not be sensitive enough to find differences associated with the context of HIV/AIDS. Further studies are important to review the scale items in order to get closer to the peculiarities related to HIV and maternal-fetal attachment.

History of perinatal loss and maternal–fetal attachment behaviors

Maternal-fetal attachment (MFA) is an important requirement for optimal maternal-infant adaptation. Current studies showed conflicting findings about whether a history of perinatal loss (fetal/neonatal death) affects maternal attachment in pregnancy. "Does a history of perinatal loss affect maternal-fetal attachment behaviors?" One hundred women with and without a history of PL were recruited using a convenience method of sampling, from prenatal care services affiliated to Shahid Behesti University of Medical Sciences. Data collected by questionnaires from a convenience sample of multiparous women in the 3rd trimester of pregnancy with no surviving children were compared with data from a selected cohort of primigravid women. The two groups of women were matched for health and literacy. The data collected included demographic characteristics and responses to 24 questions in five groups of behaviors on the Persian version of Cranly's Maternal-Fetal Attachment Scale. Data were analyzed by SPSS 13 and using t, ANOVA, Chi square, Pearson correlation and Mann-Whitney tests. Finding showed that total score of MFA for women with a history of PL (68.95±9.20%) is not significantly different from this score for women without such a history (71.22±11.75%; p<0.05). Women with a history of PL had a significantly lower score for a subgroup of behaviors "differentiation of self from fetus" compared to women without of a history of PL (78.25 vs. 83.21%; p<0.05). But, there were no statistically significant differences between two groups respecting to other subgroups of behaviors between two groups. In this study, a history of pregnancy loss was found to be associated with disturbances in the group of maternal-fetal attachment behaviors related to "differentiation of self from fetus" in a subsequent pregnancy.

A Controlled Clinical Treatment Trial of Interpersonal Psychotherapy for Depressed Pregnant Women at 3 New York City Sites

While treatment decisions for antepartum depression must be personalized to each woman and her illness, guidelines from the American Psychiatric Association and the American College of Obstetrics and Gynecology include the recommendation of psychotherapy for mild-to-moderate depression in pregnant women. Although we previously demonstrated the efficacy of interpersonal psychotherapy for antepartum depression in a sample of Hispanic women, this study provides a larger, more diverse sample of African American, Hispanic, and white pregnant women from 3 New York City sites in order to provide greater generalizability. A 12-week bilingual, parallel-design, controlled clinical treatment trial compared interpersonal psychotherapy for antepartum depression to a parenting education program control group. An outpatient sample of 142 women who met DSM-IV criteria for major depressive disorder was randomly assigned to interpersonal psychotherapy or the parenting education program from September 2005 to May 2011. The 17-item Hamilton Depression Rating Scale (HDRS-17) was the primary outcome measure of mood. Other outcome scales included the Edinburgh Postnatal Depression Scale (EPDS) and the Clinical Global Impressions scale (CGI). The Maternal Fetal Attachment Scale (MFAS) assessed mother's interaction with the fetus. Although this study replicated previous findings that interpersonal psychotherapy is a beneficial treatment for antepartum depression, the parenting education program control condition showed equal benefit as measured by the HDRS-17, EPDS, CGI, and MFAS. This study supports the recommendation for the use of interpersonal psychotherapy for mild-to-moderate major depressive disorder in pregnancy. The parenting education program may be an alternative treatment that requires further study. ClinicalTrials.gov identifier: NCT00251043

The development and psychometric evaluation of the Chinese version of the maternal attachment inventory

To develop the Maternal Attachment Inventory (MAI) into Chinese and assess its psychometric properties. The MAI measures of maternal affectionate attachment. This scale displays the most appropriate indicators associated with attachment and has been widely adopted in different fields for measuring maternal-infant attachment. Cross-sectional survey design. The study was carried out in two clinics. From the accessible population of 507 samples, a simple random sampling method of selection was used to randomly choose 200 names of mothers at 4-8 months after delivery using a computer. One hundred and eighty-one mothers agreed to participate in the study. The Chinese version of the MAI (CMAI) was developed in five stages: translation, review, back-translation, a review by a panel of specialists and a pilot test. Regarding the reliability of the CMAI, a test of correlations between the subscales and the entire scale was performed consecutively. With respect to the validity of the MAI, exploratory factor analyses, a test of relationships between items and subscales, and an analysis of concurrent criterion-related validity were conducted. The CMAI contains four factors in its structure. The CMAI and its subscales possess good internal consistency; the Cronbach's α coefficient was 0·94. In addition, the Pearson product-moment correlation coefficient between the CMAI and the Maternal-Fetal Attachment Inventory (MFAI) and between the CMAI and the Maternal-Infant Attachment Inventory (MIAI) was 0·38 and 0·5, respectively. This suggests significant medium and high respective correlations between the CMAI and these two scales. One major limitation of this study is that participants were recruited from two clinics located in central Taiwan. The CMAI possesses acceptable reliability and validity for use in measuring the levels of attachment and affectional ties between mothers and their infants. The CMAI provides further evidence of the applicability of the CMAI in clinical maternity care services.

Maternal-foetal attachment during early pregnancy in Taiwanese women pregnant by in vitro fertilization

The aim of this study was to investigate maternal-foetal attachment at 9, 12 and 20 weeks gestation and to identify factors that influenced maternal-foetal attachment in Taiwanese women who conceived by in vitro fertilization. Development of maternal-foetal attachment is an important part of taking on the maternal role. However, evidence about maternal-foetal attachment after assisted conception is inconclusive. A longitudinal design with repeated measures. A prospective, longitudinal design with repeated measures was used. Over an 18-month period in 2006-2008, a convenience sample of 160 women who conceived after undergoing successful in vitro fertilization were recruited from a major infertility care centre in Taiwan. Data were collected by self-reported measures, including: (1) Maternal-Foetal Attachment Scale; (2) Symptoms Checklist; (3) Pregnancy-related Anxiety Scale; (4) Social Support Apgar; (5) Chinese childbearing attitude Questionnaire; and (6) Awareness of Foetus Scale. The selected instruments to measure each variable were administered to participants at 9, 12 and 20 weeks gestation. Maternal-foetal attachment increased as pregnancy progressed from 9 to 20 weeks gestation. General linear mixed model showed predictors of maternal-foetal attachment included Chinese childbearing attitude, awareness of the foetus, and social support. Health provider awareness of cultural influences on the development of early maternal-foetal attachment of women pregnant by in vitro fertilization is needed. Prenatal education in early pregnancy might incorporate more information about foetal development to allow the mother to visualize her unborn child. Providing social support for women who were conceived by in vitro fertilization is beneficial to the development of maternal-foetal attachment.

State of the Science: Does the Theory of Maternal Role Attainment Apply to African American Motherhood?

This article reviews the current state of knowledge of the theory of maternal role attainment (MRA) and its relevance in describing African American motherhood. EBSCOhost Research Databases that included PubMed, CINAHL plus, MEDLINE, PsycINFO, SCOPUS, and Web of Science were searched for journal articles that examined maternal identity and MRA. Keyword searches included maternal identity, maternal role attainment, becoming a mother, prenatal attachment, maternal-fetal attachment, and maternal-infant attachment. Inclusion criteria for this review were published journal articles of studies conducted in the United States, with a clear delineation of the theoretical framework of MRA. Journal articles that measured MRA among women with depression or medically fragile infants were excluded. Two hundred and twelve studies were reviewed; 25 studies, published between 1975 and 2007, met the inclusion criteria. Nine articles described the theory of MRA, 11 articles measured variables thought to influence MRA, and 6 articles described maternal-fetal attachment, a construct of MRA. Studies were reviewed, categorized, and analyzed to determine current knowledge of how the theory of MRA describes African American motherhood. Categories included studies describing the theoretical framework of maternal identity and MRA, studies measuring key variables thought to impact MRA, and studies measuring maternal-fetal attachment and maternal-infant attachment. The studies were limited by homogenous samples of upper-middle-class white women and low-income, single, African American adolescents. Study results of MRA cannot be generalized to African American women. Further research is essential to identify attributes influencing MRA, specifically among larger samples of African American women with demographics similar to that of the white populations that have been included in studies thus far.

Effect of nursing intervention program using abdominal palpation of Leopold’s maneuvers on maternal-fetal attachment

BackgroundThe aim of this study was to investigate whether a nursing intervention program using abdominal palpation would improve maternal-fetal relationships of pregnant women.MethodsThe subjects were Japanese women aged less than 40 years with singleton pregnancies. A nursing intervention involving abdominal palpations of Leopold’s Maneuvers was performed for the intervention group (n = 35) in the 30th, 32nd, and 34th weeks’ gestation, while ordinary health-related advice was provided to the control group (n = 73) in the corresponding period.ResultsAt the 30th (baseline) week, no intergroup differences were observed. However, the intervention group showed higher Prenatal Attachment Inventory (PAI) scores in the 34th (P < 0.01) and 36th weeks (P < 0.05) as well as a higher frequency of talking to the fetus in the 32nd (P < 0.01), 34th (P < 0.01), and 36th weeks (P < 0.05). Furthermore, Fetal position awareness score in the 32nd, the 34th, and the 36th weeks were higher in the intervention group than in the control group (P < 0.001).ConclusionsThe present findings have suggested that nursing interventions involving abdominal palpations can develop the maternal–fetal relationship. Further random controlled trials are warranted to ascertain this observation.

Relationship Between Maternal Fetal Attachment and State Anxiety of Pregnant Women in the Preterm Labor.

The Purpose of this study was to investigate relationships between maternal fetal attachment and state anxiety for pregnant women in preterm labor. The subjects consisted of 56 pregnant women in preterm labor on C hospital. The data were analyzed using SPSS computer program that includes descriptive statistics, mean, standard deviation, t-test, ANOVA, Scheffe? test and Pearson correlation coefficient. Age distribution was 30~39 years of age. Mean score of maternal fetal attachment was 91.50. The group whose planned pregnancy was highest showed higher maternal fetal attachment. The primigravida group showed high maternal fetal attachment. Most frequently practiced attachment item was: "I'm really looking forward to seeing what the baby looks like". The next was was: "I enjoy watching my tummy jiggle as the baby kicks inside". There was no difference in degree of anxiety by general and obstetrical characteristics. There was statistically significant of negative correlation between maternal fetal attachment and state anxiety for pregnant women with preterm labor. Findings provide useful information for further studies in reducing anxiety and intervention programs relating to pregnancy and preterm labor. To increase maternal fetal attachment of pregnant women with preterm labor, it is necessary to standardize prenatal education program.

The effect of maternal–fetal attachment education on maternal mental health

This study aimed to investigate the effects of ram presence during estrus synchronization protocol and previous sexual experience on estrus onset, estrus duration, and sexual behaviors in Kivircik ewes. The ewes were divided into 2 groups according to the presence or absence of rams during the synchronization protocol. Ewes in each group were also divided into 3 subgroups according to their previous sexual experience. Ram presence during synchronization protocol did not affect estrus onset, estrus duration, mean attractivity, mean proceptivity, and mean receptivity. Nonexperienced ewes had longer estrus onset and shorter estrus duration than experienced ewes. Experienced ewes were more attractive and more receptive than the naive ones. It is concluded that although ram presence during estrus synchronization has no effect on sexual behaviors, previous sexual experience with males improves the expression of sexual behaviors in Kivircik ewes. Therefore, detection of estrus in maiden ewes should be performed more carefully in order to get high rates of flock fertility.