Prenatal Attachment Research Articles

Level of mother-baby bonding and influencing factors during pregnancy and postpartum period.

Bonding is the process of an emotional relationship between mothers and babies. Pregnancy and postpartum periods are most important of developing a mother-child bonding. Here we aimed to determine the level of mother-baby bonding and identify the influencing factors during pregnancy and the postpartum period and to examine the relationship between bonding level during pregnancy and the postpartum period. This cross-sectional descriptive study included twelve districts across a range of socioeconomic structures. Every district was selected by a simple random sampling method. Data were collected with Prenatal Attachment Inventory, Mother-to-Infant Bonding Scale, Center for Epidemiologic Studies' Depression Scale and Beck Anxiety Inventory. The study included two home visits. The first visit at gestational age ≥35 weeks and second visit on the seventh or eighth day of the postpartum period. The study was conducted with 227 pregnant women. We found that, 50.7% pregnant women had prenatal depression and 36.6% pregnant women had postpartum depression. We detected a negative association between depression level during pregnancy and the postpartum period with mother-baby bonding in the postpartum period (r=0.174, p=0.009; and r=0.221, p=0.001, respectively). A negative correlation was detected between anxiety level and mother-baby bonding level in the postpartum period (r=0.151, p=0.023). It was found that when the prenatal attachment level increases, the level of postpartum bonding is also increases (r=0.297, p=0.000). Depression and anxiety levels were higher during pregnancy than the postpartum period. Depression level during pregnancy and postpartum period depression and anxiety level negatively affected mother-baby bonding in the postpartum period. We found that as prenatal attachment level increases, the level of postpartum bonding also increases.

Faktor Risiko yang Berhubungan dengan Skor Maternal-Fetal Attachment pada Ibu Hamil

Maternal-Fetal Attachment (MFA) is a bond between mother and fetus during pregnancy. MFA plays an important role in maternal and fetal health and affects mothers' decisions in healthy behaviors during pregnancy. Several factors predicted to affect the MFA is the age of pregnancy, maternal age, gravida, pregnancy status, marital status, occupation, income and education of the mother. This study aims to determine the factors associated with maternal-fetal attachment scores in pregnant women in the Panarung Puskesmas Palangka Raya. This was an observational analytic study with a cross-sectional design. A sample in this research is a pregnant woman who does a pregnancy examination at Puskesmas Panarung Kota Palangka Raya. The instrument used in this research is the Indonesian version of prenatal attachment inventory (IPAI). Data analysis was done by logistic regression. The results of statistical tests showed a significant relationship between gestational age with MFA score (p<0.05). Mothers with a gestational age >28 weeks had a better MFA score because the mother already felt the presence of her fetus.

Tools for assessing parenting in the prenatal and postpartum period in Turkey

Scales describe the scientific quality and reliability of research. Some scales are used to evaluate the relation of parents with a newborn during pregnancy and the postpartum period. This study was carried out to examine the scales adapted to Turkish that assessed parenthood status during pregnancy or the postpartum period. This study is conducted between 20 March 2018 and 30 March 2018 through Turkey Measuring Tools Directory, YOK Thesis Search, and Google Scholar using keywords such as ‘being a parent’, ‘parenting pregnancy’ and so on. Maternal Attachment Inventory, Prenatal Attachment Inventory, Postnatal Paternal–Infant Attachment Questionnaire, Mother to Infant Bonding Scale, What Being the Parent of a New Baby is Like and so on were adapted to Turkish and it has been determined that the majority are valid and reliable. The scales evaluate, especially the new parent, love, stress, fear, feelings and behaviours.Keywords: Being a parent, prenatal period, postpartum period, parenting scale.

Effect of diaphragmatic breathing exercise on psychological parameters in gestational diabetes: A randomised controlled trial

IntroductionGestational Diabetes Mellitus (GDM) affects approximately 12% of women all over the world and its control is important. Diaphragmatic breathing exercises are one of the approaches being used for pregnant women with gestational diabetes to help prenatal attachment and reduce depression, anxiety and stress. MethodsThis randomised controlled trial of women with gestational diabetes randomly allocated 60 women into either an intervention group or a control group. Over a period of 30 days, the intervention group was asked to practice diaphragmatic breathing exercises for 5 min, once a day. Individuals in the control group were invited to talk about their pregnancy twice during the same time period. Demographic and clinical data were collected using a pregnancy identification form. Outcome measures included the Depression Anxiety Stress Scale (DASS), and Prenatal Attachment Inventory (PAI). ResultsThe mean age of in the intervention and control groups was 30.6 ± 3.3 and 31.3 ± 3.1, respectively, while the mean gestational age was 27.2 ± 0.8 and 27.2 ± 1.0, respectively. The increase in PAI value on day 30 compared to day 1 was more significant in the intervention group than in the control group (p = .000). The rate of decrease in the total DASS score on day 30 compared to day 1 was significantly higher in the intervention group than in the control group (p = .000). ConclusionThe results of the study indicate that diaphragmatic breathing exercises appear to provide positive effects on psychological state and may increase levels of maternal-foetal attachment.

Early Intervention to Support Parenting during Pregnancy: Improving Parent-Child Interactions

Background: Most first parents experience childbirth with little preparation for child-rearing after birth. However, after childbirth, parents often have a hard time coping with night-time feeding or baby’s crying. This study seeks to evaluate the effects of an intervention class providing parenting support during pregnancy. The program focuses on mother-infant interaction. Methods: Participants were primipara pregnant women attending a birth center. The intervention class was offered as an addition to maternity classes. The intervention addressed fetal development, mother-newborn interaction, baby’s sleeping and waking states, baby’s self-regulation, and infant cues. The intervention group answered questionnaires containing a Prenatal Attachment Inventory (PAI) and Nurturance scales before and after the additional class; the control group answered questionnaires in the third or fourth regular maternity class. Mothers in both groups were also asked to complete a postnatal questionnaire, Maternal Attachment Inventory (MAI), and Edinburgh Postnatal Depression Scale (EPDS). Results: The intervention group included 12 primiparas (initially 13), and the control group included 12 primiparas. There was no difference in baseline (Time 1) data between the intervention group and control group, nor differences in MAI and EPDS scores postnatally (Time 3). However, the PAI score increased significantly after the intervention class (Time 2) in the intervention group. The Nurturance subordinate scale “Acceptance” also increased for the intervention group between Time 1 and Time 2. Conclusion: The early intervention parenting support class considered herein enhances attachment to the baby and acceptance in the short term, but there is no long-term effect. The implementation of multiple interventions and exploration of long-term effects are future challenges.

“Ghosts” in the womb: A mentalizing approach to understanding and treating prenatal attachment disturbances during pregnancies after loss.

Pregnancies after loss are often characterized by feelings of depression, anxiety, trauma-like symptoms, and problems bonding to the fetus. Difficulties bonding to the unborn baby during pregnancy are of clinical importance because they are predictive of problems in the mother-infant attachment relationship, perhaps explaining why some studies show a higher risk of insecure attachment for babies born after loss. O'Leary (2004) has proposed that problems in prenatal bonding during pregnancies after loss are the result of the challenge these mothers face of having to grieve the loss of one baby while bonding to another. This article argues that the theory of mentalization helps to explain why some parents successfully resolve this central challenge during pregnancies after loss and go on to develop a secure attachment to the next infant, whereas others continue to experience long-term attachment problems. Specifically, pregnancies after loss are conceptualized as a potentially traumatic experience in which mentalization may decrease and, at the same time, serve as a protective factor against attachment problems with infants born after loss due to unresolved trauma and grief. Several aspects of mentalization, including the capacity to mentalize: (a) affect associated with trauma and loss, (b) attachment relationships as distinct, (c) multiple and conflicting mental states, and (d) early inadequate attachment experiences related to trauma and loss, are proposed to help mothers pregnant after loss to mourn the loss of one baby while attaching to another, ameliorating potential attachment problems postpartum. Clinical interventions for facilitating these mentalizing capacities are suggested. (PsycINFO Database Record

Prenatal and Postnatal Attachment Among Turkish Mothers Diagnosed with a Mental Health Disorder

The presence of a mental disorder in the mother is one of the key factors affecting attachment. The present study aimed to evaluate prenatal and postnatal attachment among mothers diagnosed with a mental health disorder by comparing them to a healthy group. The patient group included women who received follow-up care in a psychiatric clinic (74 pregnant and 75 postpartum), and the healthy group consisted of women who attended a follow-up polyclinic (118 pregnant and 82 postpartum). Data were collected using questionnaire forms, including the Prenatal Attachment Inventory and the Maternal Attachment Scale. Mothers diagnosed with a mental health disorder were determined to have lower attachment scores than the healthy group, both during the prenatal and postnatal periods. The literature suggests that mothers diagnosed with a mental health disorder showed low maternal attachment scores during pregnancy and/or the postnatal period. Psychiatric nurses should be involved in initiatives that may increase the prenatal and maternal attachment.

The Association of Maternal Exposure to Domestic Violence During Childhood With Prenatal Attachment, Maternal-Fetal Heart Rate, and Infant Behavioral Regulation.

Human and animal models suggest that maternal hormonal and physiological adaptations during pregnancy shape maternal brain functioning and behavior crucial for offspring care and survival. Less sensitive maternal behavior, often associated with psychobiological dysregulation and the offspring's behavioral and emotional disorders, has been observed in mothers who have experienced adverse childhood experiences. Strong evidence shows that children who are exposed to domestic violence (DV) are at risk of being abused or becoming abusive in adulthood. Yet little is known about the effect of childhood exposure to DV on the expecting mother, her subsequent caregiving behavior and related effects on her infant. Thus, the present study examined the association of maternal exposure to DV during childhood on prenatal maternal attachment, maternal heart rate reactivity to an infant-crying stimulus and post-natal infant emotional regulation. Thirty-three women with and without exposure to DV during childhood were recruited during the first trimester of pregnancy and followed until 6-month after birth. The Maternal Antenatal Attachment Scale (MAAS) was used to measure prenatal attachment of the mother to her fetus during the second trimester of pregnancy, maternal and fetal heart rate reactivity to an infant-crying stimulus was assessed at the third trimester of pregnancy, and the Infant Behavior Questionnaire-Revised (IBQ-R) was used to assess infant emotional regulation at 6-months. Results showed that pregnant women that were exposed to DV during childhood had a poorer quality of prenatal attachment of mother to fetus, regardless of whether they also experienced DV during adulthood. In addition, maternal exposure to DV during childhood was associated with increased maternal heart rate to infant-crying stimulus and worse infant emotional regulation. These findings highlight the importance of prenatal screening for maternal exposure to DV during childhood as a risk factor for disturbances in the development of maternal attachment, dysfunctional maternal behavior and emotion dysregulation.

Becoming mothers after cancer: Resilience as a protective factor for prenatal attachment and for negative moods during pregnancy.

e22156Background: Resilience can be defined as the ability to positively deal with adverse conditions, to overcome difficulties while maintaining relatively good psychological and physical health. ...

The relation between social support, anxiety and distress symptoms and maternal fetal attachment

Objective: The aims of this study were to: (1) examine the relation between social support, trait anxiety, symptoms of maternal distress (including stress, depression and anxiety) and maternal–fetal attachment; and (2) to determine if social support buffers the relation between trait anxiety, symptoms of distress and maternal–fetal attachment.Design: Ninety-four pregnant women completed five self-report questions. Two hierarchical regression analyses were conducted to examine the influence of trait anxiety, symptoms of distress, and social support on two factors of maternal–fetal attachment, quality and intensity/frequency.Results: In the first model with the dependent measure as the maternal–fetal attachment quality score, trait anxiety (β = –.24, p < .05) and social support (β = .30, p < .01) were significant predictors, accounting for 18% of the variance. In the second model with the dependent measure as the maternal–fetal attachment intensity/frequency score, trait anxiety (β = –.23, p < .05) and social support (β = .32, p < .01) were significant predictors, accounting for 23% of the variance. In addition, the interaction term contributed a significant 4% of the variance, indicating that when social support is high, the relation between anxiety and maternal–fetal attachment intensity/frequency is attenuated.Conclusions: This study demonstrates that prenatal attachment is related to trait anxiety and social support. These findings suggest that interventions to decrease anxiety and increase social support could enhance maternal–fetal attachment.

Pregnant Women Sharing Pregnancy-Related Information on Facebook: Web-Based Survey Study.

BackgroundResearch indicates expectant and new mothers use the Internet, specifically social media, to gain information and support during the transition to parenthood. Although parents regularly share information about and photos of their child or children on Facebook, researchers have neither explored the use of Facebook to share pregnancy-related information nor investigated factors that influence such sharing.ObjectiveThe aim of this study was to address a gap in the literature by exploring the use of Facebook by pregnant women. Specifically, the study examined the use of Facebook to share pregnancy-related information, as well as any association between prenatal attachment and the aforementioned aspects of sharing pregnancy-related information on Facebook.MethodsPregnant women who were at least 18 years of age were recruited for participation in the study through posts and paid advertisements on Facebook and posts to professional organization listservs. Individuals interested in participating were directed to a secure Web-based survey system where they completed the consent form and the survey that focused on their current pregnancy. Participants completed the Maternal Antenatal Attachment Scale and answered questions that assessed how often they shared pregnancy-related information on Facebook, who they shared it with, why they shared it, and what they shared.ResultsA total of 117 pregnant women completed the survey. Descriptive statistics indicated that the pregnancy announcement was most commonly shared (75/108, 69.4%), with most women sharing pregnancy-related information on Facebook less than monthly (52/117, 44.4%) with only family and friends (90/116, 77.6% and 91/116, 78.4%, respectively) and for the purpose of involving others or sharing the experience (62/107, 57.9%). Correlation and regression analyses showed that prenatal attachment, in general, was positively and significantly related to all aspects of sharing pregnancy-related information at the P<.05 level, with the exception of sharing because of expectations. Quality of attachment, which involves the positive feelings the woman has about her unborn child, was significantly associated with sharing to involve others or share the pregnancy (t8,93=2.654 , P=.009). In contrast, after controlling for other variables, the strength or preoccupation component of prenatal attachment was significantly associated with frequency of sharing (t8,100=2.554 , P=.01), number to types of information shared (t8,97=2.605 , P=.01), number of groups with whom shared (t8,99=3.467, P=.001), and sharing to get advice (χ28=5.339 , P=.02).ConclusionsPregnant women in this study used Facebook for a variety of reasons, demonstrating the use of the social media platform during pregnancy for supportive and informational purposes. Overall, the results of this study are likely to be useful to professionals who are seeking alternative methods for providing intervention, information, and support to pregnant women via social media in our technology-driven society.

EFFECT OF BIRTH PREPERATION TRAINING ON PRENATAL ATTACHMENT AND DEPRESSION

Objective: This study is conducted to specify the effects of birth preperation training on the depression risk of pregnant women and their prenatal attachment levels.Method: This semi-experimental designed single group pretest-posttest study was conducted with 44 pregnant women attending the prenatal preparatory class of a public hospital. In the data collection process of the study, Pregnancy Presentation Form, Prenatal Attachment Inventory (PBI), Beck Depression Inventory (BDI) were used . The data were collected through interview method by the researchers.Results The mean for the age of the participants is 26,29±4,34, for the mean of the participants gestational week is 30,47±3,00, for the gestational observation number is 8,06±2,33. The average BDI score before participating in the birth preparation class is is 14.77 ± 7,40, the mean PBI score is 59,90 ± 12,40. The mean BDI score of the participants after participating in the birth preparation class is 8.06 ± 5.26. The mean PBI score is 71,88 ± 8.25. Prenatal attachment was found high in women who were planned pregnant, nuclear family and working women and the risk of depression was found low in multiparous women, Conclusion: It has been observed that birth preperation training decreases the depression risk of the pregnant women and increased the level of mother-baby attachment.

Mindfulness Moderates Depression and Quality of Prenatal Attachment in Expectant Parents

The quality of the prenatal caregiving bond with the unborn baby contributes to later parenting and healthy infant behavior and development. Previous research indicates that maternal antenatal depression can disrupt bonding with the fetus and increases risks such as prematurity and low birthweight; less is known about the effects of paternal depression on prenatal bonding. Research suggests that mindfulness may ameliorate depression symptoms in adults. This study hypothesized that dispositional mindfulness would moderate the influence of parental depression symptoms during pregnancy on the quality of prenatal bonding in a sample of expectant mothers and fathers. Self-report measures of dispositional mindfulness, depression symptoms, and quality of prenatal bonding were administered to 82 expectant parents in a metropolitan Midwest city. Higher levels of mindfulness were negatively associated with depression symptoms and positively associated with quality of prenatal bonding. Mindfulness moderated the relationship between depression symptomology and quality of attachment, such that for parents with low and average mindfulness, depression symptoms were significantly and inversely related to quality of bonding; for parents with higher depression symptom levels, mindfulness did not moderate quality of bonding. These findings suggest that trait mindfulness may promote a stronger bond during pregnancy between a parent and the unborn child. Data presented highlight the potential importance of developing higher levels of mindfulness especially in parents at risk for depression or poor prenatal bonding.

Factors and Interventions Associated with Parental Attachment during Pregnancy in Iran: A Systematic Review

Introduction: Parents' attachment to the child is an intimate,warm and continuous relationship which is the basis of the natural development of the child. Attachment starts long before birth, and is affected by a variety of factors that are not definitively recognized. Also, several interventions have been proposed for improving it that their effectiveness has not yet been determined. Given the evidence about the role of cultural and national differences, it is necessary to review existing studies in order to identify these factors and interventions in Iran.Methods and Materials: In this review, Web of Science, Scopous, Proquest,Psycinfo, CINAHL and Pubmed databases and SID, Magiran, Irondoc, Barakat Knowledge Network System as Iranian databases were searched using English and Persian keywords such as prenatal attachment, relationship, maternal attachment between 2000 and 2017, to find articles related to prenatal attachment. The full text of the articles was studied by two reviewer and their main findings were extracted and categorized.Results: Factors and interventions associated with parental attachment summarized into 12 themes: parent education, culture, anxiety, family, planning for pregnancy, history of fetal loss, substance abuse, postpartum attachment, fetal anomaly, paternal attachment, attachment measurement tools, and effectiveness of education on prenatal attachment .Conclusion: the effect of education and counseling on prenatal attachment in Iranian parents suggests the use of these methods in prenatal care. Parent’s education, social support and marital satisfaction were significant associated factors with increasing maternal attachment. History of fetal loss, anxiety and smoking was associated with the poor prenatal attachment

The correlation of the gender of the fetus with prenatal attachment and perceived social support level

Gender preferences that are based on the traditions or expectations of the geography are inevitable in Turkey, as in other countries. This study aimed to determine the correlation of the gender of the fetus with prenatal attachment and perceived social support level. The cross-sectional study was conducted between August 2015 and June 2016 in family health centers in Malatya, Turkey. A power analysis was performed, and the sample size was estimated as 265 pregnant women. The data were obtained “Pregnant Introduction Form,” “Prenatal Attachment Inventory,” and “Multidimensional Scale of Perceived Social Support.” The data were analyzed using descriptive statistics, Mann–Whitney U tests, independent-samples t test, and CronbachÂ’s alpha reliability analysis test. PAI total mean score was found to be 61.67 ± 8.58 for the primigravid women bearing a female child, and 57.74 ± 8.97 for the primigravid women bearing a male child (p

Effect of fetal movement counting on prenatal attachment and maternal worries among primigravida mothers in selected hospital, Mysuru.

Effect of fetal movement counting on prenatal attachment and maternal worries among primigravida mothers in selected hospital, Mysuru.

A study to assess the effect of fetal movement counting on prenatal attachment and maternal worries among primigravida mothers in selected Hospital, Mysuru

A study to assess the effect of fetal movement counting on prenatal attachment and maternal worries among primigravida mothers in selected Hospital, Mysuru

The Effects of Fetal Movements Counting on Maternal-Fetal Attachment: A Randomised Controlled Trial

Introduction: With the decrease in fetal activity, the risk of adverse pregnancy outcomes increases and timely reporting by mother may decrease the risk of fetal death. There are conflicting reports about the impact of fetal movement counting on maternal-fetal attachment and this study is trying to address this issue. Aim: The aim of this study was to determine the effects of fetal movements counting on maternal-fetal attachment. Materials and Methods: In a randomised controlled trial from October 2012 to December 2013, 250 nulliparous women referred to Health Centers to receive the prenatal care. The Ultrasound screening was performed in 16th-18th weeks of gestation and multiple pregnancy and fetal malformations were excluded (n=4). Thirty-eight of participants did not return the baseline questionnaire and 208 women were randomly allocated into the two groups to either fetal movement counting or to standard antenatal care. Main outcome was maternal-fetal attachment, measured by the Prenatal Attachment Inventory. The analysis was performed by SPSS and p<0.05 was considered significant. Results: No difference was found between the groups with respect to individual characteristics. At 28 weeks of gestation, the mean scores given to Prenatal Attachment Inventory items, was 90.23±9.64 in the intervention group and 90.00±10.04 in the control group and the difference was not significant (Mean difference=0.230, p=0.866). Also, no significant difference was found at 37 weeks of gestation between the two groups (93.75±7.59 vs 92.78±9.90 respectively, mean difference=0.961, p=0.433). Conclusion: The counting of fetal movements by mother from 28 to 37 weeks of gestation did not affect the maternal-fetal attachment in nulliparous women. The investigation of fetal movement counting on psychological factors of mother was suggested. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved.

Women who had positive relationships with their own mothers reported good attachments to their first child before and after birth.

Bowlby's attachment intergenerational transmission theory suggests that a woman's attachment to her parents, particularly her mother, plays an important role in her future parenting. We studied whether there was any association between pregnant women's attachment to their baby before and after birth and their relationships with their mothers. A longitudinal study was carried out in 2015 on 201 first-time mothers recruited in the maternity ward of the level two Misericordia e Dolce Hospital in Prato, Italy. At 32 weeks of pregnancy, the women filled in the Parental Bonding Instrument and the Prenatal Attachment Inventory and their spontaneous attachment behaviour towards their newborn infants were observed in the nursery during the first two days after childbirth. Having a good relationship with their own mothers was a positive predictor for the women's prenatal attachment to their baby and caregiving and attachment behaviour to their newborn infants. In addition, the mothers' prenatal attachment positively predicted their behavioural attachment pattern after birth. We found that women who had positive relationships with their own mothers also had positive attachments to their unborn babies and in the period immediately after birth. Our findings supported Bowlby's attachment intergenerational transmission theory.

The Relation of Health-Related Practices of Pregnant Women, Fatigue and Prenatal Attachment.

To examine the relation of the health-related practices of expectant mothers during pregnancy and fatigue in mother and prenatal attachment. Descriptive study. Sakarya Training and Research Hospital, Turkey, between February and April 2016. The study sample consisted of pregnant women (at least 20-week gestation) aged 18 years or above (n=211) who applied to prenatal care services and agreed to participate in the study. The data were collected through a Personal Information Form, Brief Fatigue Inventory (BFI) and the Prenatal Attachment Inventory (PAI). The PAI medians of the participants were 55 [42-64], and the BFI medians were 30 [23-42], and a negative, statistically significant relationship was found between BFI and PAI (r= -0.184, p=0.007). Expectant mothers who develop positive health behaviors during pregnancy feel less fatigue and positively affect the prenatal attachment. It is important to evaluate prenatal attachment and identify the mother with low attachment scores.