CONCEPT ANALYSIS OF MATERNAL-FETAL ATTACHMENT

Endang Koni Suryaningsih, Meei-Ling Gau, Wantonoro Wantonoro


DOI: https://doi.org/10.33546/bnj.1194

Abstract


Background: Knowing about prenatal attachment is crucial because it plays a significant role in pregnant women and their babies' health. Healthcare providers, particularly midwives, need to understand the concept of attachment between mother and unborn baby. However, surrogate terms to apply the concept of maternal-fetal attachment are found, and ambiguity on the definition remains.

Objective: To provide a more precise definition of the concept of maternal-fetal attachment

Method: The Walker and Avant's concept analysis approach was applied.

Results: The attributes of maternal-fetal attachment include (i) having a positive emotion, (ii) paying attention to the physical progress of the fetus and mothers themselves, (iii) having a reciprocal interaction with the baby, (iv) monitoring and imaging the unborn baby, and (v) having a desire to protect her unborn baby from harm and increase her health practices. Maternal-fetal attachment is the affection relationship, desire for protection, building the interaction, and the emotional tie between the mother and her unborn baby during the pregnancy. This personal connection is developed, mainly when the quickening is present during the late stage of pregnancy. Maternal-fetal attachment creates an emotional relationship with the unborn baby and leads the mother to express it with behavior.

Conclusion: This concept analysis provides new insight into the maternal-fetal attachment concept used for nurses and midwives in their practice.

 


Keywords


maternal-fetal attachment; pregnancy; infant; fetal movement; emotions; attentions; mothers; midwifery; nursing

Full Text:

PDF

References


Abasi, E., Tafazzoli, M., Esmaily, H., & Hasanabadi, H. (2013). The effect of maternal-fetal attachment education on maternal mental health. Turkish Journal of Medical Sciences, 43(5), 815-820. https://doi.org/10.3906/sag-1204-97

Abazari, F., Pouraboli, B., Tavakoli, P., Aflatoonian, M., & Kohan, M. (2017). Anxiety and its relationship with maternal fetal attachment in pregnant women in southeast of Iran. i-Manager's Journal on Nursing, 7(3), 16-27.

Alhusen, J. L. (2008). A literature update on maternal-fetal attachment. Journal of Obstetric, Gynecologic & Neonatal Nursing, 37(3), 315-328. https://doi.org/10.1111/j.1552-6909.2008.00241.x

Alhusen, J. L., Gross, D., Hayat, M. J., Woods, A. B., & Sharps, P. W. (2012). The influence of maternal–fetal attachment and health practices on neonatal outcomes in low‐income, urban women. Research in Nursing & Health, 35(2), 112-120. https://doi.org/10.1002/nur.21464

Alhusen, J. L., Hayat, M. J., & Gross, D. (2013). A longitudinal study of maternal attachment and infant developmental outcomes. Archives of Women's Mental Health, 16(6), 521-529. https://doi.org/10.1007/s00737-013-0357-8

Barone, L., Lionetti, F., & Dellagiulia, A. (2014). Maternal-fetal attachment and its correlates in a sample of Italian women: a study using the Prenatal Attachment Inventory. Journal of Reproductive and Infant Psychology, 32(3), 230-239. https://doi.org/10.1080/02646838.2014.883596

Bayrami, M., Heshmati, R., Mohammadpour, V., Gholamzadeh, M., Hasanloo, H. O., & Moslemifar, M. (2012). Happiness and willingness to communicate in three attachment styles: A study on college students. Procedia-Social and Behavioral Sciences, 46, 294-298. https://doi.org/10.1016/j.sbspro.2012.05.109

Beck, C. T. (1999). Available instruments for research on prenatal attachment and adaptation to pregnancy. MCN: The American Journal of Maternal/Child Nursing, 24(1), 25-32. https://doi.org/10.1097/00005721-199901000-00006

Bielawska Batorowicz, E., & Siddiqui, A. (2008). A study of prenatal attachment with Swedish and Polish expectant mothers. Journal of Reproductive and Infant Psychology, 26(4), 373-384. https://doi.org/10.1080/02646830802426144

Bloom, K. C. (1995). The development of attachment behaviors in pregnant adolescents. Nursing Research, 44(5), 284-289. https://doi.org/10.1097/00006199-199509000-00005

Boukydis, C. F. Z., Treadwell, M. C., Delaney-Black, V., Boyes, K., King, M., Robinson, T., & Sokol, R. (2006). Women's responses to ultrasound examinations during routine screens in an obstetric clinic. Journal of Ultrasound in Medicine, 25(6), 721-728. https://doi.org/10.7863/jum.2006.25.6.721

Bowlby, J. (1958). The nature of the child's tie to his mother. International Journal of Psycho-Analysis, 39, 222-273. https://doi.org/10.4324/9780429475931-15

Brandon, A. R., Pitts, S., Denton, W. H., Stringer, C. A., & Evans, H. M. (2009). A history of the theory of prenatal attachment. Journal of Prenatal & Perinatal Psychology & Health: APPPAH, 23(4), 201.

Brandon, A. R., Trivedi, M. H., Hynan, L. S., Miltenberger, P. D., Labat, D. B., Rifkin, J. B., & Stringer, C. A. (2008). Prenatal depression in women hospitalized for obstetric risk. The Journal of Clinical Psychiatry, 69(4), 635. https://doi.org/10.4088/jcp.v69n0417

Busonera, A., Cataudella, S., Lampis, J., Tommasi, M., & Zavattini, G. C. (2017). Psychometric properties of the Postpartum Bonding Questionnaire and correlates of mother–infant bonding impairment in Italian new mothers. Midwifery, 55, 15-22. https://doi.org/10.1016/j.midw.2017.08.011

Carvalho, M. E. S. (2011). The imaginary baby, the memories of parental care and the sound-musical representations in pregnancy in the study of the representation of prenatal maternal attachment and guidance for motherhood. University of Lisbon. Retrieved from http://hdl.handle.net/10451/6597

Chen, C. J., Chen, Y. C., Sung, H. C., Kuo, P. C., & Wang, C. H. (2011). Perinatal attachment in naturally pregnant and infertility‐treated pregnant women in Taiwan. Journal of Advanced Nursing, 67(10), 2200-2208. https://doi.org/10.1111/j.1365-2648.2011.05665.x

Clout, D., & Brown, R. (2016). Marital relationship and attachment predictors of postpartum stress, anxiety, and depression symptoms. Journal of Social and Clinical Psychology, 35(4), 322-341. https://doi.org/10.1521/jscp.2016.35.4.322

Condon, J. T. (1993). The assessment of antenatal emotional attachment: Development of a questionnaire instrument. British Journal of Medical Psychology, 66(2), 167-183. https://doi.org/10.1111/j.2044-8341.1993.tb01739.x

Condon, J. T., & Corkindale, C. (1997). The correlates of antenatal attachment in pregnant women. British Journal of Medical Psychology, 70(4), 359-372. https://doi.org/10.1111/j.2044-8341.1997.tb01912.x

Cranley, M. S. (1981). Development of a tool for the measurement of maternal attachment during pregnancy. Nursing Research, 30(5). https://doi.org/10.1097/00006199-198109000-00008

Cunen, N. B., Jomeen, J., Xuereb, R. B., & Poat, A. (2017). A narrative review of interventions addressing the parental–fetal relationship. Women and Birth, 30(4), e141-e151. https://doi.org/10.1016/j.wombi.2016.11.005

Dayton, C. J., Levendosky, A. A., Davidson, W. S., & Bogat, G. A. (2010). The child as held in the mind of the mother: The influence of prenatal maternal representations on parenting behaviors. Infant Mental Health Journal: Official Publication of the World Association for Infant Mental Health, 31(2), 220-241. https://doi.org/10.1002/imhj.20253

Doan, H., & Zimerman, A. (2008). Prenatal attachment: A developmental model. International Journal of Prenatal and Perinatal Psychology and Medicine, 20(1-2), 20-28.

Dokuhaki, A., Akbarzadeh, M., Pishava, N., & Zare, N. (2017). A study of the effect of training pregnant women about attachment skills on infants' motor development indices at birth to four months. Family Medicine & Primary Care Review(2), 114-122. https://doi.org/10.5114/fmpcr.2017.67864

Dubber, S., Reck, C., Müller, M., & Gawlik, S. (2015). Postpartum bonding: the role of perinatal depression, anxiety and maternal–fetal bonding during pregnancy. Archives of Women's Mental Health, 18(2), 187-195. https://doi.org/10.1007/s00737-014-0445-4

Félix Teixeira, M. I., Martins Marcos Raimundo, F., & Quintas Antunes, M. C. (2016). Relation between maternal-fetal attachment and gestational age and parental memories. Revista de Enfermagem Referência, 4(8), 85-92. https://doi.org/10.12707/riv15025

Gau, M.-L., & Lee, T.-Y. (2003). Construct validity of the prenatal attachment inventory: A confirmatory factor analysis approach. The Journal of Nursing Research: JNR, 11(3), 177-187. https://doi.org/10.1097/01.jnr.0000347634.18218.2f

Goebel, A., Stuhrmann, L. Y., Harder, S., Schulte-Markwort, M., & Mudra, S. (2018). The association between maternal-fetal bonding and prenatal anxiety: An explanatory analysis and systematic review. Journal of Affective Disorders, 239, 313-327. https://doi.org/10.1016/j.jad.2018.07.024

Gottlieb, L. (1978). Maternal attachment in primiparas. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 7(1), 39-44. https://doi.org/10.1111/j.1552-6909.1978.tb00893.x

Granier-Deferre, C., Bassereau, S., Ribeiro, A., Jacquet, A.-Y., & DeCasper, A. J. (2011). A melodic contour repeatedly experienced by human near-term fetuses elicits a profound cardiac reaction one month after birth. PloS One, 6(2), e17304. https://doi.org/10.1371/journal.pone.0017304

Hart, R., & McMahon, C. A. (2006). Mood state and psychological adjustment to pregnancy. Archives of Women's Mental Health, 9(6), 329-337. https://doi.org/10.1007/s00737-006-0141-0

Heidrich, S. M., & Cranley, M. S. (1989). Effect of fetal movement, ultrasound scans, and amniocentesis on maternal-fetal attachment. Nursing Research. https://doi.org/10.1097/00006199-198903000-00008

Hwang, R. H. (2013). Relationship between maternal fetal attachment and state anxiety of pregnant women in the preterm labor. Korean Journal of Women Health Nursing, 19(3), 142-152. https://doi.org/10.4069/kjwhn.2013.19.3.142

Kav, S., Yilmaz, A. A., Bulut, Y., & Dogan, N. (2017). Self-efficacy, depression and self-care activities of people with type 2 diabetes in Turkey. Collegian, 24(1), 27-35. https://doi.org/10.1016/j.colegn.2015.09.005

Kemp, V. H., & Page, C. K. (1987). Maternal prenatal attachment in normal and high‐risk pregnancies. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 16(3), 179-184. https://doi.org/10.1111/j.1552-6909.1987.tb01455.x

Kochanska, G., Friesenborg, A. E., Lange, L. A., & Martel, M. M. (2004). Parents' personality and infants' temperament as contributors to their emerging relationship. Journal of Personality and Social Psychology, 86(5), 744-759. https://doi.org/10.1037/0022-3514.86.5.744

Koniak Griffin, D. (1988). The relationship between social support, self‐esteem, and maternal‐fetal attachment in adolescents. Research in Nursing & Health, 11(4), 269-278. https://doi.org/10.1002/nur.4770110408

Koniak-Griffin, D., Lominska, S., & Brecht, M.-L. (1993). Social support during adolescent pregnancy: A comparison of three ethnic groups. Journal of Adolescence, 16(1), 43-56. https://doi.org/10.1006/jado.1993.1004

Lerum, C. W., & LoBiondo‐Wood, G. (1989). The relationship of maternal age, quickening, and physical symptoms of pregnancy to the development of maternal‐fetal attachment. Birth, 16(1), 13-17. https://doi.org/10.1111/j.1523-536x.1989.tb00848.x

Lindgren, K. (2001). Relationships among maternal–fetal attachment, prenatal depression, and health practices in pregnancy. Research in Nursing & Health, 24(3), 203-217.

Lindgren, K. (2003). A comparison of pregnancy health practices of women in inner‐city and small urban communities. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 32(3), 313-321. https://doi.org/10.1177/0884217503253442

Lingeswaran, A., & Bindu, H. (2012). Validation of tamil version of Cranley's 24-item maternal–fetal attachment scale in Indian pregnant women. The Journal of Obstetrics and Gynecology of India, 62(6), 630-634. https://doi.org/10.1007/s13224-012-0175-3

Maas, A. J. B. M., Vreeswijk, C. M. J. M., Braeken, J., Vingerhoets, A. J. J. M., & van Bakel, H. J. A. (2014). Determinants of maternal fetal attachment in women from a community-based sample. Journal of Reproductive and Infant Psychology, 32(1), 5-24. https://doi.org/10.1080/02646838.2013.853170

Malm, M.-C., Hildingsson, I., Rubertsson, C., Rådestad, I., & Lindgren, H. (2016). Prenatal attachment and its association with foetal movement during pregnancy–A population based survey. Women and Birth, 29(6), 482-486. https://doi.org/10.1016/j.wombi.2016.04.005

McFarland, J., Salisbury, A. L., Battle, C. L., Hawes, K., Halloran, K., & Lester, B. M. (2011). Major depressive disorder during pregnancy and emotional attachment to the fetus. Archives of Women's Mental Health, 14(5), 425-434. https://doi.org/10.1007/s00737-011-0237-z

Mehran, P., Simbar, M., Shams, J., Ramezani-Tehrani, F., & Nasiri, N. (2013). History of perinatal loss and maternal–fetal attachment behaviors. Women and Birth, 26(3), 185-189. https://doi.org/10.1016/j.wombi.2013.04.005

Mercer, R. T., Ferketich, S., May, K., DeJoseph, J., & Sollid, D. (1988). Further exploration of maternal and paternal fetal attachment. Research in Nursing & Health, 11(2), 83-95. https://doi.org/10.1002/nur.4770110204

Müller, M. E. (1989). The development and testing of the Müller Prenatal Attachment Inventory (Dissertation), University of California, San Francisco, California.

Muller, M. E., & Mercer, R. T. (1993). Development of the prenatal attachment inventory. Western Journal of Nursing Research, 15(2), 199-215. https://doi.org/10.1177/019394599301500205

Nishikawa, M., & Sakakibara, H. (2013). Effect of nursing intervention program using abdominal palpation of Leopold's maneuvers on maternal-fetal attachment. Reproductive Health, 10(1), 12. https://doi.org/10.1186/1742-4755-10-12

Pavlova, E., Markov, D., & Ivanov, S. (2015). The impact of 3D ultrasound on maternal-fetal bonding during the fetal anomaly scan in the first and second trimester. Akusherstvo i Ginekologiia, 54(4), 18-28.

Phipps, S., Zinn, A. B., Opitz, J. M., & Reynolds, J. F. (1986). Psychological response to amniocentesis: II. Effects of coping style. American Journal of Medical Genetics, 25(1), 143-148. https://doi.org/10.1002/ajmg.1320250116

Pretorius, D. H., Gattu, S., Ji, E.-K., Hollenbach, K., Newton, R., Hull, A., . . . Nelson, T. R. (2006). Preexamination and postexamination assessment of parental‐fetal bonding in patients undergoing 3‐/4‐dimensional obstetric ultrasonography. Journal of Ultrasound in Medicine, 25(11), 1411-1421. https://doi.org/10.7863/jum.2006.25.11.1411

Priel, B., & Besser, A. V. I. (2000). Adult attachment styles, early relationships, antenatal attachment, and perceptions of infant temperament: A study of first‐time mothers. Personal Relationships, 7(3), 291-310. https://doi.org/10.1111/j.1475-6811.2000.tb00018.x

Prinzie, P., Stams, G. J. J. M., Deković, M., Reijntjes, A. H. A., & Belsky, J. (2009). The relations between parents’ Big Five personality factors and parenting: A meta-analytic review. Journal of Personality and Social Psychology, 97(2), 351. https://doi.org/10.1037/a0015823

Righetti, P. L., Dell'Avanzo, M., Grigio, M., & Nicolini, U. (2005). Maternal/paternal antenatal attachment and fourth‐dimensional ultrasound technique: A preliminary report. British Journal of Psychology, 96(1), 129-137. https://doi.org/10.1348/000712604x15518

Rincy, K., & Nalini, S. J. (2014). Effect of fetal movement counting on prenatal attachment and maternal worries among primigravidae. Asian Journal of Nursing Education and Research, 4(2), 224-227.

Rossen, L., Hutchinson, D., Wilson, J., Burns, L., Olsson, C. A., Allsop, S., . . . Mattick, R. P. (2016). Predictors of postnatal mother-infant bonding: The role of antenatal bonding, maternal substance use and mental health. Archives of Women's Mental Health, 19(4), 609-622. https://doi.org/10.1007/s00737-016-0602-z

Sandbrook, S. (2009). Love or protection? Defining and measuring maternal-fetal attachment from the woman's perspective. (Dissertation), University of Wolverhampton, United Kingdom.

Sandbrook, S. P., & Adamson-Macedo, E. N. (2004). Maternal-fetal attachment: Searching for a new definition. Neuro Endocrinology Letters, 25, 169-182.

Schwerdtfeger, K. L., & Goff, B. S. N. (2008). The effects of trauma-focused research on pregnant female participants. Journal of Empirical Research on Human Research Ethics, 3(1), 59-67. https://doi.org/10.1525/jer.2008.3.1.59

Sedgmen, B., McMahon, C., Cairns, D., Benzie, R. J., & Woodfield, R. L. (2006). The impact of two‐dimensional versus three‐dimensional ultrasound exposure on maternal–fetal attachment and maternal health behavior in pregnancy. Ultrasound in Obstetrics & Gynecology, 27(3), 245-251. https://doi.org/10.1002/uog.2703

Shieh, C., & Kravitz, M. (2006). Severity of drug use, initiation of prenatal care, and maternal‐fetal attachment in pregnant marijuana and cocaine/heroin users. Journal of Obstetric, Gynecologic & Neonatal Nursing, 35(4), 499-508. https://doi.org/10.1111/j.1552-6909.2006.00063.x

Siddiqui, A., & Hägglöf, B. (2000). Does maternal prenatal attachment predict postnatal mother–infant interaction? Early Human Development, 59(1), 13-25. https://doi.org/10.1016/s0378-3782(00)00076-1

Siddiqui, A., Hagglof, B., & Eisemann, M. (1999). An exploration of prenatal attachment in Swedish expectant women. Journal of Reproductive and Infant Psychology, 17(4), 369-380. https://doi.org/10.1080/02646839908404602

Slade, M., Bird, V., Le Boutillier, C., Williams, J., McCrone, P., & Leamy, M. (2011). REFOCUS Trial: protocol for a cluster randomised controlled trial of a pro-recovery intervention within community based mental health teams. BMC Psychiatry, 11(1), 185. https://doi.org/10.1186/1471-244x-11-185

Sukriani, W., & Suryaningsih, E. K. (2018). Risk factors associated with the maternal-fetal attachment score in pregnant women. Jurnal Kesehatan, 9(2), 185-191. https://doi.org/10.26630/jk.v9i2.840

Suryaningsih, E. K. (2015). Translation and validation prenatal attachment inventory into Indonesia: A preliminary study. (Thesis), National Taipei University of Nursing and Health Sciences, Taiwan.

Ustunsoz, A., Guvenc, G., Akyuz, A., & Oflaz, F. (2010). Comparison of maternal–and paternal–fetal attachment in Turkish couples. Midwifery, 26(2), e1-e9. https://doi.org/10.1016/j.midw.2009.12.006

Van Bussel, J. C. H., Spitz, B., & Demyttenaere, K. (2010). Reliability and validity of the Dutch version of the maternal antenatal attachment scale. Archives of Women's Mental Health, 13(3), 267-277. https://doi.org/10.1007/s00737-009-0127-9

Van den Bergh, B., & Simons, A. (2009). A review of scales to measure the mother–foetus relationship. Journal of Reproductive and Infant Psychology, 27(2), 114-126. https://doi.org/10.1080/02646830802007480

Vedova, A. M. D., Dabrassi, F., & Imbasciati, A. (2008). Assessing prenatal attachment in a sample of Italian women. Journal of Reproductive and Infant Psychology, 26(2), 86-98. https://doi.org/10.1080/02646830701805349

Verhoeven, M., Junger, M., Van Aken, C., Deković, M., & Van Aken, M. A. G. (2007). Parenting during toddlerhood: Contributions of parental, contextual, and child characteristics. Journal of Family Issues, 28(12), 1663-1691. https://doi.org/10.1177/0192513X07302098

Wada, F. H., Prabandari, Y. S., & Hapsari, E. D. (2020). Bonding and attachment experience among postnatal mothers with spontaneous childbirth. Belitung Nursing Journal, 6(1), 14-20. https://doi.org/10.33546/bnj.779

Walker, L. O., & Avant, K. C. (2014). Strategies for theory construction in nursing (5th ed.). New Jersey: Pearson/Prentice Hall Upper Saddle River.

Wayland, J., & Tate, S. (1993). Maternal‐fetal attachment and perceived relationships with important others in adolescents. Birth, 20(4), 198-203. https://doi.org/10.1111/j.1523-536x.1993.tb00227.x

Wilson, M. E., White, M. A., Cobb, B., Curry, R., Greene, D., & Popovich, D. (2000). Family dynamics, parental‐fetal attachment and infant temperament. Journal of Advanced Nursing, 31(1), 204-210. https://doi.org/10.1046/j.1365-2648.2000.01245.x

Yarcheski, A., Mahon, N. E., Yarcheski, T. J., Hanks, M. M., & Cannella, B. L. (2009). A meta-analytic study of predictors of maternal-fetal attachment. International Journal of Nursing Studies, 46(5), 708-715. https://doi.org/10.1016/j.ijnurstu.2008.10.013

Zimerman, A. (2003). Prenatal attachment and other feelings and thoughts during pregnancy in three groups of pregnant women. Journal of Prenatal & Perinatal Psychology & Health, 18(2), 131.


Refbacks

  • There are currently no refbacks.




Copyright (c) 2020 Endang Koni Suryaningsih, Meei-Ling Gau, Wantonoro Wantonoro

License URL: https://creativecommons.org/licenses/by-nc/4.0/