Most mothers will admit that their relationship with their children began during pregnancy. The mother will be focusing on the emotional connection with her child. On a different angle, scientists are interested to determine the physiological relationship the mother shares with their child before and after birth (DiPietro, 2010). Research has pointed to the long-term effect of maternal stress during pregnancy on the physical and mental health of children after birth (Glover, O’connor, & O’Donnell, 2010). This paper discusses the background of such health-related problems, explores evidence-based practice on the subject and provides costs associated with implementation of such interventions to the stakeholders.
Maternal-Fetal Attachment
Mothers have been known to be able to identify the specific needs of the child apart from her own by the second trimester of pregnancy. As the woman develops the specific feeling towards her fetus, maternal responses are observed forming the foundations of the concept of maternal-fetal attachment. These responses include attributes, feelings and thoughts about her fetus in relation to herself. As the pregnancy grows and the fetus movement is stronger, responses become more elaborate in anticipation of birth. Thus, the systems work complimenting each other to ensure the survival of the child. The maternal-fetal attachment is thus a critical development aspect within the pregnancy to provide care for the unborn child.
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The maternal-fetal attachment can be assed in different ways, including a questionnaire that asks the expectant mother concerning their feelings and behaviors expressed towards their unborn child. For example, expectant mothers can be asked whether they speak to their babies. This questionnaire can assess the level of positive attachment between the mother and her unborn child. A second method involves a semi-structured interview which could lead to three categories of attachment: disengaged, distorted or balanced. Mothers with a balanced view can make balanced expressions of their pregnancy, highlighting both positive and negative aspect of their pregnancy and parenthood in general. Disengaged mothers are generally uninterested about the pregnancy, giving short and curt responses, while distorted mothers have too much to say, alluding to their experiences as a child. Maternal-fetal attachment predicts both mental and physical health in infants as well as mothers. Mothers with higher maternal-fetal attachment had children with best development and secure attachment, while mothers with low maternal-fetal attachment experienced adverse outcomes on themselves and children (Alhusen, Hayat, & Gross, 2013). Moreover, studies have shown the impact of mother-fetal attachment during pregnancy and the cessation of smoking, bonding between mother and child as well as positive parenting (Alvarenga, Dazzani, Lordelo, Alfaya, & Piccinini, 2013; Dubber, Reck, Müller, & Gawlik, 2015).
Intimate Partner Violence (IPV) as a Pregnancy Stressor
Pregnancy stress can affect child outcomes. In this paper, focus is put on intimate partner violence and the deleterious effects it has on children. IPV here is defined as the violence perpetrated by the male against his pregnant female partner. According to Crime Survey of England and Wales, up to 7% of women reported IPV within the last 12 months. IPV is episodic and normally unpredictable. Exposure to the phenomenon has led to poor health among women and personality disorders including depression, post-traumatic stress disorder and anxiety. In the instance of pregnancy, IPV does not only have direct effects on the mother, but also the fetus. As a result, it is possible that women experiencing IPV during pregnancy experience spontaneous miscarriage, higher miscarriage rates and premature delivery (Alhusen, Ray, Sharps, & Bullock, 2015). Moreover, women who experienced IPV were more often likely to have disengaged or distorted responses towards their unborn children (Huth‐Bocks, Levendosky, Theran, & Bogat, 2004).
Interventions
While interventions are limited, a few programs have been developed to counter the effects of IPV. One of the intervention methods used is increasing maternal knowledge of the physical presence of the fetus. This is based on the premise that maternal-fetal attachment increased over increased perceptions of fetal development (Laxton-Kane & Slade, 2002). This can be done through regular 3D sonogram viewing. However, studies with this intervention found mixed results. Moreover, this intervention has not been applied to women experiencing IPV as it is not known the impact of physical viewing of the mother and child’s body has on the physical assault experienced. Group interventions are helpful as they build social support and many improve maternal-fetal attachment. High-risk women can participate in the program to gain knowledge about the development of their fetus in a supportive environment. Despite this, empirical evidence has not supported conclusions on maternal-fetal attachment as a result of group intervention programs.
It can therefore be concluded that post-partum problems can be experienced by women if during pregnancy, maternal-fetal attachment was not present. Medical practitioners have limited evidence-based practice to follow regarding effective interventions. However, self-reporting evidence regarding interventions which improve sensitivity to parenting, mood improvement and social support enhance maternal-fetal attachment. Future research is required to aid health practitioners and mothers in achieving high maternal-fetal attachment and avoid the adverse effects that come about due to the lack thereof.
References
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.
Alhusen, J. L., Ray, E., Sharps, P., & Bullock, L. (2015). Intimate partner violence during pregnancy: maternal and neonatal outcomes. Journal of women's health, 24(1) , 100-106.
Alvarenga, P., Dazzani, M. V., Lordelo, E. D., Alfaya, C. A., & Piccinini, C. A. (2013). Predictors of sensitivity in mothers of 8-month-old infants. Paidéia (Ribeirão Preto), 23(56) , 311-320.
DiPietro, J. A. (2010). Psychological and psychophysiological considerations regarding the maternal–fetal relationship. Infant and child development, 19(1) , 27-38.
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.
Glover, V., O’connor, T. G., & O’Donnell, K. (2010). Prenatal stress and the programming of the HPA axis. Neuroscience & Biobehavioral Reviews, 35(1) , 17-22.
Huth‐Bocks, A. C., Levendosky, A. A., Theran, S. A., & Bogat, G. A. (2004). The impact of domestic violence on mothers' prenatal representations of their infants. Infant Mental Health Journal, 25(2) , 79-98.
Laxton-Kane, M., & Slade, P. (2002). The role of maternal prenatal attachment in a woman's experience of pregnancy and implications for the process of care. Journal of Reproductive and Infant Psychology, 20(4) , 253-266.
