Lindgren, K. (2001).Research in Nursing and Health, 24. 203-217.

A total of 252 childbearing women participated in this study of maternal-fetal attachment, prenatal depression, and health practices during pregnancy. Lindgren found that maternal depression was a significant predictor of maternal fetal attachment. Women who were more depressed had lower scores on the Maternal Fetal Attachment Scale and also exhibited less positive health practices. Higher education, lower parity, and being engaged in a stable relationship with a significant other also predicted more positive health practices. This study confirms what clinicians have observed in practice, and contributes to our knowledge about the complexities of maternal/fetal attachment as well as ways in which nurses can promote such attachment.

Because positive health practices such as avoiding substance use, managing stress, accessing prenatal care, appropriate weight gain, exercise, and rest are associated with positive perinatal outcomes in both the mother and her child, assessment of the expectant mother for depression and low levels of maternal/fetal attachment is essential. Lack of self-care during pregnancy may contribute to depression, and this reciprocal relationship may become a downward trajectory. Working with the woman to ameliorate factors that may contribute to her depression such as lack of social support, childhood sexual abuse, and current domestic violence is essential. In addition, assisting the woman in managing her depressive symptoms is an important nursing intervention. Further work should include intervention studies to determine nursing strategies that can make a difference for women and their newborns. Beck (1999) has identified instruments on prenatal attachment and adaptation to pregnancy which may be useful for researchers and clinicians.

Comment by Lynn Clark Callister

ReferenceRelationships Among Maternal-Fetal Attachment, Prenatal Depression, and Health Practices in Pregnancy