The effect of maternal-fetal attachment education on pregnant women’s mental health


Mail Orcid Perwitasari Perwitasari(1*)
Mail Mohammad Hakimi(2)
Mail Anjarwati Anjarwati(3)

(1) Universitas 'Aisyiyah Yogyakarta, Indonesia
(2) Universitas Gajah Mada, Indonesia
(3) Universitas ‘Aisyiyah Yogyakarta, Indonesia
(*) Corresponding Author
10.31101/jhtam.1043| Abstract views : 1940 | PDF views : 442


Physiological and psychological changes in pregnancy have a considerable effect on mother’s wellbeing. Hence, in this period pregnant women are vulnerable to develop mental health difficulties due to hormonal alterations and other external factors. Mental health problems during pregnancy may impact to child’s growth and psychological development. The aim of this study was to determine the effect of maternal-fetal attachment (MFA) education on the scores of mental health disorders among pregnant women. This study was quasy-experimental. The sample were 55 pregnant women (28=control group, 27=experimental group) who registered in Community Health Centers. Participants were selected by consecutive sampling technique. Data collection tools were EPDS, SRQ, SSQ-6, and demographic questionnaire. These questionnaires were filled out by both groups as pre-test and two weeks later. The data were analyzed by paired and independent t-test in SPSS/20 with significant levels p0,05). This study indicated that maternal-fetal attachment education might contribute in improving pregnant women’s mental health. The future study should be tested in larger sample sizes with more than two weeks follow up to confirm these results.


Maternal-Fetal Attachment; Mental Health; Pregnancy

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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, 815–820. https://doi.org/10.3906/sag-1204-97

Ajinkya, S., Jadhav, P.R., Srivastava, N.N., 2013. Depression During Pregnancy: Prevalence And Obstetric Risk Factors Among Pregnant Women Attending A Tertiary Care Hospital In Navi Mumbai. Industrial Psychiatry Journal 22, 37. https://doi.org/10.4103/0972-6748.123615

Akbarzadeh, M., Moattari, M., Abootalebi, M., 2017. The Effect Of BASNEF Model On Maternal-Fetal Attachment In Pregnant Mothers Referring To Pregnancy Clinics In Shiraz University Of Medical Sciences Affiliated Hospitals. Iranian Journal Of Neonatology IJN. https://doi.org/10.22038/ijn.2017.20521.1229

Anindyajati, G., Ismail, R.I., Diatri, H., Elvira, S.D., 2017. Antenatal Depression and Its Determinant Factors in Urban Community Setting [WWW Document]. https://doi.org/info:doi/10.1166/asl.2017.9122

Ayano, G., Tesfaw, G., Shumet, S., 2019. Prevalence And Determinants Of Antenatal Depression In Ethiopia: A Systematic Review And Meta-Analysis. PLoS One 14. https://doi.org/10.1371/journal.pone.0211764

Biaggi, A., Conroy, S., Pawlby, S., Pariante, C.M., 2016. Identifying The Women At Risk Of Antenatal Anxiety And Depression: A Systematic Review. Journal of Affective Disorders 191, 62–77. https://doi.org/10.1016/j.jad.2015.11.014

Bisetegn, T.A., Mihretie, G., Muche, T., 2016. Prevalence and Predictors of Depression among Pregnant Women in Debretabor Town, Northwest Ethiopia. PLOS ONE 11, e0161108. https://doi.org/10.1371/journal.pone.0161108

Boryri, T., Navidian, A., 2017. The Effect Of Training Attachment Behaviors On Perceived Stress, Parental Expectations In Primiparous Women 7.

Brandon, A.R., 2011. A History Of The Theory Of Prenatal Attachment. J Prenat Perinat Psychol Health 15.

Clinical Guideline Screening for Perinatal Anxiety and Depression Clinical Guideline (2015). Department of Health, Government of South Australia. https://www.sahealth.sa.gov.au/wps/wcm/connect/9050aa004eedd75ab40bb76a7ac0d6e4/Screening+for+Perinatal+Anxiety+and+Depression_Sept2015.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-9050aa004eedd75ab40bb76a7ac0d6e4-mHVcOSg

Diniz, E., Koller, S.H., Volling, B.L., 2015. Social Support And Maternal Depression From Pregnancy To Postpartum: The Association With Positive Maternal Behaviours Among Brazilian Adolescent Mothers. Early Child Development and Care 185, 1053–1066. https://doi.org/10.1080/03004430.2014.978309

Edozien, L.C., P.M Shaughn, O., 2017. Biopsychosocial Factors in Obstetrics and Gynaecology - Google Buku [WWW Document]. URL https://books.google.co.id/books?id=mxYuDwAAQBAJ&pg=PA251&lpg=PA251&dq=The+maternal-fetal+relationship:+conceptualisation,+measurement+and+application+in+practice&source=bl&ots=3VXsQiJXdi&sig=ACfU3U1RcfqknMQbYfXSBlWskuV2_QkHdg&hl=id&sa=X&ved=2ahUKEwjzxrizhYDjAhUQ3o8KHZRtCqYQ6AEwB3oECAkQAQ#v=onepage&q=The%20maternal-fetal%20relationship%3A%20conceptualisation%2C%20measurement%20and%20application%20in%20practice&f=false (accessed 6.25.19).

Howard, L.M., Molyneaux, E., Dennis, C.-L., Rochat, T., Stein, A., Milgrom, J., 2014. Non-Psychotic Mental Disorders In The Perinatal Period. The Lancet 384, 1775–1788. https://doi.org/10.1016/S0140-6736(14)61276-9

Karakoça, H., Ozkanb, H., 2017. The Relationship with Prenatal Attachment of Psychosocial Health Status of Pregnant Women. International Journal of Health Sciences (IJHS) 5. https://doi.org/10.15640/ijhs.v5n1a6

Lavanya, R., Poongundran, D., 2019. A Study on Antenatal Depression in Primigravida Pregnancy Across Trimesters. Research & Reviews: Journal of Medicine 8, 27–29.

Nagandla, K., Nalliah, S., Yin, L., Majeed, Z., Ismail, I., Zubaidah, S., Ragavan, U., Krishnan, S., 2016. Prevalence and associated risk factors of depression, anxiety and stress in pregnancy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2380–2388. https://doi.org/10.18203/2320-1770.ijrcog20162132

Okagbue, H.I., Adamu, P.I., Bishop, S.A., Oguntunde, P.E., Opanuga, A.A., Akhmetshin, E.M., 2019. Systematic Review of Prevalence of Antepartum Depression during the Trimesters of Pregnancy. Open Access Maced J Med Sci 7, 1555–1560. https://doi.org/10.3889/oamjms.2019.270

Riset Kesehatan Dasar(Riskesdas). (2013). Badan Penelitian dan Pengembangan Kesehatan Kementerian RI tahun 2013. http://www.depkes.go.id/resources/download/general/Hasil%20Riskesdas%20 2013.pdf.

Suryaningsih, E.K., Wu, S., Yan, X and Lin, H., 2019. Indonesian mother’s feeling and thought during pregnancy: a qualitative study. Journal of Health Technology Assessment in Midwifery 1 (2),57-63

Stein, A., Pearson, R.M., Goodman, S.H., Rapa, E., Rahman, A., McCallum, M., Howard, L.M., Pariante, C.M., 2014. Effects of perinatal mental disorders on the fetus and child. The Lancet 384, 1800–1819. https://doi.org/10.1016/S0140-6736(14)61277-0

Toosi, M., 2011. Effect of Attachment Training on Anxiety and Attachment Behaviors of first-time Mothers - Journal of hayat [WWW Document]. URL http://hayat.tums.ac.ir/browse.php?a_id=56&sid=1&slc_lang=en (accessed 6.25.19).

Walsh, J., Hepper, E., Bagge, S., Wadephul, F., Jomeen, J., 2013. Maternal-fetal relationships and psychological health: Emerging research directions. Journal of Reproductive and Infant Psychology 31, 490–499.

WHO | Maternal mental health [WWW Document], n.d. . WHO. URL https://www.who.int/mental_health/maternal-child/maternal_mental_health/en/ (accessed 7.19.19).

World Health Organization (Ed.), 2016. WHO Recommendations On Antenatal Care For A Positive Pregnancy Experience. World Health Organization, Geneva.

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, 708–715. https://doi.org/10.1016/j.ijnurstu.2008.10.013

Yuan, L., Gu, Z., Peng, H., Zhao, L., 2018. A Paternal-fetal Attachment Pilot Intervention on Mental Health for Pregnant Mothers 16, 6.

DOI: https://doi.org/10.31101/jhtam.1043

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