• Users Online: 141
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 17  |  Issue : 1  |  Page : 73-77

Exploring the experiences of maternal-fetal attachment among primigravida women


1 Department of Obstetric and Gynecological Nursing, Bharati Vidyapeeth (Deemed to be University) College of Nursing, Pune, Maharashtra, India
2 Department of Community Health Nursing, Bharati Vidyapeeth (Deemed to be University) College of Nursing, Pune, Maharashtra, India

Date of Submission03-Oct-2020
Date of Decision07-Mar-2021
Date of Acceptance17-Oct-2021
Date of Web Publication25-Jul-2022

Correspondence Address:
Dr. Memchoubi Keithellakpam
Bharati Vidyapeeth (Deemed to be University) College of Nursing, Dhankawadi, Pune - 411 043, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_273_20

Rights and Permissions
  Abstract 


Background: In India, in which the mortality rate for women is 130 per 100,000 live births and the neonatal mortality rate at 25.4 deaths per 1000 live births that makes it 12th worst among the 52 lower middle-income countries. Healthy maternal–fetal attachment (MFA) may serve to allow women to adopt optimal health practices earlier, thereby on a larger scale contribute toward the reduction of obstetric maternal and child morbidity and mortality. The objective of the study was to explore the experience of MFA among primigravida women. Materials and Methods: Qualitative approach was used and the research design adopted was hermeneutic phenomenology. Data were collected from six samples. The sampling technique used was the nonprobability purposive sampling technique. The tool consisted of demographic profile and a guiding questionnaire. The data were collected through one-to-one in-depth interview and field notes. To ensure the trustworthiness of the data credibility, transferability and dependability were done. The data collected were analyzed using descriptive statistics, i.e., frequency and percentage for demographic variables, and thematic analysis for determining essential codes, subthemes, and themes through content analysis was used to analyze the data gathered through interview. Results: Out of six samples, 50% were in the age group of 18–25 years, 33.3% each studied up to secondary and graduation education, 83.3% were homemaker, no one with significant past medical and surgical history, 83.3% of them were in 36–40 weeks of gestation, all had a history of nausea and vomiting, and all women taken antenatal care information from health personnel. A total of 8 themes, 28 subthemes, and codes were generated. The themes emerged were experience as ready for change, feeling of life, social and family support, self-awareness, embracing motherhood, health promotional practices, hopeful anticipation, positivity, and gratitude.

Keywords: Experiences, maternal–fetal attachment, primigravida women


How to cite this article:
Keithellakpam M, Ray S. Exploring the experiences of maternal-fetal attachment among primigravida women. J Datta Meghe Inst Med Sci Univ 2022;17:73-7

How to cite this URL:
Keithellakpam M, Ray S. Exploring the experiences of maternal-fetal attachment among primigravida women. J Datta Meghe Inst Med Sci Univ [serial online] 2022 [cited 2022 Aug 16];17:73-7. Available from: http://www.journaldmims.com/text.asp?2022/17/1/73/352228




  Introduction Top


Pregnancy is described as a unique, exciting, and indeed a joyous time in a woman's life. During this period, women develop an insight of creative and nurturing powers while providing a bridge to the future. Or, pregnancy is a process or series of changes that take place in a woman's body as a result of developing a baby in the womb. A woman's body undergoes many changes both physically and psychologically during the 9 months of pregnancy. It is remarkable how a woman's body adapts to accommodate a pregnancy. During this period, women not only adapt to the physical changes but also develop a very unique relation with the baby that is growing inside their womb, which is described as maternal–fetal attachment (MFA). Maternal attachment is a biologically driven construct, inherent within humans and other primates, designed to preserve the species through nurturing and protective behaviors (Bowlby 1982/1969; Bowlby 1978).[1],[3]

The prenatal period is the most appropriate time for evaluating MFA as this is the sensitive period of growth. Since all of the mother's behavior, actions, and thoughts during pregnancy could have more permanent effects on the fetus than any other period of the child's life and pregnancy is considered as a critical period in the development, therefore it is necessary to evaluate women attachment to her baby in the womb.[2],[5] This can be achieved by exploring the experiences of MFA among women, especially primigravida women as they are experiencing pregnancy for the first time can share pure feelings/experiences toward their pregnancy.

Purpose of the study

India, being a multiethnic, highly culturally diverse country in South Asia, offers an ideal location for conducting research on the MFA concept. Although India has recently risen economically from a global perspective, a great social and economic divide still exists between the rich and poor. Stereotypes and traditions still prevail in most of the Indian societies even today, and when it comes to women and pregnancy, many would immediately assume that the concept of attachment between mother and child begins invariably only after delivery and is greatly influenced by many variables such as social, educational, economic, religious, and health, unlike the western world, where women consider pregnancy an equally important period that initiates and leads into a healthy maternal–child attachment after birth. Environmental- and health-related factors that affect the antenatal phase of pregnancy have been clearly shown to impact the process of normal delivery and mental and physical health of the mother and the child postnatally.[1],[4]

It is observed that experiences of MFA among women during pregnancy have not been explored much in India, in which the mortality rate for women is 130 per 100,000 live births and the neonatal mortality rate at 25.4 deaths per 1000 live births in India makes it 12th worst among the 52 lower middle-income countries. One-third of babies born in India are of low birth weight (<2.5 kg), in addition to high infant mortality rates and childhood growth failure among survivors. Low birth weight in India has been attributed to widespread maternal undernutrition. This has been hypothesized that healthy MFA may serve to allow women to adopt optimal health practices earlier, thereby on a larger scale contribute toward the reduction of obstetric maternal and child morbidity and mortality.[7],[8]

The present study aims to explore the experience of women during pregnancy to identify the attachment to their baby in the womb. This also provides evidence-based data to direct and create policies in reproductive health care specific to maternity care. In some western and eastern countries, some studies have done which explore the experiences of pregnancy and assess the MFA, but in India, very few studies have conducted to assess the MFA using some parameters such as fetal movement count, but there is no study to discover the experiences through a qualitative approach which are important as it deals with individual experiences. A qualitative study can provide detailed description of human understanding, explanation, and occurrences from individual viewpoints irrespective of their demographics. Therefore, a qualitative approach was thought to be appropriate for exploring the experiences of MFA among primigravida women for in-depth understanding of the phenomenon of interest.

Objective

  • To explore the experiences of MFA among primigravida women.



  Materials and Methods Top


Design

The research design or method of inquiry adopted for the present study was hermeneutic phenomenological research design.

Setting

The study was conducted at selected districts of western Maharashtra.

Target population

The target population of the study comprised of all primigravida mother from selected districts of western Maharashtra.

Data collection tool and technique

The present study aimed at exploring the experiences of MFA among the primigravida, therefore the researcher developed a tool which was used as a guiding questionnaire for the study.

The tool consisted of two sections, Section 1 – demographic data and Section – II semi-structured interview schedule/guiding questionnaire.

Section I

It consists of a structured questionnaire to assess the demographic variables of primigravida mothers which include the age of the mother, education status, occupational status, monthly family income, any history of medical illness, history of surgery, gestational period in weeks, information regarding antenatal care, and minor ailments.

Section II

This section had open-ended questions to bring out the experiences of primigravida women in MFA.

Questions for the interview are focused on the following aspects

  • Maternal bonding with the fetus: This involves the mother's subjective feeling of love and emotional bonding with the fetus
  • Maternal behavior change: This will address the demonstration of maternal attachment in terms of behavior such as searching or inquiring for the information on antenatal care, feeling the quickening, talking to the baby in the womb, taking good care of herself, and try to live a healthier life
  • Recognition of mother role during pregnancy: This will address conscious recognition of the fetus existence
  • Mother's expectation for the child in the womb: This will address the mother's imagination about the baby after birth.


Procedure for data collection

A formal permission was obtained from the administrative authorities of the health centers and data collection was conducted on six primigravida women from the outpatient department and maternity ward from selected hospitals of selected districts of western Maharashtra.

The researcher approached the participants, briefed them about the study objectives, obtained informed consent, and assured them about the confidentiality of the data.

The data were collected during the morning and evening schedule as per the availability of the participants. Located a quite suitable place, ensured that she was comfortable.

A face-to-face interview was conducted which consists of four phases. Contact with the women was about 2–3 times depending upon the need for each.

An audio recorder was used to record the interview and filed notes were also used if needed. Enough time was given to the participant to respond, to gather herself. Silence, tone, body language, and expressions were also noted

Made her hear the tape-recorded interview and transcribed notes made from them in the next contact. Ensured the credibility and terminated the interview.


  Results Top


Section 1: Analysis of the demographic characteristics of primigravida mothers

Out of 6 samples, 3 (50%) were in the age group of 18–25 years, 2 (33.3%) each studied up to secondary and graduation education, 5 (83.3%) were homemaker, all of them did not have any significant past medical and surgical history, 5 (83.3%) of them were in 36 weeks to 40 weeks of gestation, all had a history of nausea and vomiting during the first trimester, and all women had taken antenatal care information from health personnel [Table 1].
Table 1: Frequency and percentage distribution of demographic variables of primigravida women (n=6)

Click here to view


Section 2: Thematic analysis of interview data to explore the maternal–fetal attachment among primigravida women

A total of 8 themes, 28 subthemes, and codes were generated. The themes which emerged from the study were experience as ready for change, feeling of life, social and family support, self-awareness, embracing motherhood, health promotional practices, hopeful anticipation, positivity, and gratitude [Table 2].
Table 2: Thematic analysis of interview data to explore the maternal–fetal attachment among primigravida women (n=6)

Click here to view


Description with verbatim

All women express their changes of daily routine for the betterment of their baby in the womb. Women express the importance of taking care of themselves, changing their lifestyle in terms of food, activities, habits, etc.

“Changes, yes many changes have come. I always take care while doing any work so that no problem occurs. In the beginning, when there was vomiting, I face problem in eating but I ate what I could like fruits. From 5th month, I could eat properly. I eat thinking for my baby.”

“I do things, thinking for the baby whether is good or bad. Before I got pregnant, I didn't think this much but now as I become a mother, I have to think 10 times before doing anything, whether it is right or not for my baby.”

“Before marriage, I used to think about my figure. But, now it's not of concern at all.”

The women refer to a sense of the divinity of life, a supernatural force within their body, and that they feel the soul of the fetus within themselves.

“I know that life is happening in me, yes I talk with my baby, I share my feelings to my baby when I am alone at home. I feel that my baby will be beautiful, should be healthy. My baby should come in this world without any problem. Yes, I put up baby's picture and imagine my baby should look alike. I put up even Krishna's picture and imagine for my baby. It says that if you imagine something then, it looks like that a bit in your baby.”

Women express getting more support from their husband and family members. Pregnancy became more real to them when they told their husband and parents that they were expecting a baby. Women refer to both joy and pride when they talk about the moment when their parents got to know about the pregnancy.

“My husband always take care of me as we stay away from family, he doesn't allow me to do much work.”

“My mother-in-law always take care of me. She cooks food that I like to eat. Sometime we go out together for evening walk. My parents stay far away but because of my pregnancy, they visited us more frequently.”


  Discussion and Conclusion Top


  • Women relate that they are happy and preoccupied with the pregnancy and that they like to talk about it with others. They are also so overwhelmed with the changes that they experience in terms of behavior, feelings, lifestyle, relationships, etc., They feel that they do not react in the same way as before, they react more strongly, become more adjustable, and feel intensely engaged. The women also feel humility toward life and express this as an inner change, an inner calm, and as if they are taking a new path in their lives and that they have changed mentally. (Carin Modh et al. 2011).[6]
  • The pregnancy in this context brings a new understanding of what is important and essential in life, which promotes their attachment with their baby in the womb, which in turn makes the women to adopt healthy practices during pregnancy, thus contributes in reducing the maternal and neonatal morbidity and mortality.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Doan H, Zimerman A. Prenatal attachment: A developmental model. Int J Prenat Perinat Psychol Med 2008;20:20-8.  Back to cited text no. 1
    
2.
Cannella BL. Maternal–fetal attachment: an integrative review. J Adv Nurs 2005;50:60-8.  Back to cited text no. 2
    
3.
Narita S, Maehara S. The development of maternal-fetal attachment during pregnancy. Nihon Kango Kagakkaishi 1993;13:1-9.  Back to cited text no. 3
    
4.
Lingeswaram A, Bindu H, Validation of Tamil Version of Cranley's 24-item maternal–fetal attachment scale in Indian pregnant women. J Obstet Gynecol 2012;62:630-4.  Back to cited text no. 4
    
5.
Alhusen JL, Gross D, Hayat MJ, Woods AB, Sharps PW. The influence of maternal-fetal attachment and health practices on neonatal outcomes in low-income, urban women. Res Nurs Health 2012;35:112-20.  Back to cited text no. 5
    
6.
Ingegerd B, Modh C, Ingela L, Lillemor L. First time pregnant women's experiences of their body in early pregnancy. Natl Libr Med 2017;31:579-86.  Back to cited text no. 6
    
7.
Union Health Minister. New Delhi: PTI; 2018 The Wire, Health “India Records 22% Drop in Maternal Mortality Rate”.  Back to cited text no. 7
    
8.
UNICEF “Report on newborn mortality rate” Tuesday, 20th February, 2018.  Back to cited text no. 8
    



 
 
    Tables

  [Table 1], [Table 2]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Materials and Me...
Results
Discussion and C...
References
Article Tables

 Article Access Statistics
    Viewed124    
    Printed4    
    Emailed0    
    PDF Downloaded4    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]