Maternal-Fetal Attachment: What We Know and What We Need to Know

Abstract

The attachment theory was first introduced by John Bowlby in 1960s about the mother-child bond.1 He defined attachment as “a set of internal behaviors that would cause the infant to become closely related to his/her main caregiver, who is usually the mother”.2 Although this concept was first introduced for the post-partum period, but it is believed that attachment starts long before birth, during pregnancy.3‒5 In other words, attachment starts when mother finds out about her pregnancy and this is the real start point for fetus’ dialog with his/her surrounding world.7 Cranley has expressed mother’s attachment as her enthusiasm in behaviors for interacting with her fetus8 and Muller believed that it is more than just a behavior and has defined as a unique relationship between the mother and her fetus.9 The common characteristic between all of these definitions is emphasis on the importance of maternal-fetal relationship.10,11 Development of this relationship is important due to its role in creation of attachment after birth.12,13 Some researchers have reported that mother’s attachment to the fetus would develop during pregnancy and it would help her prepare for transition to the motherhood period.14,15 Some studies have shown that prenatal attachment is an important factor in predicting post-partum attachment behaviors,6 it is associated with mother-infant post-partum interactions and communications12 and it has an important role in the health of the pregnant mother and her fetus.11 Attachment, which is one of the essential needs of human beings, would act like an invisible connection and maintain a close relation between the mother and the child,16 is considered an important part of child’s development,4,18‒24 and would develop a sense of trust in the child.5 Results of studies conducted on human beings and other species have revealed that care deprivation has a major effect on the evolution of regulatory system and coping with stress. Mother’s reaction to child’s stress is considered an important source for coping; therefore infants with sensitive and respondent parents would learn that at the time of stress, parents are always available and it would be more chance for them to have secure attached relationship with their parents in the future. But infants with insensitive parents would learn that parents are not always available at the time of stress and crisis; so they would probably develop an insecure relationship with their parents.25