Comparison of the Effects of Attachment and Relaxation Instruction on the Third Trimester Depression and Post-partum Blues

Abstract

Aims:This study was conducted to compare the effects of attachment and relaxation instruction on the third trimester depression and post-partum blues.Methods: Randomized controlled trial in three arms (teaching relaxation, maternal-fetal attachment skills and control) of 42 women each among 126 nulliparous women in a selected educational center (Hafez) affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from January 2012 to February 2012. The patients filled out the demographic data sheet, Cranley maternal-fetal attachment test questionnaire, Beck depression questionnaire, Spilberger anxiety and written consent Questionnaires. Results:The mean and standard deviation of the Beck depression test scores after the intervention were 20.5±3/10, 21.1±3.8, and 23.2±3.8 for the attachment, relaxation, and control group, respectively. The changes were statistically significant according to the one-way ANOVA test (P= 0.002). The post-hoc test was statistically significant for the decrease in the depression groups after delivery in the attachment (P = 0.01) and relaxation group (P = 0.01).The reduction in the depression scores before, and after the intervention in the attachment (P=0.001) and relaxation group (P = 0.002) was significant based on paired-t-test results. However, the control group showed an increase in the depression scores which were statistically significant (P= 0.04). Conclusions:Prenatal educational program based on attachment and relaxation training can improve maternal identity role and reduce maternal depression. This study showed that preventing post-partum depression by simple, available and cost beneficial training programs skills.

Maternal-Fetal Attachment Levels in The Prenatal Period and the Factors Affecting It

“…Prenatal attachment, on the other hand, is defined as the emotional intimacy between the mother and her unborn baby (Muller, 1993;Salehi et al, 2019;Ranjbar et al, 2020). Attachment begins in the prenatal period, increases as birth approaches, and continues to develop after birth (Akbarzade et al, 2017). Attachment, which is a bi-directional process, increases the quality of emotional communication to the extent that the mother and baby can respond to each other's emotions (Palma et al, 2020).…”

“…The mother, who is attached to her baby with love, can contribute positively to the healthy growth and development of the baby (Çıldır et al, 2020;Ponti et al, 2021). On the other hand, in case of an inadequate attachment, an increased risk of anxiety and depression in the mother and neglect and abuse of the fetus/baby have been reported (Akbarzade et al, 2017;Dağlı, 2018;Salehi et al, 2019). It is important to be aware of the factors that can affect prenatal attachment to develop a healthy mother-baby attachment (Camarneiro and Justo, 2017;Akbarzade et al, 2017;Vedova et al, 2019;Coşkun et al, 2019;Özdemir et al, 2020).…”

“…On the other hand, in case of an inadequate attachment, an increased risk of anxiety and depression in the mother and neglect and abuse of the fetus/baby have been reported (Akbarzade et al, 2017;Dağlı, 2018;Salehi et al, 2019). It is important to be aware of the factors that can affect prenatal attachment to develop a healthy mother-baby attachment (Camarneiro and Justo, 2017;Akbarzade et al, 2017;Vedova et al, 2019;Coşkun et al, 2019;Özdemir et al, 2020). In their study on 1473 women who were between their 17th and 32nd gestational week and who had at least one delivery before, Garthus-Niegel et al (2019) reported that there was a negative relationship between fear of birth and prenatal attachment.…”

Effect of attachment-based interventions on prenatal attachment: a protocol for systematic review

“…the pattern of prenatal attachment during pregnancy could be changed [5] and parents’ preparation for developing a joyful relationship with their fetus could be strengthened using various strategies. Thus some researchers have considered the prenatal period to be a proper opportunity to build a desirable mother-infant bond before birth [17].…”