Promoting Mother-to-Baby Attachment to Prevent Postpartum Depression: An Intervention Study

Abstract

Weak attachment to the fetus during pregnancy has been linked to postpartum depression and child abuse. A longitudinal study was conducted to verify the hypothesis that postpartum depression decreases when bonding between the mothers to fetus is promoted during pregnancy. This study aimed to verify the hypothesis that postpartum depression decreases when bonding is promoted during pregnancy. Methods One hundred and fifty-seven pregnant women were enrolled in a mothers' class and were divided into either a control or intervention group. The intervention group listened to music and maintained a "fetal diary". The control group received no additional instructions beyond the mothers' class. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen pregnancy and postpartum depression. The Mother-to-Infant Bonding Scale (MIBS) and the Prenatal Attachment Inventory/Maternal Attachment Inventory were used to evaluate mothers' attachment to the fetus/neonate. The paired t-test and Fisher's exact test were used to compare scores within and between the two groups in the antepartum and postpartum periods. The level of statistical significance was set to p<0.05. Results Data were obtained for 85 (54.1%) women (control group: n=47, intervention group: n=38). Approximately 19% and 20.4% of participants were in a depressive state in the antepartum and postpartum periods, respectively. There was no difference in depressive state between the antepartum and postpartum periods in the intervention group. However, EPDS scores were increased in the period of postpartum than antepartum in the control group (p=0.05). There were no significant differences in MIBS scores between the control and intervention groups in the antepartum period. However, MIBS scores were significantly higher in the control group in the postpartum period (p=0.001). The intervention group showed a reduction in mothers' negative feelings towards the baby between the antepartum and postpartum periods than the control group. Conclusion The results supported the hypothesis that postpartum depression decreased when bonding between the mothers to fetus is promoted during pregnancy.