Psychological changes over the course of pregnancy: a study of attitudes toward the fetus/neonate.

Pregnant women's attitudes towards their fetus over the course of the pregnancy were studied in relation to physiological events of pregnancy, namely seeing the fetus via ultrasound and experiencing fetal movement. A consecutive series of primiparae (n = 129) was randomly assigned, at recruitment between 10 and 14 weeks menstrual age, to conditions of high (n = 67) or low (n = 62) feedback real time ultrasound. Thereafter, women were assessed at 16 and 32 weeks gestation, within 24 hours of delivery and by questionnaire at 3 months postpartum. On each occasion women completed attitude rating scales concerning their pregnancy and their fetus or neonate. These scales were subjected to principal components analysis and two main dimensions were derived for ratings of both attitudes towards the pregnancy and the fetus/neonate. No relationship was found between factor scores and ultrasound feedback condition, although scores on the fetal attachment dimension showed a significant linear increase over the pregnancy. Women reporting fetal movement at 16 weeks displayed significantly higher scores on the fetal-attachment dimension at all three assessment points. Multiple regression analyses were utilized to identify predictors of initial reactions to the neonate and attachment ratings at 3 months postpartum. At delivery, ratings of attachment to the neonate were related to drug requirements in labor and attachment ratings at 32 weeks. Reactions to the neonate at delivery and ratings of postpartum mood emerged as significant predictors of maternal attachment at 3 months postpartum. These results are discussed in the context of research attempting to establish the importance of postpartum bonding.