Prenatal attachment levels enhanced with positive body self-perception


Prenatal attachment levels were enhanced among pregnant women who were pleased with their appearance and body, displayed a positive attitude about their physical fitness, and engaged in practices that bolstered their health and physical capacity, according to a study in the Journal of Obstetric, Gynecologic & Neonatal Nursing.

“Prenatal attachment is defined as the affiliative relationship between the pregnant woman and her fetus and is formed and developed in the woman’s mind,” wrote the authors.

The study comprised 183 healthy women at least 20 weeks pregnant who visited the ob-gyn outpatient clinic of a university hospital in Ankara, Turkey, between April and July 2019.

Information was gleaned from a personal data collection form, the Prenatal Attachment Inventory (PAI) and the Multidimensional Body Self Relations Questionnaire (MBSRQ).

The MBSRQ and PAI were selected due to their scale items containing clear sentences and validity, according to the authors, noting that reliability studies om both scales have been conducted in Turkey and elsewhere.

The mean PAI score was 67.74, with women younger than 20 years having the lowest mean PAI score of 57.20.

Younger women may have ambiguous and mixed feelings about the physical and psychological changes that occur during pregnancy and may not feel ready to be mothers, according to the authors, thus conceivably stifling their prenatal attachment levels.

Women who had 2 or more pregnancies, or arranged marriages, also had low prenatal attachment levels, whereas women with chronic disease had higher mean PAI scores (P < 0.05).

Chronic disease may increase the anxiety levels of pregnant women, potentially causing a strong connection between prenatal attachment levels and feelings of anxiety and concern about the baby’s health.

There were no significant differences in PAI scores by the number of children, planned pregnancy, history of miscarriage/stillbirth, common discomforts of pregnancy, gestational age at the time of data collection or criticism of physical appearance (P > 0.05).

Mean PAI score also had a weak positive relationship to the total body self-perception score (r = 0.226), as well as to the Appearance Evaluation, Fitness Evaluation, Health Orientation, Fitness Orientation and Body Areas Satisfaction subscales (P < 0.05).

The study’s prenatal attachment scores are similar to other studies, according to the authors, but some researchers have concluded no link between age and PAI scores.

Interventions by nurses and midwives to teach younger pregnant women prenatal attachment techniques can increase prenatal attachment levels.

Nursing practices that encourage women to talk with their fetus, touch the fetus through their abdomen, and count fetal movements may also help prepare for motherhood and increase prenatal attachment.

“We recommend conducting education programs concentrating on adaptation to pregnancy that enable women to evaluate their bodies more positively during pregnancy, to adopt behaviors to improve their health in pregnancy, and to increase prenatal attachment,” summarized the authors.

They also propose future studies that incorporate sociocultural characteristics to examine the connection between body self-perception and prenatal attachment, as well as longitudinal studies spanning pregnancy to the postpartum period.


  1. Canli A, Dermirtas. Prenatal attachment and the relationship with body self-perception. J Obstet Gynecol Neonatal Nurs. Published online September 28, 2021. doi:10.1016/j.jogn.2021.09.003
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