Physical Health and Maternal-Fetal Attachment among Women: Planned Versus Unplanned Pregnancy

Abstract

Introduction Planned pregnancy is an important indicator of improving the health status of mothers and newborns, as today unplanned pregnancy is a public health indicator (1). There are 2 types of unplanned pregnancies; first, the pregnancy which happens sooner than intended pregnancy time called mistimed pregnancy. And the second type which is unintended pregnancy, when a woman has no decision to have a baby in the future (2-4). Pregnancy and childbirth are joyful experiences for women (4). This event raises pleasure and satisfaction as well as concerns about accepting pregnancy and changes in family and social roles (5). In planned pregnancy, the couple feels stronger; however, women need to get ready for a healthy pregnancy, childbirth, and childcare. On the contrary, unplanned and forced pregnancy makes mothers fearful and anxious (5,6). During this period, mothers may face high risk factors (7) including delayed or no referral to health care centers for receiving pregnancy health care, lack of self-care behaviors (taking no folic acid and iron tablets, no tetanus injection), and increased risk of medical complications and surgery (anemia and increased risk of preeclampsia) (8). Unplanned pregnancy and its consequences is a global problem which affects women, children, as well as families, and the society (9,10). It often leads to induced abortions and preterm labor, and sometimes its complications can cause mother's death (11). In developing countries, 20%-40% of births are unplanned or mistimed, posing problems for families and jeopardizing the health of millions of women and children, which lead to an estimated number of 50 million induced abortions(12). In the United States, 45% of the pregnancies are unplanned, from which 85% belong to the women who use no contraceptive methods. Forty-five percent of these women are 15-44 years old from which 22% choose abortion (13). In Iran, annually 400 000-500 000 unplanned pregnancies (constituting 40% of total pregnancies) are reported. In a meta-analysis performed in Iran, the total prevalence of unplanned pregnancy was 30.6%. Despite success in Iran's family planning program, one third of pregnancies are unintended and it is increasing 3.2 times per year, and 75% of these unintended pregnancies are among the couples using the contraceptive methods (1). The most important causes of this problem can be traced back to failure of contraceptive Abstract Objectives: The present study aimed at comparing the physical health and maternal-fetal attachment in the women with planned and unplanned pregnancies. Materials and Methods: This was a descriptive-comparative study including 300 pregnant women (165 planned and 135 unplanned pregnancies) with mean age of 29.8±5.8 (age range of 16-50 years old) who had referred to the prenatal clinic of a hospital from September to October, 2016. The maternal-fetal attachment was analyzed using frequency distribution of attachment scores which did not follow the normal distribution of the subscale totally and specifically. Therefore, to...

The Relationship Between Pregnant Women s Prenatal Attachment Levels and Health Practices During Pregnancy and Affecting Factors

“…So, planned pregnancies can increase the prenatal attachment level. Previous studies also support this finding (Ossa et al, 2012;Karakoç and Ozkan, 2017;Pakseresht et al, 2018;Coşkun et al, 2019;Karabulutlu et al, 2020;Çelik and Güneri, 2020). Pregnant women with unplanned pregnancies fall behind in receiving health care services, encounter more risky situations, have more complications, and have less self-care (Boden et al, 2015;Goossens et al, 2016;Srewart et al, 2016;Canella et al, In this regards, Zibellina et al highlighted that a planned pregnancy and women's level of education has great importance for the increase of prenatal attachment and a healthy pregnancy.…”

“…A review of the literature showed that a higher prenatal attachment level is related to positive pregnancy, labor, and postpartum results. Pregnant women with a higher prenatal attachment have a healthier pregnancy, less labor-related fear, and a lower rate of depression and anxiety in the postpartum period (Salehi and Kohan, 2017;Coşkun et al, 2019;Bakır and Sarızayim, 2020;Pakseresht et al, 2018).…”

Clustering of characteristics associated with unplanned pregnancies: the generation R study

“…Especially age > 35 years, higher educational level and history of depression were associated with prolonged ambivalent feelings towards the pregnancy. Since parents with ambivalent feelings towards the pregnancy may experience less connection with the fetus and newborn child [ 48 – 50 ], the results of this study suggests that additional support in bonding, attachment and parent-child interaction during and after pregnancy is recommended in this cluster [ 51 ].…”

Pregnancy Intentions of First‐Time Mothers and Their Children's Outcomes: Unraveling Reciprocal Pathways

“…Findings from recent clinical trials indicate parent training interventions may also reduce parental depressive symptoms and improve children's outcomes (Beach & Whisman, 2012). However, it may be difficult to engage multi‐stressed families, such as those who are more likely to experience unintended pregnancies, in parent training interventions (Reyno & McGrath, 2006). Therefore, future research should seek to evaluate the efficacy of empirically supported parent training interventions (e.g., The Incredible Years, Webster‐Stratton & Reid, 2010; Parent Management Training‐Oregon Model, Patterson et al, 2010) to reduce parenting stress and depressive symptoms and promote positive parenting practices among families who have experienced unintended pregnancies.…”

“…In turn, their high-stress context increases risk for postpartum depression (Venkatesh et al, 2014). Women with unintended pregnancies tend to report less emotional attachment to their baby in pregnancy (Pakseresht et al, 2018) and tend to need more time to accept their pregnancy (Bajurna et al, 2014), which may each help explain their risk for depressive symptoms. Still, not all studies have found a significant association (Su, 2012), suggesting the need for further study of the association between pregnancy intention and maternal depressive symptoms.…”