Awareness-Based Parentıng And Bırth Preparatıon Educatıon Gıven To Couples; Impact Of Maternal-Paternal Attachment, Bırth Parameters And Postpartum Rapport
Phase: NA
Conditions: Educational Problems
Sponsor: Kayseri Training and Research Hospital

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DOCUMENT DATE: 07.07.2025 
 
 
 
THE EFFECT OF MINDFULNESS-BASED CHILDBIRTH AND PARENTING 
EDUCATION TO MATERNAL AND PATERNAL ATTACHMENT, BIRTHING 
PARAMETERS AND  
POSTPARTUM ADAPTATION 
 
Study Protocol and Statistical Analysis Plan 
 
 
NCT: NONE 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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ENTRANCE 
The word parent means mother and father according to the Turkish Language Association. It is also called nuclear family. is 
explained and represents the mother and father of a child (Cüceloğlu, 2016; TDK, 2023). The meaning of being a parent It is 
defined as the continuous provision of care, needs and support for a child's development and survival (Aksoy, 2005). 
Becoming a parent is one of the developmental transition periods that include radical changes and new roles and responsibilities 
in an individual's life (Meleis, 2010; Young et al., 2020). This process of change is called the transition to parenthood (Cowan & 
Cowan, 2003). Although there are many different views on when the transition to parenthood begins and ends, the most widely 
accepted view is that it begins with pregnancy for individuals who become mothers/fathers for the first time and ends within a few 
months after birth, and the parenthood period begins (Fox, 2019). 
The transition to parenthood also brings about parent-infant bonding. The term attachment is the ability to establish and maintain 
an emotionally positive, mutual, and supportive relationship between babies and parents. If the relationship is established 
appropriately, adults adapt themselves to their babies and babies give adults clues about their needs. This relationship, which 
develops in the early period, has an important place in the physical, psychological, and intellectual development of the child and 
continues to have an effect throughout life. The process of parent-infant bonding develops in three periods: pregnancy, birth, and 
postpartum (Condon et al., 2013). During pregnancy, parents feel and caress their babies physically, believe that their babies are 
in touch with them, talk to the fetus, say its name, think about their babies, and have positive feelings about their babies. It is 
important for the development of attachment to feel and imagine the future situation of the baby (Çelik and Ergin, 2019; Marzouk 
and Nabil, 2015). It has been observed that the attachment that begins during pregnancy gradually increases as the pregnancy 
progresses, and continues after the baby is born. It is stated that prenatal attachment is strengthened (Bouchard, 2011; Hicks et 
al., 2018). In a study examining attachment, prenatal attachment It has been determined that there is a strong and significant 
relationship between attachment and postpartum attachment (Condon et al., 2013). The conscious emotions it creates are 
motivating during pregnancy and facilitate adaptation to the parenting role, thus positively affecting the parent-infant adaptation 
process (Duyan et al., 2013; Hicks et al., 2018; Yılmaz, 2013). 
Pregnancy period, to parenthood oriented physiological, psychological, social And emotional changes happened And This to the changes 
rapport 
It is seen as an important preparation period that requires preparation (Van Vreeswijk, Broersen, Schurink, 2014). Especially 
individuals who will become mothers and fathers for the first time may experience some feelings of uncertainty regarding the 
changes experienced in the pregnancy, birth and postpartum period. Parents want the pregnancy to be smooth and the birth to be 
painless and with high satisfaction (Figo, 2012; Taşkın, 2020). However, during this process, they experience complex emotions 
such as anxiety, fear and excitement together (Ay et al., 2019). Fears usually arise from the idea of an episiotomy during vaginal 
birth, the possibility of a perineal tear, the pain felt during all these processes and the responsibilities related to baby care that 
parenthood brings (Bolsoy et al., 2019; Lukasse et al., 2014; Sluij et al., 2020). 
There are many educational programs that focus on attitudes and behaviors for parents in order to facilitate individuals' adaptation 
to these changes and to better manage the transition to parenthood. These programs have a positive effect on the individual well- 
being of parents, their ability to acquire parenting skills in a healthy way, and the healthy development of the child (Feinberg and 
Kan, 2008; Feinberg and Sakuma, 2011; Hock et al., 2022; Vural Batık and Kalkan, 2018). By supporting the uncertainty of this 
transition process with educational programs in the prenatal period, family-baby bonding and adaptation can be achieved, and 
pregnancy, birth, and the postpartum process can be continued in a healthy way (Seyhan, 2023). 
One of the behavioral intervention programs used to adapt to the changes experienced during pregnancy, birth and postpartum 
and to maintain the transition to parenthood in a healthy way is Conscious Awareness-Based Practices (Goetz et al., 2020; 
Matvienko-Sikar et al., 2016). Conscious awareness is an experiential process in which attention is directed purposefully and 
consciously to what is happening in the body and mind at that moment, and the content that emerges as a result of these 
observations is accepted with curiosity, understanding and compassion without judgment, analysis or reaction (Atalay et al., 2017; 
Hall et al., 2016; Hisli Şahin, 2015; Kabat-Zinn, 2015). It is a skill that allows us not to be passive towards everything that is 
happening in the moment and is associated with all our positive, negative and neutral experiences, reducing all levels of suffering 
and increasing our well-being (Özyeşil et al., 2011). Because of their reported effects, these interventions may help parents increase 
their awareness and acceptance of thoughts, feelings, and body sensations, reduce reactivity, avoid distressing experiences, 
accept the roles and responsibilities of parenting in a nonjudgmental manner, learn to use mechanisms to cope with the stress of 
parenting, and develop compassion for themselves and their children. to show (Corthorn and Milicic, 2016; Duncan et al., 2009; 
Hall et al., 2016;). In addition, as stated in the 12th Development Plan (Ministry of Strategy and Budget, 2023), the goals of 
sustainable development will be served by increasing qualified, sustainable, accessible and behavioral change-oriented parent 
education starting from pre-birth. 
In a study conducted in Türkiye, a conscious awareness-based approach was applied to women who were being followed up in the 
clinic with a diagnosis of premature rupture of membranes and its effect on their adaptation to motherhood in the prenatal period, 
maternal attachment levels and adaptation to motherhood in the postpartum period was investigated. evaluated. After the 
intervention, women's pregnancy acceptance, preparation for birth, maternal attachment 

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and it was determined that there was an increase in the competence levels related to the motherhood role (Körükçü and Kukulu, 
2017). In a study where a systematic review was made of mindfulness-based interventions during pregnancy, it was determined 
that unwanted situations such as anxiety, depression, fear of childbirth and perceived distress were reduced. overcome for 
is useful and psychological well-being It has been found that it increases (Dhillon And al., 2017; Hulsboch, 2020; Khoury et al., 
2013; Veringa, 2016; Vieten and Astin, 2008;). Pan et al. (2019) increase for their work As a result; awareness And birth 
essence sufficiency levels increased significantly . Shorey et al. (2019) reported that mindfulness interventions implemented to 
improve maternal outcomes has positive effects on maternal well-being They emphasized that state of well-being not only 
psychologically but also physically in blood pressure and blood sugar organized, heart slows down the heart rate, fatigue And 
activity levels healed results They reported. 
Mindfulness-based training can be integrated into childbirth preparation training as it is a method that can be used to improve birth 
parameters. When the literature is examined, there are studies examining the effects of Mindfulness-Based Parenting and Childbirth 
Preparation Training on mothers in the perinatal period, but there are limited studies that include fathers in the practice and studies 
examining the relationship between adaptation and attachment with awareness. It is stated that actively including both parents in 
group-based parenting training is more effective in increasing the efficiency of the program (McHale and Negrini, 2018; Xiao and 
Loke, 2022). 
Meleis (2010) stated that conscious awareness is an important feature of the transition. The higher the awareness of the individual 
about the new role he/she will assume at the end of the transition, the more competence and achievement level that high will be 
(Bryne et al., 2014; Dunn et al., 2012; Meleis, 2010; Prinds et al., 2016; Schumacher & Meleis, 1994). Therefore, Mindfulness- 
Based Parenting and Childbirth Preparation Education Parenting Competence and adaptation to their roles, facilitation of the birth 
process, ensuring maternal and paternal bonding are important as they will increase the quality of pregnancy, birth and postpartum 
care. In this context, in the 12th Development Plan prepared by the Presidency of Strategy and Budget of the Republic of Turkey, 
(2024-2028) stated “Starting from the prenatal period children Increasing accessibility and provision of services for health, nutrition, 
early learning, responsive care, safe environment and social protection policies; “The quality of the service will be increased” It is 
thought that it will serve the article. In this direction, it is expected that awareness-based birth preparation trainings will affect the 
behavioral changes of parents. In addition, parents will be able to easily access the trainings and will be able to make the 
awareness-based practices they learn in the training sustainable by integrating them into every moment of their lives and parenting 
roles. 
For all these reasons, this study was planned to investigate the effects of the Awareness-Based Parenting and Birth Preparation 
Education given to couples on maternal-paternal attachment, birth parameters and postpartum sleep. It is thought that the education 
that parents receive with awareness of their own bodies and the birth process will positively contribute to the pregnancy, birth and 
postpartum process. In this way, it is aimed that this education activity, which is organized for expectant mothers to have a healthy 
birth, will contribute to the third goal of Sustainable Development, "Securing Healthy and Quality Life at All Ages" and will develop 
awareness for expectant mothers to have a healthier birth and to act with mother-baby health in mind during pregnancy, birth and 
postpartum. 
1.1. Problem Status 
The research question was formulated as “What is the effect of Mindfulness-Based Parenting and Childbirth Preparation Education 
on maternal-paternal attachment, birth parameters and postpartum sleep?” 
1.1.1. Sub Problems 
 
Awareness Fundamentally Parenthood And To birth Preparation His education maternal to connect What is the effect ? 
 
Awareness Fundamentally Parenting and To birth Preparation His education paternal to connect effect why? 
 
Awareness Fundamentally Parenthood And To birth Preparation His education in parents birth to fear effect why? 
 
Awareness Fundamentally Parenthood And To birth Preparation His education birth expectation/experience effect why? 
 
Awareness Fundamentally Parenting and To birth Postpartum Preparation Training sleep What is the effect ? 
1.1.2. The research Hypotheses 
H 01 : Mindfulness-based parenting and childbirth preparation education has no effect on maternal attachment in 
primiparous women. H 11 : Mindfulness-based parenting and childbirth preparation education has an effect on 
maternal attachment in primiparous women. H 02 : Mindfulness Based Parenting And Preparation for Birth Education 
in primiparas has no effect on paternal attachment. H 12 : Awareness-Based Parenting and Childbirth Preparation 
Education has an effect on paternal attachment in primiparas. H 03 : Awareness-Based Parenting and Childbirth 
Preparation Education has no effect on fear of childbirth in parents. 
H 13 : Awareness Based Parenting And Preparation for Birth Education of parents fear of birth H 04 : Awareness- 
Based Parenting and Childbirth Preparation Education has no effect on childbirth expectation/experience. 
H 14 : Awareness Based Parenting And Preparation for Birth Education based on birth expectation/experience H 
05 : Awareness-Based Parenting and Childbirth Preparation Education has no effect on postpartum sleep. 
H 15 : Awareness Fundamentally Parenthood And Preparation for Birth His education postpartum sleep effect There is. 
 
1.2. Aim And Goals 
 
Araştırmanın amacı doğuma hazırlık sınıflarında verilen Farkındalık Temelli Ebeveynlik ve Doğuma Hazırlık Eğitiminin maternal- 
paternal bağlanma, doğum parametreleri ve postpartum uyuma etkisini değerlendirmektir. 
Bu doğrultuda birinci iş paketinde veri toplama formları hazırlanarak müdahale grubuna gönderilecek ev ödevlerini içeren ses 
kayıtları derlenecektir. İkinci iş paketinde müdahale ve kontrol gruplarının randomizasyon yöntemiyle atanması sağlanacaktır. 
Üçüncü iş paketinde ön testler uygulanacaktır. Dördüncü iş paketinde eğitimler verilecektir. Beşinci iş paketinde son testler 
uygulanacak ve altıncı iş paketinde ise veri analizi ve bulguların yorumlanması yapılacaktır. 

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1. METHOD 
1.1. The study The pattern 
This quantitative in the study research experimental method pattern has been used. Quantitative research, current situation and 
research that involves the process of observing and measuring numerical values objectively and systematically in order to gain 
information about the facts and the measurements made can be repeated (Burns and Grove, 1993). Quantitative research focuses 
on the relationships and differences between variables and aims to provide future provides instructions for And generalization to its 
purpose (Başol, 2008). In quantitative research based on the positivism approach, hypotheses are clearly determined and tested 
(Fraenkel and Wallen, 2006). In the study, a sample group that has reached the power to represent the universe was subjected to 
the Mindfulness-Based Parenting and Birth Since the effects of the Preparatory Training on maternal-paternal bonding, birth 
parameters and postpartum sleep were examined, a pre-test post-test control group experimental design was used in the study 
(Büyüköztürk, 2007). 
1.2. The research The Universe And Sample 
The universe of the study consisted of pregnant women who applied to the Kayseri City Hospital Pregnancy School and Pregnancy 
Polyclinic between October 1 and December 31, 2023. The number of pregnant women who attended the Pregnancy School in 
these three months was approximately 100, and the number of pregnant women who attended the Pregnancy Polyclinic was 
approximately 100. The number of pregnant women who applied was 800. In determining the number of pregnant women to be 
included in the study sample, in the study of Duncan and Bardacke (2010), the mean difference of pre and post Mindfulness values 
(0.30) was taken as basis and 95% confidence (1- α), 95% test power (1- β) and d=1.111 effect size were calculated with the Gpower 
program and as a result of the paired samples t test, it was found that a total of 13 couples should be included in the study. It was 
planned to include 15% more couples (1.95) considering that there may be data losses in the study. Therefore, 15 couples will be 
included in the study. In the study, couples will be assigned to groups according to the randomization list below (Figure 1). 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Shape 1. Randomization list 
Randomization on the list first eight couple intervention group while creating remainder seven couple control group will create. 
1.3. The research It was made Place And Features 
The research will be conducted in Kayseri City Hospital Pregnancy School and Pregnancy Polyclinic. There is one pregnancy school 
and 10 pregnancy polyclinics in Kayseri City Hospital. Pregnancy polyclinics and pregnancy school provide service in the 
Gynecology and Obstetrics building. Polyclinics are on the ground floor of the Gynecology and Obstetrics building, and the 
pregnancy school is on the ground floor. It provides service on the third floor. Each pregnancy clinic has a doctor and a secretary. 
Each pregnancy clinic provides service to an average of 60 pregnant women per day. Two midwives take turns in training at the 
pregnancy school. Pregnant women who are 24 weeks pregnant and over can attend the pregnancy school. Training is provided at 
different times for pregnant women who are in the clinic and those who come from outside. Training is provided in the morning for 
pregnant women who are in the hospital and in the afternoon for pregnant women who come from outside. Training lasts 1 week, 5 
days a week and 3 hours per day for a group. 
Kayseri City Hospital Pregnant School Education Plan: 
Monday: Education is given about introductions and expectations, the pregnancy process, the physiology of pregnancy, the 
formation of pregnancy, fetal development, physiological and psychological changes that occur during pregnancy, daily life during 
pregnancy and individual preparations during pregnancy, followed by practical breathing exercise training. 
Tuesday: Education is given about perception of birth, normal labor, signs of birth, massage methods, breathing exercises, skin-to- 
skin contact and safe birth, followed by practical breathing exercise training. 
Wednesday: Training is given on the postpartum period, breast milk and breastfeeding techniques, newborn care, family planning 
methods, followed by practical breathing exercise training. 
Thursday: Affirmations, positive to birth focusing, subconscious work, sleep meditation is being done. 
Friday: Pregnancy Pilates is done. At least Pregnant women who have received three sessions of training can participate in pilates. 
Those with risky pregnancies and those with systematic and chronic diseases cannot participate in pregnancy pilates. 
1.4. Dependant And Independent Variables 
Independent Variables: Sociodemographic features (age, education situation, job, economic situation), with pregnancy relating to 
characteristics (gestational week, planned/unplanned pregnancy, birth method preference) 
Dependent Variables: Maternal-paternal bonding, birth parameters and postpartum compliance scores 
Intervention variable: Mindfulness-Based Parenting and Childbirth Preparation Education 
 
 
 
 

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1.5. To the research Including Being made Criteria 
 
18-35 in the age group , 
 
First pregnancy the one which, 
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24-28. pregnancy in the week the one which, 

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 
The research was made Dates between Pregnant To the polyclinic Applicant And Pregnant School to their education 
acceptance the said, 
 
Most little literacy education at the level of the one which, 
 
Communication obstacle not available Persons to work including will be done. 

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1.6. From research Exclusion Criteria 
 
Psychiatric discomfort those who have, 
 
Early birth at risk path can open with pregnancy relating to risk factor the one which... pregnant women, 
 
Early birth at risk path can open chronic to the disease owner the one which... Pregnant women to work including will not be 
made. 
1.7. Data Collection Tools 
In the prenatal period; Parent Introduction Form, Conscious Awareness Scale (Özyeşil et al., 2011), Prenatal Attachment Scale 
(Türkmen Çevik & Kurnaz, 2018), Prenatal Paternal Attachment Scale (Benli & Aksoy Derya, 2019), Fathers The Fear of Childbirth 
Scale (Calpbinici et al., 2023) and the Wijma Childbirth Expectation/Experience Scale Version A (Körükcü et al., 2009) will be used 
for mothers. 
In the postpartum period; Conscious Awareness Scale (Özyeşil et al., 2011), Wijma Birth Expectation/Experience Scale Version B 
(Körükcü and al., 2014), Postpartum Self-Assessment Father-Infant Attachment Scale (Taşçı & Mete, 2010) Scale (Güleç & Kavlak, 
2013) and Maternal Attachment Scale ( Kavlak & Şirin, 2009) will be used. 
1.7.1. Parents Promotion The form (ETF) 
The ETF, created by the researcher, is a data collection tool consisting of 16 questions to examine the obstetric history, pregnancy 
and birth preferences and sociodemographic characteristics of pregnant women and the sociodemographic characteristics of fathers 
(Appendix-1). 
1.7.2. Conscious Awareness The scale (BFO) 
The English version of the Mindful Attention Awareness Scale (MAAS) was developed by Brown and Ryan (2003) and its Turkish 
adaptation was made by Özyeşil et al. (2011). The aim of the scale is to evaluate the individual differences in the state of being 
conscious in the daily experiences of individuals, the frequency of being conscious, and the awareness and attention in the present 
moment. Mindful awareness includes the experiences in the present moment and towards these experiences It measures the 
tendency to be aware (Özyeşil et al., 2011). It has a 6-point Likert scale (“1=almost always”, “2=most of the time”, “3=sometimes”, 
“4=rarely”, “5=fairly rarely”, “6=almost never”). The scale consists of 15 items. There are no reverse items in the scale. The lowest 
score that can be obtained from the scale is 15, and the highest score is 90. A high score indicates a high level of conscious 
awareness. The Cronbach Alpha internal consistency coefficient of the scale is 0.80 (Özyeşil et al., 2011) (Appendix-2). 
1.7.3. Prenatal Attachment The scale (PBO) 
In the womb of pregnant women by Türkmen Çevik and Kurnaz (2018) level of attachment to the baby a measuring tool The scale, 
PBÖ, consists of 33 items. The scale items are graded in three and each item is answered as I definitely agree (3), I partially agree 
(2), I definitely disagree (1). There is no reverse statement in the scale. The lowest score that can be obtained from the scale is 33, 
and the highest score is 99. A high score obtained from the scale indicates a high level of prenatal attachment. The scores that can 
be obtained from the curiosity and excitement factor vary between 13-39; from the acceptance and enthusiasm factor between 9-27 
and from the hope factor between 11-33. The total internal consistency coefficient of the scale was calculated as 0.94 and it was 
determined that the scale is a reliable and valid tool for measuring the level of attachment to the baby in pregnant women (Appendix- 
3). 
1.7.4. Birth Pre Father Attachment The scale (DOBBÖ) 
The scale, developed by John Condon (1993) and adapted into Turkish by Benli and Aksoy Derya (2019), consists of 16 Likert-type 
items. Each item of the scale measures the father's feelings, attitudes, behaviors, and thoughts towards the developing fetus in the 
womb. measure over while focusing, most items fathers last two in the week to their experiences is based on. The scale 
measures the father's emotional experience when thinking about the baby in the womb, the "quality of attachment", and the intensity 
of preoccupation with the fetus. It has two factors, namely “time spent on attachment”. Items 1, 3, 5, 6, 7, 8, 12, 13 and 15 in the 
scale is reverse scored. Sixth and articles 13 scale total is added to the score. The scale is An item is scored as 1 = no feelings 
towards the fetus; 5 = very strong feelings towards the fetus. The scale can be obtained from point 16-80 is between; attachment 
sub quality from the size available to be taken point 8-40; to connect spent time The score that can be obtained from the sub- 
dimension is 6-30. Increasing scores indicate a higher degree of attachment. Cronbach's α in the total of the DÖBBÖ is 0.82. The 
same scale was later studied by Güleç Şatır and Kavlak (2021) under the name "Paternal Antenatal Attachment Scale" (Appendix- 
4). 
1.7.5. Fathers Birth Fear of The scale (BDKO) 
The scale was developed by Ghaffari et al. (2021) to determine the levels of fear of childbirth in expectant fathers during pregnancy. 
The scale consists of two sub-dimensions: the birth process (12 items) and hospital fear (5 items), which affect fathers' fear of 
childbirth. It is a 5-point Likert-type scale and the items are answered as strongly disagree (1), disagree (2), undecided (3), agree 
(4), and strongly agree (5). The score that can be obtained from the scale varies between 17 and 85. Scores of 17–35, 36–54, and > 
55 indicate low, moderate, and high fear of childbirth, respectively. Higher scores indicate a higher level of fear related to childbirth 
(Ghaffari et al., 2021). The Cronbach alpha coefficient of the scale was calculated as 0.84. The validity and reliability of the scale in 
Turkish was performed by Calpbinici et al. (2023). The content validity index of the scale was found to be 0.96. Cronbach alpha 
reliability coefficient for the entire scale is 0.93 (Appendix-5). 
1.7.6. Wijma Birth Expectation/Experience The scale A Version (WDBDÖ- A) 
This scale was developed by Wijma et al. (1998). The aim of the scale is to evaluate the fear of childbirth experienced by women 
during pregnancy. The Turkish validity and reliability study was conducted by Korukcu et al. (2009). The scale consists of 33 items. 
The responses on the scale are numbered from 0 to 5 and are in the six-point Likert type. Zero is expressed as “completely” and 5 
as “not at all”. The minimum score on the scale is 0, while the maximum score is 165. A high total score indicates a high level of 
fear. The negatively loaded questions in the scale (2, 3, 6, 7, 8, 11, 12, 15, 19, 20, 24, 25, 27, 31) were turned in the opposite 
direction to ensure consistency in measurement. is calculated. From the scale received score of 37 small is light level Fear of 
childbirth, between 38-65 indicates moderate fear of childbirth, between 66-84 indicates severe fear of childbirth, and 85 and above 
indicates clinical level fear of childbirth. In the study of Körükcü et al. (2009), the Cronbach alpha value of the W-DEQ Scale A 
version was found to be 0.89 (Appendix-6). 
1.7.7. Wijma Birth Expectation/Experience The scale B Version (WDBDÖ- B) 
The current scale is for women lived in birth fear of measure purpose with Klaas And Barbaro Wijma (1998) by developed. 
Scale to women birth after doing later in their rooms is applied. Six Likert in type the one which... This scale 32 from matter It 

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consists of (Wijma and (al., 1998). Answers From 0 To 5 and numbered up to 0 “completely”, 5 whereas "none" shaped expression 
is being done. Minimum of scale score 0, maximum score It is 160. The scale some your questions Answers Which to the 
number equivalent if it is coming he in this way 

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When calculating the W-DEQ, questions numbered “2, 3, 6, 7, 10, 11, 14, 18, 19, 23, 24, 26 and 30” are calculated by turning them 
in the opposite direction. The calculated W-DEQ- B score ≤37 is low level, Intermediate level between 38-65, Between 66-84 
heavy level, ≥ 85 and above indicates a level of fear of childbirth that requires clinical treatment (Wijma et al, 1998). The scale was 
adapted to Turkish and its validity and reliability study was conducted by Körükcü et al in 2014, and the Cronbach alpha value was 
found to be 0.88 (Körükcü et al, 2014) (Appendix-7). 
1.7.8. Postpartum Self Evaluation The scale (PKDO) 
The Cronbach alpha value of the scale, whose validity and reliability study was conducted by Taşçı and Mete (2010), was determined 
as 0.84. It is an 82-item, 4-point Likert-type scale developed by Lederman and Weingarten in 1981 to evaluate the adaptation of 
women in the postpartum period to motherhood. The scale has 7 sub-dimensions that evaluate the postpartum adaptation of 
mothers. 39 of the items in the scale are reverse-biased. The numbers of the reverse-biased items in the scale are as follows; 1, 2, 
4, 6, 9, 10, 14, 15,16, 22, 29, 30, 32, 33, 36, 38, 40, 41, 42, 43, 44, 46, 47, 49, 51, 53, 54, 59, 61, 62, 67, 69, 71, 73, 77, 78, 79, 
81, 82. 
The scale is measured with a 4-point evaluation. Postpartum adjustment is rated from “1” to “4” (4: “Describes very much”, 3: “Partially 
describes”, 2: “It describes a little bit”, 1: "It doesn't define anything") until changing your points evaluated based on the results. The 
entire scale A minimum score of 82 and a maximum score of 328 can be obtained for . Low scores indicate high postpartum 
adjustment (Appendix-8). 
1.7.9. Father Baby Attachment The scale (BBBBÖ) 
It was developed by Condon et al. (2008) to measure the postpartum father-infant bond. The validity and reliability of the Turkish 
version was done by Güleç and Kavlak (2013). Each item of the scale is scored between one and five points. 12 items in the scale 
(4, 5, 7, 8, 9, 10, 11, 12, 13,14, 15,16) are reverse-coded. High scores obtained from the scale indicate high bonding. The original 
scale consists of three sub-dimensions and 19 items. The Turkish version of the scale includes three sub-dimensions (patience- 
tolerance, pleasure in interaction, love-pride) and 18 items (item 16 was removed) (Appendix-9). 
1.7.10. Maternal Attachment The scale (MBO) 
MBI was developed by Mary and Muller (1994) to measure maternal love and attachment. In the study in which Kavlak and Şirin 
(2009) tested the validity and reliability of the scale in Turkish society, Cronbach's alpha reliability of the scale was found. The 
coefficient was found to be 0.77 for mothers with 1-month-old babies and 0.82 for mothers with 4-month-old babies. It was 
determined that it can be used safely for mothers with babies in the 1st and 4th months after birth. The scale is a 4-point Likert-type 
scale consisting of 26 items. Each item contains direct expressions and always (a) = 4 points, often (b)=3 points, It is calculated as 
sometimes (c) = 2 points and never (d) = 1 point. The lowest score that can be obtained from the scale varies between 26 and the 
highest score is 104. A high score indicates that maternal attachment is high (Appendix-10). 
1.8. Data Analysis 
From this research The obtained data were obtained using SPSS for Windows 22.00 (Statistical Package for Social Sciences) will 
be analyzed with a statistical package program. Descriptive statistics will be given as number of units (n), percentage (%), mean ± 
standard deviation (x̄  ±ss), minimum value (min), maximum value (max). Whether the data show a normal distribution will be 
determined with the Kolmogorov-Simirnov test and p>0.05 will be considered statistically significant. Also, kurtosis skewness values 
mode The median and median values will be evaluated within the framework of the normality test. 
In case of normal distribution of data, comparisons of groups in time for numerical variables will be made with Paired-Samples t 
(dependent groups) test in repeated measurements and comparisons between groups will be made with Independent-Samples t 
(Independent groups) test. The relationship between scale scores will be evaluated with Pearson correlation analysis. In all 
comparisons, p<0.05 value will be accepted for the significance level of statistical tests (Pallant, 2020). In case of non-normal 
distribution of data nonparametric tests will be used. 
1.9. The research Ethic Direction 
Erciyes University Faculty of Health Sciences Academic Board decision was received (09.10.2023, 2023/50, Decision number: 71) 
(Appendix- 11). Institutional permission was received from Kayseri City Training and Research Hospital Education Planning Board 
(24.11.2023, Number: 76397871) (Appendix-12). Ethics committee permission was received from Kayseri City Training and 
Research Hospital Clinical Research Ethics Committee (31.10.2023, Decision no: 938) (Appendix-13). Pregnant women who 
volunteer to participate in the research during the data collection phase will be asked to read and sign the Informed Consent Form 
(Appendix-14). 
1.10. APPLICATION The steps 
Kayseri City Hospital Pregnant School and Pregnant Polyclinic on October 1st 2024- November 1st Dates 2024 Fifteen pairs of 
parents who applied between and met the inclusion criteria will be assigned to groups according to the randomization list. 
Awareness-Based Parenting and Childbirth Preparation Education will be given as a group education on Mondays of each week 
during the hours when the pregnancy school does not provide education. The control group constituent Kayseri to parents City The 
hospital is conducting a birth No intervention will be made other than the preparatory training. The flow chart (Figure 2) is given 
below. 

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Shape 2. Flow scheme 

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1.10.1. Control Group APPLICATION The steps 
No additional application will be made to the control group other than the 1-week birth preparation training at the Kayseri City Hospital 
Pregnancy School. In the first session, written consent will be obtained from parents who meet the criteria for inclusion in the study 
and agree to participate, and the researcher will fill out the questionnaires in the first hour of the training. In this session, the pregnant 
woman and her partner will be introduced and the ETF will be filled out in order to learn her socio-demographic information. BFÖ, 
PBÖ, DÖBÖ, BDKÖ, WDBDÖ-A will be applied. Later, the trainer at the pregnancy school will start the pregnancy school's own 
training. 
1 week to birth preparatory training after completion then BFÖ, PBÖ, DÖBÖ, BDKÖ, WBDÖ-A will be applied. 
WBDÖ-B will be applied on the first postpartum day to determine the birth experiences of the mothers. 
Contact with mothers via phone in the 1st and 4th months postpartum The PKDÖ will be used to assess mother-infant adjustment, 
and the MBI will be used to assess mother-infant attachment; and the fathers will be contacted at the 6th postpartum month to assess 
father-infant attachment. 
1.10.2. Intervention Group APPLICATION The steps 
In addition to the 1-week birth preparation training at the Kayseri City Hospital Pregnancy School, the intervention group will receive 
Mindfulness-Based Parenting training. This training aims to teach participants how to monitor their thoughts and emotional states, 
how to deepen their sensory awareness of their bodies and how to be more careful about how their minds work, and how to deepen 
their sensory self-awareness, so that they can be more sensitive during the birth and parenting processes. A total of 9 separate 
sessions are planned. Mindfulness-Based Parenting and Birth Preparation Training will be held for 9 weeks, with one session per 
week, and the duration of each session will vary according to the parents' compliance and needs. each One session It will take 
approximately 120 minutes. Practices education researcher during to be taught by and the sections related to practice will be 
marked and shown in the training booklet and read once in class. Home practice assignments, audio recordings containing guiding 
conscious awareness practices and the Mindfulness-Based Parenting and Birth Preparation Training Booklet developed by the 
facilitator and containing the training protocol will be distributed for each session. If you do not attend the training for any reason, 
For parents who cannot attend, make-up training for the relevant week will be provided on a different day. 
1.  Session (120 min) 
The first session will be held on Monday of the first week. In the first hour of this session, the researcher will fill out the questionnaires. 
The pregnant woman and her partner will be introduced and ETF will be filled out in order to learn their socio-demographic 
information. BFÖ, PBÖ, DÖBÖ, BDKÖ, WDBDÖ-A will be applied. Then, the training will start and in the first session, the definition 
of awareness, the purpose and content of Awareness-Based Parenting and Childbirth Preparation Training will be explained, when 
did she first learn about pregnancy, what did she do after learning what he did and what Talking about feelings, Breath Awareness 
Meditation, Together with Baby Practice of Being and Raisin Meditation will be included. 
2.  Session (120 min) 
The second session will be held on Monday of the second week. In this session, Body Scanning Practice, Breath Awareness 
Practice, Being with the Baby Practice and Birth Yoga Practices will be done. She will discuss the milestones in her life and the 
mother- Questioning role models related to fatherhood and mindfulness-based eating behavior will be discussed. (Doing 
mindfulness-based eating exercises with raisins and in the next session, eating experiences will be discussed and it will be expected 
that this mindfulness will be adapted to every moment of the pregnancy and birth process). Formal and informal practical homework 
assignments will be evaluated. Formal Practices: Usually guided (self, with a guide or recording) progress (body scan, sitting 
meditation) etc). Informal Practices: Daily alive what we did activities with awareness to do includes (external scrub, cooking 
etc.) 
3.  Session (120 min) 
The 3rd session will be held on Monday of the third week. In this session, the Body Scan Practice will be applied. How to do daily 
activities such as brushing teeth, driving, taking a shower, shaving, washing dishes, and cooking with awareness will be discussed. 
Breath Awareness Meditation and Being with the Baby Practice will be done. The Calendar of Pleasant Events will be explained and 
homework will be given to the couples. The formal and informal homework given in the previous week will be evaluated. Talking about 
what kind of mother she dreams of being, talking about her fears and concerns about the future, and breastfeeding education will be 
discussed. Breastfeeding Education: The structure of breast tissue, the importance of breastfeeding, how breastfeeding is 
performed, placing the baby on the breast, breastfeeding positions, evaluating breastfeeding, starting supplementary foods, breast 
care, possible problems related to the nipple, burping the baby after breastfeeding, and rehearsing breastfeeding with a baby model 
will be discussed. Formal and informal homework assignments will be evaluated. 
4.  Session (120 min) 
The 4th session will be held on Monday of the fourth week. Birth Yoga Practices and Body Scan Practice will be applied. Breath 
Awareness Practice and Three-Minute Breathing Break Practice and Being with the Baby Practice will be applied. Formal Pain 
Practice will be applied with ice. Formal and informal homework will be evaluated. Unpleasant Events The calendar about A 
statement will be made and will be assigned. Baby care Education Baby Care Training: Umbilical cord care, baby bath and skin 
care, nail care, excretion, diaper use and diaper rash, thrush, body temperature assessment and dressing, vaccination, baby care 
rehearsal with a baby model will be done. 
5.  Session (120 min) 
The 5th session will be held on Monday of the fifth week. Birth Yoga Practices, Body Scan Practice, Breath Awareness Practice, 
Being with the Baby and Formal Pain Practice will be practiced. Mindful Pooping Practice will be discussed. Formal and informal 
homework assignments will be evaluated. After the practices, the mother-to-be will be given training on how to care for herself during 
the postpartum period. This training will include early mobilization, lochia follow-up, perineal care, care if an episiotomy was 
performed, breast care and problems, information on milk expression and storage conditions, information on the wound healing 
process and facilitating factors if a cesarean section was performed, nutrition, sleep and rest, Kegel exercises and postpartum 
exercises, transition time to sexual activity and contraception, emotional preparation for the process and information on support 
systems. 
6.  Session (120 min) 
The 6th session will be held on Monday of the sixth week. Birth Yoga Practices, thirty-minute Sitting Meditation and Body Scan 
Meditation will be applied. Formal Pain Practice will be done. Fear and Happiness Research Practice will be done. Walking 

12 
  
Meditation And Speech And Listening His research will be implemented. Formal And informal given house your homework 

13 
 
 
 
 
 
 
will be evaluated. In this session, the choice of delivery method, preparation of the delivery bag, 
signs of labor and ways to make birth easier will be discussed. * A Daily Mindfulness Practice 
assignment will be given between Week 6 and Week 7. 
7.  Session (120 min) 
The 7th session will be held on Monday of the seventh week. Sitting Meditation, Choiceless 
Awareness, Body Scan, Birth Yoga Practices, Compassion Meditation and Family Roots Talking 
About and Listening Research will be applied. Formal and informal homework assignments will 
be evaluated. In this session, fear of birth and subconscious factors in pain perception will be 
discussed. 
8.  Session (120 min) 
8. The 8th session will be held on Monday of the week. Compassion Meditation is applied. How 
much time do you spend looking at your mobile phone, texting or sharing on social media? How 
might this be related to your stress? The practice of spending one day of the week as a 
“technology-free day” is explained by seeking answers to these questions. Formal and informal 
homework assignments will be evaluated. 
9.  Session (120 min) 
9. The 9th session will be held on Monday of the week. The practices that the group found most 
useful are re-implemented. The section titled “Endings and Beginnings: The Last Lesson” is read 
and discussed. They are told to share with each other the things that come to mind together with 
their partners. They are given homework to continue to apply formal pain practices at certain 
intervals until they give birth. They are encouraged to continue to develop their awareness in 
every moment of their daily lives by approaching routine activities with awareness. They are 
encouraged to practice Being with the Baby, Compassion Meditation, and Three-Minute 
Breathing Break. On the day the 9th session is completed, BFÖ, PBÖ, DÖBÖ, BDKO, WBDÖ- 
A will be applied. WBDÖ-B Version will be applied on the 1st day postpartum to determine the 
mothers’ birth experiences. Mothers will be contacted by phone in the 1st and 4th months 
postpartum. mother baby harmony In order to evaluate the PKDÖ and mother and baby MBI 
will be applied to assess father-infant bonding; fathers will be contacted at the 6th month 
postpartum and BBBI will be applied to assess father-infant bonding. 

14 
 
 
 
 
1.11. Awareness Fundamentally Parenthood And To birth Preparation Education Booklet 
“Mindfulness-Based Parenting and Birth Preparation” was created by the researcher by 
scanning the relevant literature (Atalay, 2018; Bardacke, 2012; Vreeswijk, 2019) The “Education 
Booklet” (Annex-15) will be sent to the participants in printed form and the audio recordings to 
be played during meditation (Annex-16) will be sent to the participants via WhatsApp application. 
Before using the booklet, the Birth-Women's Health and It was presented to the opinion of two 
academicians who are experts in the field of Disease Nursing and the booklet was finalized in 
line with the suggestions received.