The relationship between maternal-foetal attachment, self esteem and social support in pregnant adolescents

Fifty pregnant teenagers (mean age 17.8, range 15-19) were recruited to take part in a semi-structured research interview investigating the relationships between self esteem, social support and maternal-foetal attachment. Three objective research instruments were employed: i) The Maternal-Foetal Attachment Scale (MFAS, Cranley, 1981), ii) The Support Behaviours Inventory (SBI, Brown, 1988) and iii) Rosenberg's Self Esteem Scale (RSE, Rosenberg, 1979). Measures of social support were derived from self-ratings and qualitative data was collected exploring the mother's relationship with her foetus. Maternal-foetal attachment has been defined as the extent to which women engage in behaviours that represent an affiliation and interaction with their unborn baby or an enduring affectional tie and commitment (Cranley, 1981 ; Mercer and Ferketich, 1990). This study is a comparison study to that of Koniak-Griffin (1988) who Investigated the relationship between self esteem, social support and maternal-foetal attachment in adolescents. Significant flaws were identified in Koniak-Griffin's study which included the use of a non-representative sample of teenagers who were institutionalised. Our population was selected from pregnant adolescents attending a large country health service area. There is limited information available related to maternal-foetal attachment in adolescents. Pregnancy is the beginning of the woman sharing her body with another being and this event creates changes for the woman in the way she will perceive herself and the future relationship with the "unknown" baby (Kemp and Page, 1987). Evidence is increasing that the relationship ix initiated by the woman with her unborn baby assists in maternal-role development. Current studies indicate that maternal-foetal attachment is an important aspect of the developmental tasks of pregnancy and influences maternal-infant attachment (Gaffney, 1988). The events of the prenatal period effect the degree to which the woman is prepared for the birth experience and the role of motherhood. Unless positive maternal-foetal attachment occurs for the adolescent mother, literature suggests that she will experience problems in her relationship with her infant. The results indicated that Maternal-Foetal Attachment was significantly related to Self Esteem (r = 0.359, p < 0.005), and to the total number of people indicated as being supportive (r = 0.271, p < 0.05). There was no relationship, however, with the Support Behaviours inventory measure. Interestingly, Maternal-Foetal Attachment was significantly related to perceived support from the teenager's father (r = 0.294, p < 0.05) but was not related to support from the mother (r = 0.032, ns.) a finding at odds with the literature. Maternal-Foetal Attachment was not significantly related to the age of the teenager, but was significantly related to gestation (r =0.49, p < 0.0005). The Maternal-Foetal Attachment Scale was re-scored, removing items that were gestation-specific (i.e. that specifically primed for foetal movement responses) because it was reasoned that these were not measuring foetal attachment. Using the revised scale gestation was no longer related to maternal-foetal attachment, but self esteem and social support dispersion were significantly related. The conclusion is that the two most important variables in promoting maternal-foetal attachment are the pregnant mother's self esteem and the size of the social support network.