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Psychological
processes involved
in childbearing

Adjustment to pregnancy,
prenatal attachment,
attitudes to motherhood
and fatherhood

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Reproductive decisions – the

individual factors

Psychological factors

Having children in individual hierarchy of life goals

Feeling ready / not ready for parenthood

„The right time” for a child

Interpersonal factors

The quality of a relationship

„The right partner”

Material factors

Sufficient resources for rising children

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Pregnancy – duration

The duration of pregnancy

280 days (40 weeks) – caunting from the
first day of last menstrual cycle

267 days – caunting from the ovulation

The phases of pregnancy

1 trimester (3 months period)

2 trimester

3 trimester

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Psychological processes across

pregnancy

Emotions

Changes across pregancy – both positive and
negative emotions

More negative emotions and emotional instability in
the first trimester – not confirmed, eg. Lips (1982),
Elliott (1983), Wijma (1992)

Cognitive processes

Gross & Pattison (1994, 2007) – more memory and
concentration deficits in 4th month then later
(„information overload”)

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Psychological processes across

pregnancy

Psychological changes

Mood swings, memory and concentration

problems, fatigue and a need for more sleep

Social changes

Passing information about pregnancy to

others

Study by Kroelinger & Oths (2000) - positive

partner’s reaction to information of

conception – leads to more acceptance of a

pregnancy in women

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Phases of pregnancy – female

perspective (J. Raphael-Leff,

1991)

The maturational process

Pregnancy as the process

The foetus develops in the womb

The woman develops into a mother

The belief that pregnancy was conceived - the belief

that the foetus is present and develops – the belief

that a newborn can exist outside the mother’s body

The phases of the maturational process of

pregnancy are related to medically defined

trimesters

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Phases of pregnancy – female

perspective

The first phase

From the conception till the experience of fetal
movements

Physical changes

Breast enlargement and tenderness, vaginal
discharge, changes in the skin and hair
condition, change in apetite and food carvings,

Nausea and vomiting

In most women until 12 weeks of gestation

An evolutionary mechanism that prevents intoxication

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Phases of pregnancy – female

perspective

The second phase

From fetal movements till development of
a strong anxiety related to delivery

Development of the attachment to a child

Changes in the relationships with a male
partner

A women initiates talks about the child

More sexual contacts than in the first phase

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Phases of pregnancy – female

perspective

The third phase

Untill the delivery

Preparation to labour and delivery

The idea that child can live outside a
mother’s body

Looking for the signs of approaching delivery

Fear of labour

Preparation for a maternal role

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Phases of pregnancy – male

perspective

Phases of pregnancy by May (1986)

Announcement

From the first thoughts about possibility of conception

untill their confirmation

Support to a partner – for continuation of a pregnancy,

healthy behaviours

Moratorium

12 – 25 weeks of gestation, untill visible changes in a

partner’s figure

Expectations related to emotional stability of a female

partner

More interest in pregnancy when better partners’

relationships

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Phases of pregnancy – male

perspective

Phases of pregnancy – cont.

Focusing

25/30 weeks untill delivery

Preparation to labour/delivery

Ideas of paternal role

Intense emotions, eg. anxiety

Difficulties in adjustment to a new

role/situation

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Couvade syndrome

(„a pregnant male”)

Information about changed behaviour and
symptoms in partners of pregnant women

60 BC – Diodorus Siculus (Corsica)

XVII Century – East England

Anthropological findings – couvade as a
symbol of accepting a child

„Pseudo-maternal” couvade

„Diet” couvade

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Symptoms associated with the

Couvade syndrome

(Conner & Denson, 1990)

1. Gastrointestinal symptoms

Nausea, heartburn, abdominal pain, bloating

and appetite changes

Upper respiratory disturbances and pains

Colds, breathing difficulties

Toothache, leg cramps, backache, urogenital

irritations

Psychological symptoms

Changes in sleeping patterns, anxiety & worry,

depression, reduced libido, restlessness

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Intensity of symptoms associated

with the Couvade syndrome

I trimester

II trimester

III
trimester

Appear in the
first trimester
and might be
intense

Reappear in
the
last trimester,
but cease at
birth or
shortly within
the
postpartum
period

Temporaril
y
disappear
in the
middle
trimester

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The prevalence of the Couvade

syndrome (Bennan et al.,

2007)

The detailed data
from:

UK – 11-50%

Sweden – 20%

USA – 94-97%

Thailand – 61%

China – 68%

The incidence in:

South Africa

France

Russia

Serbia

Australia

Consistent findings – higher incidence among black men

Inconsistent findings – age, social class, educational level, number
of previous children, planned/unplanned pregnancy

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Theoretical concepts of the

Couvade syndrome

(Bennan et al., 2007)

Psychoanalythical theories

The effect of man’s envy of the woman’s procreative ability

For the expectant man the partner’s pregnancy acts as a

catalyst of the resurgence of the Oedipal conflicts

Man’s rivalry with his unborn child

Psychosocial theories

A reaction to the marginalisation of men during pregnancy

An effect of men’s transitional crisis to prospective parenthood

Paternal theories

Preparation to paternal role

Anxiety as the cause (but also as the effect) for the syndrome

Hormonal changes

Increase level of prolactine & oestrogen and lower level of

testosterone associated with Couvade symptoms (Storey et al.,

2000; Berg & Wynne-Edwards, 2001)

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Description of the Couvade syndrome

(Based on Brennan et al., 2007)

Men’s

experience

s

Emotional diversity
in response to
pregnancy

Nature, duration &
meaning of
symptoms

Explanation
of
symptoms

The Couvade

syndrome

Feelings towards
pregnancy/parentho
od/partner/
involvement in
pregnancy

By
professionals/male
partner/failure to
explain

Investigatio
n/managem
ent

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Attachment - a definition

...a relatively enduring emotional tie
to a specific other person

Maccoby (1980)

the strong emotional tie that a
person feels toward a special other
person in his or her life

Lefton (1997)

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The other side of

attachment

(bonding with a child)

A special process of emotional
attachment that may occur
between parents and babies in
the minutes and hours
immediately after birth

Lefton (1997)

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Prenatal attachment

first concepts

Forming emotional bonds with a child - one
of the psychological tasks of pregnancy

First mentioned by Deutsch (1945)

Bibring (1959) - one of the psychological
task of pregnancy - to invest libido in the
foetus

Benedek (1959) - the concept of
pregnancy as ‘the gestation of the person’

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Prenatal attachment

more recent concepts

Lumley (1972) - women form
‘mental picture’ of the foetus in 2nd
& 3rd trimester of pregnancy

Leifer (1977) - no attachment in
25% of mothers; these women less
attracted to infants 7 months
postpartum

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Prenatal attachment

more recent concepts

Raphael-Leff (1991)

Approaches to pregnancy / foetus in women

Facilitator

Regulator

Intermidiate / Bipolar (proposed later by other
authors)

Approaches to pregnancy / foetus in men

Participator

Renouncer

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Can we measure it?

Theoretical concepts of measurement

tools

Cranley (1981) - self-report questionnaire for
maternal-foetal attachment

Condon (1993) – parental prenatal love

Condon (1998) – prenatal love continues
postnatally

Muller (1993) – affectionate relationship between
a mother and her unborn baby from a mother’s
perspective

Used in Sweden by A. Siddiqui

Polish validation has finished and will be presented soon

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Studies on prenatal

attachment

Development of attachment during
the course of pregnancy

in mothers and in fathers

Correlates of attachment

Effects of pregnancy complications

Attachment and experience of
pregnancy and the process of care

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Studies on prenatal

attachment in Lodz

Changes of attachment in pregnancy

Pregnancy complications and attachment

Gender identity and attachment

Depression, prenatal attachment and
postnatal relationships with a baby

Paternal attachment as perceived by a
baby’s mother

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Development of attachment

in mothers (MAAS by

Condon)

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Development of attachment

in fathers (PAAS by Condon)

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Attachment in complicated and in normal

pregnancy (mothers and fathers)

Mothers

Fathers

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Attachment in mothers in

different types of pregnancy

(Maternal Foetal Attachment Scale by Cranley)

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Other studies

Previous fetal loss

Armstrong & Hulti, 1998

Less strong attachment in next pregnancy

High risk pregnancy

Chazotte et al. 1995

No differences in attachment between women with

GDM, risk of preterm delivery and normal pregnancy

Wisniewska, 2003

Less strong attachment when complications and

prenatal screening

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Fathers’ prenatal

attachment as perceived by

mothers

Women
correctly
predicted their
partners’ FAS
scores in 73%
of cases

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Depression and father-infant

attachment (prenatal)

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Father-infant attachment

(pregnancy and postnatal

period)

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Prenatal attachment and
parental behaviour towards an
infant

Study by A. Siddiqui & B. Haggloff (2000)

Stronger prenatal attachment more intense

postnatal interaction

Maternal behaviour observed and videorecored (!)

Study by H. Pearce & A. Ayers (2005)

Mothers who during pregnancy present negative

attitudes toward a baby:

are more prone to negative behaviour after the delivery

(when asked about their possible reactions)

do express more negative behaviour towards the baby

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Attachment and parental
behaviour towards an infant

Study by R.B. Wilkinson & F.B. Schrel (2006)

Comparison of breast-feeding and bottle-feeding

mothers

Measures: e.g. Maternal attachment inventory

(MAI) by Muller (1994), Relationships questionnaire

by Bartholomew &Horowotz, 1991)

Breast-feeding mothers do not express more

positive affect (attachment) towards their infants

If mothers are securely attached to infants, then:

More positive affect towards an infant

More often breast-feeding


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