Warning message

This content is filtered. APPPAH membership is required for full access to journal articles.
-A +A
Publication Date: 
December, 2003
Page Count: 
Starting Page: 

It has been established that attachment to one's preborn child is often associated with attachment with the child after the birth (Benoit, Parker, & Zeanah, 1997; Muller, 1996; Fuller, 1990). Also attachment between child and primary care giver has been shown to be paramount to the emotional well being of children (Bowlby, 1969; Ainsworth, 1985a). As well, attachment to one's fetus may contribute to lower risk of child abuse (Pollock & Percy, 1999). There has been considerable interest in the past 20 years in antenatal attachment and its correlates. Despite some contradictory results, the literature highlights that prenatal attachment is likely contextual (i.e., it interacts with demographic, situational, and personality variables, and is influenced by, for example, culture, age, social and health-related support, marital relationship, etc.; Salisbury, Law, LaGasse, & Lester, 2003). However, pregnancy occurring when one is already a mother, is infrequently examined. Further, the context of a mother of a child with disabilities who is expecting another baby, constitutes an intuitively important, yet neglected area in the study of prenatal attachment.

This paper reports results of a study where mothers of a child with Down syndrome (DS) who are pregnant again, pregnant mothers of 'typically' developing child(ren), and first-time mothers-to-be, were surveyed on a number of areas related to prenatal attachment. Results indicated that there were group differences in a number of domains. For example, initial reaction to pregnancy was less joyful for mothers of a child with DS; prenatal attachment was lower in mothers expecting a subsequent baby; and women expecting their first child spent more time in prenatal attachment behaviors than those expecting a subsequent baby. As well, correlations among the variables were different in the three groups. An interesting finding was that half of the DS group did not plan this pregnancy (compared with only 20% and 21% respectively for the other groups), and cited religious or moral reasons for having the baby. Further study is needed in order to, improve the knowledge in the area of subsequent pregnancy, especially after having a child with disabilities, and to enhance clinical and social service delivery systems for this population.


Ainsworth, M. D. S. (1985). Patterns of mother-infant attachment: Antecedents and effects on development. Bulletin of New York Academy of Medicine, 61, 771-790.

Armstrong, D. S. (2002). Emotional distress and prenatal attachment in pregnancy after perinatal loss. Journal of Nursing Scholarship, 34(4), 339-345.

Armstrong, D., & Hutti, M. (1998). Pregnancy after perinatal loss. Journal of Gynecology and Neonatal Nursing, 27(2), 183-189.

Benoit, D., Parker, K., & Zeanah, C. H. (1997). Mothers' representations of their infants assessed prenatally: Stability and association with infants' attachment classifications. Child Psychology and Psychiatry, 38, 307-313.

Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment (2nd ed., 1982). New York: Basic Books.

Bryan, A. A. (2000). Enhancing parent-child interaction with a prenatal couple intervention. MCN, 25, 139-144.

Byrne, E. A., & Cunningham, C. C. (1985). The effects of mentally handicapped children on families-A conceptual review. Journal of Child Psychiatry and Psychology, 26, 847-864.

Coffman, S., Levitt, M., & Brown, L. (1994) Effects of clarification of support expectation in prenatal couples. Nursing Research, 43, 111-116.

Condon, J. T., & Corkindale, C. (1997). The correlates of antenatal attachment in pregnant women. British Journal of Medical Psychology, 70, 359-372.

Condon, J. T. (1993). The assessment of antenatal emotional attachment: Development of a questionnaire instrument. British Journal of Medical Psychology, 66, 167-183.

Cranley, M. S. (1981a). Development of a tool for the measurement of maternal attachment during pregnancy. Nursing Research, 30, 281-284.

Davis, M. H. (1983a). The effects of dispositional empathy on emotional reactions and helping: A multidimensional approach. Journal of Personality, 51, 167-184.

Davis, M. H. (1983b). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44, 113-126.

Doan, H. McK., & Green, M. (2001). Maternal-fetal attachment: A function of cognitive and personality correlates. Poster presented at the meeting of the Canadian Psychological Association, Calgary, Alberta.

Doan, H. McK., & Zimerman, A. (in press) Prenatal attachment: Where do we go from here? The International Journal on Pre- and Perinatal Psychology and Medicine.

Fonagy, P., Steele, H., & Steele, M. (1991). Maternal representations of attachment during pregnancy predict the organization of infant-mother attachment at one year of age. Child Development, 62, 891-905.

Fuller, J. R. (1990). Early patterns of maternal attachment. Health Care for Women International, 11, 433-446.

Gan-Wong, C. (1991). The discovery of hope in families with a developmentally disabled child: perspectives of families from two ethic groups. Unpublished Masters Thesis.

Mercer, R., Ferketich, S., May, K., DeJoseph, J., & Sollid, D. (1988). Further exploration of maternal and paternal fetal attachment. Research in Nursing and Health, 11, 83-95.

Muller, M. E. (1993). Development of the prenatal attachment inventory. Western Journal of Nursing Research, 15(2), 199-215.

Muller, M. E. (1996). Prenatal and postnatal attachment: A modest correlation. JOGNN, 25, 161-166.

Nihira, K., Meyers, C., & Mink, I. (1980). Home environment, family adjustment and the development of mentally retarded children. Applied Research in Mental Retardation, 1, 5-24.

Pollock, P. H., & Percy, A. (1999). Maternal antenatal attachment style and potential fetal abuse. Child Abuse and Neglect, 23, 1345-1357.

Quinn, M. M. (1991). Attachment between mothers and their down syndrome infants. Western Journal of Nursing Research, 13, 382-396.

Siddiqui, A., Hagglof, B., & Eisenmann, M. (1999). An exploration of prenatal attachment in Swedish expectant women. Journal of Reproductive and Infant psychology, 17(4), 369-380.

Salisbury, A., Law, K., LaGasse, L., & Lester, B. (2003). Maternal-fetal attachment. JAMA 289, 1701.

Solnit, A. J., & Provence, S. (1979). Vulnerability and risk in early childhood; In: J. Osofsky (Ed.) Handbook of Infant Development, (pp 799-808). New York: Wiley.

Stoleru, S., Grinshpoun, M. F., & Morales-Hue, M. (1995). Maternal attitudes during pregnancy predict mother-infant physical proximity six months after birth. Early Development and Parenting, 4, 137-149.

Wilson, M., White, M., Cobb, B., Curry, R., Greene, D., & Popovich, D. (2000). Family dynamics, parental-fetal attachment and infant temperament. Journal Of Advanced Nursing, 31, 204-210.

Anona Zimerman, M.A. and Helen McK. Doan, Ph.D.

Anona Zimerman M.A. is a doctoral candidate in Clinical Developmental Psychology at York University, Toronto, Ontario and a therapist at Surrey Place Centre where she works with families of children with Developmental Disabilities. She is also a Certified Childbirth Educator and Doula in Toronto. This paper was based on data collected for her doctoral dissertation. Helen McKinnon Doan Ph.D. is a Senior Scholar and Professor Emeritus in the Department of Psychology at York University, Toronto, Ontario and a Psychologist in Private Practice in Toronto. The address for both authors is Department of Psychology, York University, 4700 Keele Street, Toronto, Ontario, Canada, M3J 1P3. Their email addresses are anonaz@yorku.ca and hdoan@ yorku.ca.

To speak with a representative about our products and services or for technology inquiries, please call 1-720-490-5612.