Exploring the Connection between Difficulties in Emotion Regulation and Maternal-Fetal Attachment

Background and Purpose: Maternal-fetal attachment refers to the relationship between a pregnant woman and her fetus. Higher levels of maternal-fetal attachment have been positively associated with successful adaptation to pregnancy and prenatal health behaviors. Symptoms of depression and anxiety have been found to be negatively associated with maternal-fetal attachment and prenatal health behaviors. In this study, we aim to expand on the existing research to explore the relationship between difficulties in emotion regulation and maternal-fetal attachment among a sample of pregnant women. Emotion dysregulation is a transdiagnostic process underlying depression and anxiety, among other mental health diagnoses. Emotion regulation can be conceptualized as the ability to respond adaptively to emotional experiences. We hypothesized that difficulties in emotion regulation would be negatively correlated with maternal-fetal attachment, such that a woman with more difficulties regulating her emotions would report lower levels of maternal-fetal attachment.

Methods: Women were recruited from the Salt Lake City community (N = 105) as a part of a larger study of the effects of maternal stress on infant behavior. Women completed a battery of questionnaires including the 36-item Difficulties in Emotion Regulation Scale (DERS; α = 0.93) and the 24-item Maternal-Fetal Attachment Scale (MFAS; α = 0.86). The DERS is made up of five subscales: emotional awareness, emotional clarity, emotional acceptance, impulse control, and ability to engage in goal-directed behavior while experiencing negative emotions. The MFAS consists of five subscales: self-differentiation and differentiation of the fetus, interaction with the fetus, attributing characteristics to the fetus, donating oneself, and taking responsibility. Examples of MFAS items include I talk to my unborn baby and I can hardly wait to hold my baby.

Results: We found that difficulties in emotion regulation were significantly negatively correlated with maternal-fetal attachment (r = .18, p = .04). Upon further inspection, we found that the nonacceptance sub-scale of the DERS was the highest correlated with the MFAS (r = .23, p = .01). Examples of items from this sub-scale include: When I’m upset, I feel ashamed with myself and When I’m upset, I become irritated with myself. In fact, a simple linear regression revealed that nonacceptance of emotional experiences predicted level of maternal fetal attachment, such that higher levels of higher levels of nonacceptance predicted lower levels of maternal fetal attachment (R² = .05, F(1,103) = 5.49), p = .02, β = .43 p = .02, CI [.65, .78]). 

Conclusion and Implications: Promoting maternal-fetal attachment could be a strategy to promote prenatal health behaviors, successful transition to motherhood, and ultimately child well-being. A growing body of research supports mindfulness as an intervention for mental health problems. Mindfulness may be particularly effective in addressing nonacceptance of emotional experiences among pregnant women as a way to increase maternal-fetal attachment.