Prenatal attachment and its association with foetal movement during pregnancy – A population based survey



      To investigate the association between the magnitude of foetal movements and level of prenatal attachment within a 24 h period among women in the third trimester of pregnancy.


      a prospective population-based survey.


      A county in central Sweden.


      Low risk pregnant women from 34 to 42 weeks gestation, N = 456, 299 multiparous and 157 primiparous women.


      The revised version of the Prenatal Attachment Inventory (PAI-R) and assessment of the perception of foetal movements per 24 h in the current gestational week.


      A total of 81 per cent of the eligible women completed the questionnaire. The overall sample of women found that the majority (96%) felt their baby move mostly in the evening. More than half of the respondents (55%) stated that they perceived frequent foetal movement on two occasions during a 24 h period, while almost a fifth (18%) never or only once reported frequent foetal movement in a 24 h period. Just over a quarter (26%) of respondents perceived frequent movement at least three times during a 24 h period. Perceiving frequent foetal movements on three or more occasions during a 24 h period, was associated with higher scores of prenatal attachment in all the three subscales. Key conclusion: Perceiving frequent foetal movements at least during three occasions per 24 h periods in late pregnancy was associated with prenatal attachment. Implications for practice: encouraging women to focus on foetal movements may positively affect prenatal attachment, especially among multiparous women >35 years.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Raphael-Leff J.
        The psychological processes of childbearing: fourth edition.
        4th ed. Anna Freud Centre, Great Britan2012
        • Muller M.
        Development of the prenatal attachment inventory.
        West J Nurs Res. 1993; 15: 199-215
        • Salisbury A.
        • Law K.
        • LaGasse L.
        • Lester B.
        MSJAMA. Maternal-fetal attachment.
        JAMA: J Am Med Assoc. 2003; 289: 1701
        • Stainton M.C.
        Parents’ awareness of their unborn infant in the third trimester.
        Birth. 1990; 17: 92-96
        • Reading A.
        • Cox D.
        • Sledmere C.
        • Campbell S.
        Psychological changes over the course of pregnancy: a study of attitudes toward the fetus/neonate.
        Health Psychol. 1984; 3: 211-221
        • Van den Bergh B.
        • Simons A.
        A review of scales to measure the mother-foetus relationship.
        J Reprod Infant Psychol. 2009; 27 (13): 114-126
        • Pallant J.H.
        • Heins H.L.
        • Hildingsson I.
        • Cross M.
        • Rubertsson C.
        Psychometric evaluation and refinement of the Prenatal Attachment Inventory.
        J Reprod Infant Psychol. 2014; 32: 112-125
        • Mikhail M.
        • Freda M.
        • Merkatz R.
        • Polizzotto R.
        • Mazloom E.
        • Merkatz I.
        The effect of fetal movement counting on maternal attachment to fetus.
        Am J Obstet Gynecol. 1991; 165: 988-991
        • Saastad E.
        • Israel P.
        • Ahlborg T.
        • Gunnes N.
        • Froen J.F.
        Fetal movement counting – effects on maternal-fetal attachment: a multicenter randomized controlled trial.
        Birth. 2011; 38: 282-293
        • Strevens H.
        • Fadl H.
        • Westergren C.
        • Knutson B.
        • Ny P.
        Antenatal care. Sexual and reproductive health SFOG and SBF (The Swedish Association of Obstetricans and Gynecologist and The Swedish association of Midwives).
        2008 (Report No. 59)
        • Malm M.
        • Lindgren H.
        • Rubertsson C.
        • Hildingsson I.
        • Rådestad I.
        Development of a tool to evaluate fetal movements in full-term pregnancy.
        Sex Reprod Healthc. 2014; 5: 31-35
        • DeVellis R.F.
        Scale development: theory and applications.
        3rd ed. 2003
        • Condon J.T.
        The parental–foetal relationship – a comparison of male and female expectant parents.
        J Psychosom Obstet Gynecol. 1985; 4: 271-284
        • Rubertsson C.
        • Pallant J.F.
        • Sydsjö G.
        • Haines H.
        • Hildingsson I.
        Maternal depressive symptoms have a negative impact on prenatal attachment – findings from a Swedish community sample.
        J Reprod Infant Psychol. 2015; 33: 153-164
        • Siddiqui A.
        • Hagglof B.
        An exploration of prenatal attachment in Swedish expectant women.
        J Reprod Infant Psychol. 1999; 17: 369-371
        • Lindgren K.
        Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy.
        Res Nurs Health. 2001; 24: 203-217
        • Caplan G.
        An approach to preventive intervention in child psychiatry.
        Can J Psychiatry Rev Can Psychiatrie. 1980; 25: 671-682
        • McArdle A.
        • Flenady V.
        • Toohill J.
        • Gamble J.
        • Creedy D.
        How pregnant women learn about foetal movements: sources and preferences for information.
        Women Birth: J Austral College Midwives. 2015; 28: 54-59
        • Berndl A.
        • O’Connell C.
        • McLeod N.
        Fetal movement monitoring: how are we doing as educators?.
        J Obstet Gynaecol Can. 2013; 35: 22-28
        • Radestad I.
        Strengthening mindfetalness.
        Sex Reprod Healthc: Off J Swed Assoc Midwives. 2012; 3: 59-60
        • Ehrström C.
        Circadian rhythm of fetal movements.
        Acta Obstetr Gynecol Scand. 1984; 63: 539-541
        • Yarcheski A.
        • Mahon N.E.
        • Yarcheski T.J.
        • Hanks M.M.
        • Cannella B.L.
        A meta-analytic study of predictors of maternal-fetal attachment.
        Int J Nurs Stud. 2009; 46: 708-715
        • Condon J.C.C.
        The correlates of antenatal attachment in pregnant women.
        Br J Med Psychol. 1997; 70: 359-372