Year

1999

Degree Name

Doctor of Philosophy

Department

Department of Nursing

Abstract

The purpose of this study was to investigate the psychosocial correlates of attachment in adolescents living in a rural area during pregnancy and early motherhood. Early exchanges between the mother and her infant provide a positive foundation on which to build relationships across the lifespan. The aims of this research is twofold. Firstly, problems in attachment have been proposed to have an important causative role in childhood delay and problems in emotional, social and intellectual development. Secondly, postnatal depression in mothers is known to be associated with problems of attachment and social support.

One hundred and twenty two consenting pregnant adolescents attending a public based midwifery antenatal clinic in a rural health service area in south west New South Wales participated in a correlational study. One hundred and thirteen adolescent mothers were reinterviewed at 6 weeks and 6-12 months after the birth of the baby.

A demographic questionnaire and six objective research instruments were employed to measure the main variables of attachment, self esteem, social support and postnatal depression. i) The Maternal-Foetal Attachment Scale, ii) Prenatal Attachment Inventory, iii) The Support Behaviours Inventory, iv) Rosenberg's Self Esteem Scale. During motherhood: v) How I Feel About My Baby Now Scale, vi) Maternal Attachment Inventory vii) Parenting Sense of Competence Scale, viii) Edinburgh Postnatal Depression Scale and ix) Facilitators and Regulators Questionnaire. Qualitative data was collected exploring the mother's relationship with her foetus and her infant.

The results indicated that maternal-foetal attachment was significantly related to the amount and quality of social support. Higher maternal-infant attachment scores were associated with self esteem at 6-12 months after the birth of the baby and to greater social support. High maternal-infant attachment was associated with positive parenting sense of competence and high self esteem at 6 weeks and 6-12 months during motherhood. Lower maternal-infant attachment was associated with those adolescents suggestive of the symptoms of postnatal depression at 6 weeks and 6-12 months after the birth of the baby. Self esteem decreased as the symptoms suggestive of postnatal depression increased at 6 weeks and 6-12 months.

This study found that self esteem, social support and postnatal depression were the main variables impacting on attachment In adolescents during pregnancy and early motherhood. The quality of support and number of people perceived supportive by the adolescent influences greater attachment behaviours in pregnancy. High self -esteem influenced greater attachment behaviours at 6-12 months after the birth of the baby but not at 6 weeks after delivery. Positive parenting sense of competence was associated with high maternal-infant attachment and higher self esteem at 6 weeks and 6-12 months during motherhood. Symptoms suggestive of postnatal depression were associated with lower attachment scores and lower self esteem. Maternal-foetal attachment in pregnant adolescents was not associated with maternal-infant attachment in adolescent mothers at 6 weeks or 6-12 months.

This study alerts us to the issues faced by pregnant adolescents and adolescent mothers living in a rural area in relation to attachment. Of concern is the high rate of symptoms suggestive of postnatal depression which may influence attachment. It is essential that midwives and health professionals provide a family centred approach, actively involving not only the pregnant adolescent and adolescent mother but also the family where possible. This in turn may reduce the risk of postnatal depression and its potential impact on maternal-infant attachment.

A significant finding not directly associated with the hypotheses of this study relate to the high rate of older partners, conflict relationships and domestic violence. This issue is a cause for concern and midwives need to be vigilant for indicators of domestic violence.

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