Abstract
The quality of the prenatal caregiving bond with the unborn baby contributes to later parenting and healthy infant behavior and development. Previous research indicates that maternal antenatal depression can disrupt bonding with the fetus and increases risks such as prematurity and low birthweight; less is known about the effects of paternal depression on prenatal bonding. Research suggests that mindfulness may ameliorate depression symptoms in adults. This study hypothesized that dispositional mindfulness would moderate the influence of parental depression symptoms during pregnancy on the quality of prenatal bonding in a sample of expectant mothers and fathers. Self-report measures of dispositional mindfulness, depression symptoms, and quality of prenatal bonding were administered to 82 expectant parents in a metropolitan Midwest city. Higher levels of mindfulness were negatively associated with depression symptoms and positively associated with quality of prenatal bonding. Mindfulness moderated the relationship between depression symptomology and quality of attachment, such that for parents with low and average mindfulness, depression symptoms were significantly and inversely related to quality of bonding; for parents with higher depression symptom levels, mindfulness did not moderate quality of bonding. These findings suggest that trait mindfulness may promote a stronger bond during pregnancy between a parent and the unborn child. Data presented highlight the potential importance of developing higher levels of mindfulness especially in parents at risk for depression or poor prenatal bonding.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aiken, L. S., West, S. G., & Reno, R. R. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park: Sage.
Alhusen, J. L., Hayat, M. J., & Gross, D. (2013). A longitudinal study of maternal attachment and infant developmental outcomes. Archives of Women's Mental Health, 16(6), 521–529. https://doi.org/10.1007/s00737-013-0357-8.
Arch, J. J., & Craske, M. G. (2006). Mechanisms of mindfulness: Emotion regulation following a focused breathing induction. Behaviour Research and Therapy, 44(12), 1849–1858. https://doi.org/10.1016/j.brat.2005.12.007.
Ashley, J. M., Harper, B. D., Arms-Chavez, C. J., & LoBello, S. G. (2016). Estimated prevalence of antenatal depression in the US population. Archive of Women's Mental Health, 19(2), 395–400. https://doi.org/10.1007/s00737-015-0593-1.
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Journal of Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504.
Baker, R., Orton, E., Kendrick, D., & Tata, L. J. (2015). Maternal depression in the five years after childbirth among women with and without perinatal depression: A population-based cohort study. The Lancet, 386, S22. https://doi.org/10.1016/s0140-6736(15)00860-0.
Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., & Kroonenberg, P. M. (2004). Differences in attachment security between African-American and white children: Ethnicity or socio-economic status? Infant Behavior and Development, 27(3), 417–433. https://doi.org/10.1016/j.infbeh.2004.02.002.
Bardacke, N. (2012). Mindful birthing: Training the mind, body, and heart for childbirth and beyond. New York: HarperOne.
Bennett, H. A., Einarson, A., Taddio, A., Koren, G., & Einarson, T. R. (2004). Depression during pregnancy. Clinical Drug Investigation, 24(3), 157–179. https://doi.org/10.2165/00044011-200424030-00004.
Benoit, D., & Parker, K. C. H. (1994). Stability and transmission of attachment across three generations. Child Development, 65(5), 1444–1456. https://doi.org/10.2307/1131510.
Benoit, D., Zeanah, C. H., Parker, K. C. H., Nicholson, E., & Coolbear, J. (1997). “Working model of the child interview”: Infant clinical status related to maternal perceptions. Infant mental health journal, 18(1), 107–121. https://doi.org/10.1002/(SICI)1097-0355(199721)18:1<107::AID-IMHJ8>3.0.CO;2-N.
Bolton, H. L., Hughes, P. M., Turton, P., & Sedgwick, P. (1998). Incidence and demographic correlates of depressive symptoms during pregnancy in an inner London population. Psychosomatic Obstetrics and Gynaecology, 19(4), 202–209. https://doi.org/10.3109/01674829809025698.
Caldwell, J. G., & Shaver, P. R. (2013). Mediators of the link between adult attachment and mindfulness. Interpersona: An International Journal on Personal Relationships, 7(2), 299–310. https://doi.org/10.5964/ijpr.v7i2.133.
Condon, J. T. (1993). The assessment of antenatal emotional attachment: Development of a questionnaire instrument. British Journal of Medical Psychology, 66, 167–183. https://doi.org/10.1111/j.2044-8341.1993.tb01739.x.
Condon, J. T., & Corkindale, C. J. (1997). The correlates of antenatal attachment in pregnant women. British Journal of Medical Psychology, 70, 359–372. https://doi.org/10.1111/j.2044-8341.1997.tb01912.x.
Condon, J. T., Corkindale, C. J., Boyce, P., & Gamble, E. (2013). A longitudinal study of father-to-infant attachment: Antecedents and correlates. Journal of Reproductive and Infant Psychology, 31(1), 15–30. https://doi.org/10.1080/02646838.2012.757694.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. British Journal of Psychiatry, 150, 782–786. https://doi.org/10.1192/bjp.150.6.782.
Creel, S., Dantzer, B., Goymann, W., & Rubenstein, D. R. (2013). The ecology of stress: Effects of the social environment. Journal of Functional Ecology, 27(1), 66–80. https://doi.org/10.1111/j.1365-2435.2012.02029.x.
Davis, T. J., Morris, M., & Drake, M. M. (2016). The moderation effect of mindfulness on the relationship between adult attachment and wellbeing. Personality and Individual Differences, 96, 115–121. https://doi.org/10.1016/j.paid.2016.02.080.
Dayton, C. J., Levendosky, A. A., Davidson, W. S., & Bogat, G. A. (2010). The child as held in the mind of the mother: The influence of prenatal maternal representations on parenting behaviors. Infant Mental Health Journal, 31(2), 220–241. https://doi.org/10.1002/imhj.20253.
Desrosiers, A., Vine, V., Klemanski, D. H., & Nolen-Hoeksema, S. (2013). Mindfulness and emotion regulation in depression and anxiety: Common and distinct mechanisms of action. Depression and Anxiety, 30(7), 654–661. https://doi.org/10.1002/da.22124.
Dimidjian, S., Goodman, S. H., Felder, J. N., Gallop, R., Brown, A. P., & Beck, A. (2015). An open trial of mindfulness-based cognitive therapy for the prevention of perinatal depressive relapse/recurrence. Archives of Women's Mental Health, 18(1), 85–94. https://doi.org/10.1007/s00737-014-0468-x.
Dixon, H. C., & Overall, N. C. (2016). Dispositional mindfulness attenuates the link between daily stress and depressed mood. Journal of Social and Clinical Psychology, 35(3), 255–268. https://doi.org/10.1521/jscp.2016.35.3.255.
Duncan, L. G., & Bardacke, N. (2010). Mindfulness-based childbirth and parenting education: Promoting family mindfulness during the perinatal period. Journal of Child and Family Studies, 19(2), 190–202. https://doi.org/10.1007/s10826-009-9313-7.
Eberhard-Gran, M., Eskild, A., Tambs, K., Opjordsmoen, S., & Samuelsen, S. O. (2001). Review of validation studies of the Edinburgh postnatal depression scale. Acta Psychiatrica Scandinavia, 104(4), 243–249. https://doi.org/10.1111/j.1600-0447.2001.00187.x.
Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2008). G*Power Version 3.1.2. Uiversität Kiel, Germany. Retrieved from http://www.psycho.uni-duesseldorf.de/abteilungen/aap/gpower3/download-and-register.
Field, T., Diego, M., Dieter, J., Hernandez-Reif, M., Schanberg, S., Kuhn, C., et al. (2004). Prenatal depression effects on the fetus and the newborn. Infant Behavior and Development, 27(2), 216–229. https://doi.org/10.1016/j.infbeh.2003.09.010.
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(5), 891–905. https://doi.org/10.1111/j.1467-8624.1991.tb01578.x.
Frodl, T., & O'Keane, V. (2013). How does the brain deal with cumulative stress? A review with focus on developmental stress, HPA axis function and hippocampal structure in humans. Neurobiology of Disease, 52, 24–37. https://doi.org/10.1016/j.nbd.2012.03.012.
Goodall, K., Trejnowska, A., & Darling, S. (2012). The relationship between dispositional mindfulness, attachment security and emotion regulation. Personality and Individual Differences, 52(5), 622–626. https://doi.org/10.1016/j.paid.2011.12.008.
Goyal, N. K., Hall, E. S., Jones, D. E., Meinzen-Derr, J. K., Short, J. A., Ammerman, R. T., & Van Ginkel, J. B. (2014). Association of maternal and community factors with enrollment in home visiting among at-risk, first-time mothers. American Journal of Public Health, 104(Suppl 1(S1)), S144–S151. https://doi.org/10.2105/AJPH.2013.301488.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press.
Heidrich, S. M., & Cranley, M. S. (1989). Effect of fetal movement, ultrasound scans, and amniocentesis on maternal-fetal attachment. Journal of Nursing Research, 38(2), 81–84.
Holzman, C., Eyster, J., Tiedje, L. B., Roman, L. A., Seagull, E., & Rahbar, M. H. (2006). A life course perspective on depressive symptoms in mid-pregnancy. Maternal and Child Health Journal, 10(2), 127–138. https://doi.org/10.1007/s10995-005-0044-0.
Huth-Bocks, A. C., Levendosky, A. A., Bogat, G. A., & von Eye, A. (2004). The impact of maternal characteristics and contextual variables on infant-mother attachment. Child Development, 75(2), 480–496. https://doi.org/10.1111/j.1467-8624.2004.00688.x.
Jallo, N., Elswick Jr., R. K., Kinser, P., Masho, S., Price, S. K., & Svikis, D. S. (2015). Prevalence and predictors of depressive symptoms in pregnant African-American women. Issues in Mental Health Nursing, 36(11), 860–869. https://doi.org/10.3109/01612840.2015.1048014.
Junge, C., Garthus-Niegel, S., Slinning, K., Polte, C., Simonsen, T. B., & Eberhard-Gran, M. (2017). The impact of perinatal depression on children's social-emotional development: A longitudinal study. Maternal and Child Health Journal, 21(3), 607–615. https://doi.org/10.1007/s10995-016-2146-2.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33–47. https://doi.org/10.1016/0163-8343(82)90026-3.
Kendall-Tackett, K. A. (2007). Violence against women and the perinatal period: The impact of lifetime violence and abuse on pregnancy, postpartum, and breastfeeding. Trauma Violence Abuse, 8(3), 344–353. https://doi.org/10.1177/1524838007304406.
Kiken, L. G., Garland, E. L., Bluth, K., Palsson, O. S., & Gaylord, S. A. (2015). From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness. Personality and Individual Differences, 81, 41–46. https://doi.org/10.1016/j.paid.2014.12.044.
Kim, P., & Swain, J. E. (2007). Sad dads: Paternal postpartum depression. Psychiatry (Edgmont), 4(2), 35–47.
Lefkovics, E., Baji, I., & Rigo, J. (2014). Impact of maternal depression on pregnancies and on early attachment. Infant Mental Health, 35(4), 354–365. https://doi.org/10.1002/imhj.21450.
Letourneau, N. L., Dennis, C. L., Benzies, K., Duffett-Leger, L., Stewart, M., Tryphonopoulos, P. D., et al. (2012). Postpartum depression is a family affair: Addressing the impact on mothers, fathers, and children. Issues in Mental Health Nursing, 33(7), 445–457. https://doi.org/10.3109/01612840.2012.673054.
Madsen, S. A., & Juhl, T. (2007). Paternal depression in the postnatal period assessed with traditional and male depression scales. Men's Health & Gender, 4(1), 26–31. https://doi.org/10.1016/j.jmhg.2006.10.017.
Marcus, S. M. (2009). Depression during pregnancy: Rates, risks and consequences - Motherisk update 2008. Canadian Journal of Clinical Pharmacology, 16(1), e15–e22.
Melen, S., Pepping, C. A., & O’Donovan, A. (2016). Social foundations of mindfulness: Priming attachment anxiety reduces emotion regulation and mindful attention. Mindfulness, 8(1), 136–143. https://doi.org/10.1007/s12671-016-0587-8.
Murray, D., & Cox, J. L. (1990). Screening for depression during pregnancy with the Edinburgh Depression Scale (EDDS). Journal of Reproductive and Infant Psychology, 8(2), 99–107.
Murray, L., Fiori-Cowley, A., Hooper, R., & Cooper, P. (1996). The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome. Child Development, 67(5), 2512–2526. https://doi.org/10.2307/1131637.
Muzik, M., Hamilton, S. E., Rosenblum, K. L., Waxler, E., & Hadi, Z. (2012). Mindfulness yoga during pregnancy for psychiatrically at-risk women: Preliminary results from a pilot feasibility study. Complementary Therapies in Clinical Practice, 18(4), 235–240. https://doi.org/10.1016/j.ctcp.2012.06.006.
Parfitt, Y., Ayers, S., Pike, A., Jessop, D., & Ford, E. (2014). A prospective study of the parent–baby bond in men and women 15 months after birth. Journal of Reproductive and Infant Psychology, 32(5), 441–456. https://doi.org/10.1080/02646838.2014.956301.
Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. Journal of the American Medical Association, 303(19), 1961–1969. https://doi.org/10.1001/jama.2010.605.
Perren, S., von Wyl, A., Burgin, D., Simoni, H., & von Klitzing, K. (2005). Depressive symptoms and psychosocial stress across the transition to parenthood: Associations with parental psychopathology and child difficulty. Psychosomatic Obstetric Gynaecology, 26(3), 173–183. https://doi.org/10.1080/01674820400028407.
Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36(4), 717–731. https://doi.org/10.3758/bf03206553.
Preacher, K. J., Rucker, D. D., & Hayes, A. F. (2007). Addressing moderated mediation hypotheses: Theory, methods, and prescriptions. Multivariate Behavioral Research, 42(1), 185–227. https://doi.org/10.1080/00273170701341316.
Ramchandani, P. G., O'Connor, T. G., Evans, J., Heron, J., Murray, L., & Stein, A. (2008). The effects of pre- and postnatal depression in fathers: A natural experiment comparing the effects of exposure to depression on offspring. Child Psychology and Psychiatry, 49(10), 1069–1078. https://doi.org/10.1111/j.1469-7610.2008.02000.x.
Raskin, M., Easterbrooks, M. A., Lamoreau, R. S., Kotake, C., & Goldberg, J. (2016). Depression trajectories of antenatally depressed and nondepressed young mothers: Implications for child socioemotional development. Journal of Women’s Health Issues, 26(3), 344–350. https://doi.org/10.1016/j.whi.2016.02.002.
Rich-Edwards, J. W., Kleinman, K., Abrams, A., Harlow, B. L., McLaughlin, T. J., Joffe, H., & Gillman, M. W. (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology and Community Health, 60(3), 221–227. https://doi.org/10.1136/jech.2005.039370.
Schmidt, D., Seehagen, S., Vocks, S., Schneider, S., & Teismann, T. (2016). Predictive importance of antenatal depressive rumination and worrying for maternal–foetal attachment and maternal well-being. Cognitive Therapy and Research, 40(4), 565–576. https://doi.org/10.1007/s10608-016-9759-z.
Schore, A. N. (2001). Effects of a secure attachment relationship on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1–2), 7–66. https://doi.org/10.1002/1097-0355(200101/04)22:1<7::aid-imhj2>3.0.co;2-n.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression : A new approach to preventing relapse. New York: Guilford Press.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression (2nd ed.). New York, New York: Guilford Press.
Shapiro, S. L., Brown, K. W., Thoresen, C., & Plante, T. G. (2011). The moderation of mindfulness-based stress reduction effects by trait mindfulness: Results from a randomized controlled trial. Clinical Psychology, 67(3), 267–277. https://doi.org/10.1002/jclp.20761.
Slade, A., Cohen, L. J., Sadler, L. S., & Miller, M. (2009). The psychology and psychopathology of pregnancy: Reorganization and transformation. In C. H. Zeanah (Ed.), Handbook of infant mental health (3rd ed., pp. 22–39). New York, New York: Guilford Press.
Sugiura, T., & Sugiura, Y. (2015). Common factors of meditation, focusing, and cognitive behavioral therapy: Longitudinal relation of self-report measures to worry, depressive, and obsessive-compulsive symptoms among nonclinical students. Mindfulness, 6(3), 610–623. https://doi.org/10.1007/s12671-014-0296-0.
van Bussel, J. C., Spitz, B., & Demyttenaere, K. (2010). Three self-report questionnaires of the early mother-to-infant bond: Reliability and validity of the Dutch version of the MPAS, PBQ and MIBS. Archives of Women's Mental Health, 13(5), 373–384. https://doi.org/10.1007/s00737-009-0140-z.
Vreeswijk, C. M., Maas, A. J., Rijk, C. H., & van Bakel, H. J. (2014). Fathers’ experiences during pregnancy: Paternal prenatal attachment and representations of the fetus. Psychology of Men & Masculinity, 15(2), 129. https://doi.org/10.1037/a0033070.
Walsh, T. B., Tolman, R. M., Davis, R. N., Palladino, C. L., Romero, V. C., & Singh, V. (2014). Moving up the "magic moment": Fathers' experience of prenatal ultrasound. Journal of Fathering, 12(1), 18–37.
Weikum, W. M., Mayes, L. C., Grunau, R. E., Brain, U., & Oberlander, T. F. (2013). The impact of prenatal serotonin reuptake inhibitor (SRI) antidepressant exposure and maternal mood on mother–infant interactions at 3 months of age. Infant Behavior and Development, 36(4), 485–493. https://doi.org/10.1016/j.infbeh.2013.04.001.
Woody, M. L., Feurer, C., Sosoo, E. E., Hastings, P. D., & Gibb, B. E. (2016). Synchrony of physiological activity during mother-child interaction: Moderation by maternal history of major depressive disorder. Child Psychology and Psychiatry, 57(7), 843–850. https://doi.org/10.1111/jcpp.12562.
Yonkers, K. A., Ramin, S. M., Rush, A. J., Navarrete, C. A., Carmody, T., March, D., et al. (2001). Onset and persistence of postpartum depression in an inner-city maternal health clinic system. American Journal of Psychiatry, 158(11), 1856–1863. https://doi.org/10.1176/appi.ajp.158.11.1856.
Acknowledgements
We are grateful to all the families who participated in this study and to the research assistants who helped with the data collection. This study was funded by the Lois and Samuel Silberman Fund Faculty Grant Program.
Author information
Authors and Affiliations
Contributions
LMH: collected study data, formulated the data analytic plan, performed the data analysis, wrote the paper. CJD: designed the larger study from which these data were pulled, collaborated in determining the data analytic plan, and collaborated in the writing of the paper. SB: collaborated in developing the analytic plan, writing and interpreting the analytic results and assisted with editing of the paper. MM: consulted on the development of the study design, collaborated in the writing and editing of the final manuscript. HR: collaborated in formulating the analytic plan and interpreting the results and wrote parts of the paper.
Corresponding author
Ethics declarations
The research protocol was approved by the University’s Institutional Review Board and deception was not used.
Ethical Standards
All human and animal studies have been approved by the Wayne State University Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Hicks, L.M., Dayton, C.J., Brown, S. et al. Mindfulness Moderates Depression and Quality of Prenatal Attachment in Expectant Parents. Mindfulness 9, 1604–1614 (2018). https://doi.org/10.1007/s12671-018-0907-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12671-018-0907-2