Skip to main content
Log in

The Effect of Support Expectations on Prenatal Attachment: An Evidence-Based Approach for Intervention in an Adolescent Population

  • Published:
Child and Adolescent Social Work Journal Aims and scope Submit manuscript

Abstract

This study was designed to determine the significant variables predicting prenatal attachment in an adolescent population. Scientifically supported knowledge of the factors enhancing attachment plays a crucial role in assisting social workers and other health care professionals to accurately assess and intervene to decrease pregnancy risks. Previous prenatal attachment studies demonstrated conflicting findings due to problems from using different theoretical frameworks and research methodologies. In order to ensure consistency, this study infused an attachment theory perspective. Bowlby’s attachment theory, Levitt’s support expectations model, and research from prenatal relationship studies were integrated. The social survey sampled 129 minority status pregnant adolescents attending public school. Measurements included the Prenatal Attachment Inventory (PAI) and the Support Expectations Index (SEI). Regression analyses revealed that support expectation was a powerful predictor of prenatal attachment with pregnancy planning and less stress adding importantly to explain over 33% of the variance. Support expectation was a greater predictor of prenatal attachment than the actual support available. Findings also supported the construct of prenatal attachment as the initial stage of development of the life cycle.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Ainsworth M. D. S., Eichberg C. (1991). Effects on infant–mother attachment of mother’s unresolved loss of an attachment figure or other traumatic experiences. In: Parkes C. M., Stevenson-Hinde J., Marris P. (eds) Attachment across the life cycle. Routledge, London, pp. 160–183

    Google Scholar 

  • Ainsworth M. S., Blehar M. C., Waters E. D., Wall S. (1978). Patterns of attachment assessed in the Strange Situation and at home. New Jersey: Erlbaum

    Google Scholar 

  • Alan Guttmacher Institute (2003). Teen Pregnancy: Trends and lessons learned (Issue brief no. 1). New York: Alan Guttmacher Institute, Author

  • Annie E. Casey Foundation (2004, January 29). Definitions, data sources, and reporting issues for cities. Retrieved February 10, 2004 from http://www.aecf.org/kidscount/rightstart/city_defs.htm

  • Annie E. Casey Foundation (2003). Kids count data book. Baltimore, MD: Author

  • Ard, L. D. C. (2000). Adolescent prenatal attachment, psychosocial development, and parental bonding: Is there a relationship? Dissertations Abstracts International 60:10B

    Google Scholar 

  • Belsky J. (1985). Exploring individual differences in marital change across the transition to parenthood: The role of violated expectations. Journal of Marriage and the Family 47:1037–1044

    Article  Google Scholar 

  • Berryman J. C., Windridge K. C. (1996). Pregnancy after 35 and attachment to the fetus. Journal of Reproductive and Infant Psychology 14(1):133–143

    Google Scholar 

  • Bloom K. (1995). The development of attachment behaviors in pregnant adolescents. Nursing Research 44(5):284–288

    Article  PubMed  Google Scholar 

  • Bowlby J. (1969). Attachment and loss: Attachment (Vol. 1). New York: Basic Books, Inc

    Google Scholar 

  • Bowlby J. (1973). Attachment and loss: Separation, anxiety, and anger (Vol. 2). New York: Basic Books Inc

    Google Scholar 

  • Bowlby J. (1980). Attachment and loss: Loss, sadness and depression (Vol. 3). New York: Basic Books, Inc

    Google Scholar 

  • Bowlby J. (1988). Attachment theory: Retrospect and prospect. Society for Research in Child Development 50(1–2):3–35

    Google Scholar 

  • Bronfenbrenner U. (1979). The ecology of human development. Cambridge: Harvard University Press

    Google Scholar 

  • Bronfenbrenner U. (1986). Ecology of the family as a context for human development research perspectives. Development Psychology 22:723–742

    Article  Google Scholar 

  • Carter B., McGoldrick M. (2005). The expanded family life cycle: Individual, family and social perspectives (4th ed.). Boston: Allyn & Bacon

    Google Scholar 

  • Coffman S., Levitt M. J., Brown L. (1994). Effects of clarification of support expectations in prenatal couples. Nursing Research 43(2):111–116

    Article  PubMed  Google Scholar 

  • Coffman S., Levitt M. J., Deets C., Quigley K. L. (1991). Close relationships in mothers of distressed and normal newborns: Support, expectancy, confirmation, and maternal-well being. Journal of Family Psychology 5(1):93–107

    Article  Google Scholar 

  • Coffman S., Levitt M. J., Guacci-Franco N. (1993). Mothers’ stress and close relationships: Correlates with infant health status. Journal of Pediatric Nursing 10(1):135–140

    Google Scholar 

  • Coffman S., Levit M. J., Guacci-Franco N. (1995). Infant–mother attachment: Relationships to maternal responsiveness and infant temperament. Journal of Pediatric Nursing 10(1):9–17

    Article  PubMed  Google Scholar 

  • Cohen S., Wills T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin 98:310–357

    Article  PubMed  Google Scholar 

  • Colpin H., De Munter A., Nys K., Vandemeulebroecke L. (1998). Prenatal attachment in future parents of twins. Early Development & Parenting 7(4):223–227

    Article  Google Scholar 

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

    PubMed  Google Scholar 

  • Cranley M. S. (1981). Development of a tool for the measurement of maternal attachment during pregnancy. Nursing Research 30(5):281–284

    Article  PubMed  Google Scholar 

  • Cranley M. S. (1984). Social support as a factor in the development of parents attachment to their unborn. Birth Defects Original Article Series 20:99–124

    PubMed  Google Scholar 

  • Damato, E. G. (1998). Maternal prenatal attachment to twins. Dissertation Abstracts International 59:03B (UMI no. 9828005)

  • Erikson E. (1950). Childhood and society. (2nd ed,). New York: Norton

    Google Scholar 

  • Fonagy P., Steele M., Steele H. (1991). Maternal responsiveness of attachment during pregnancy predict the organization of infant–mother attachment at one year. Child Development 62:880–893

    Article  Google Scholar 

  • Fraiberg S., Adelson E., Shapiro V. (1975). Ghosts in the nursery: A psychoanalytic approach to the problems of impaired infant–mother relationships. Journal of the American Academy of Child Psychiatry 14:397–421

    Article  Google Scholar 

  • Gaffney K. F. (1986). Maternal-fetal attachment in relation to self-concept and anxiety. Maternal-Child Nursing Journal 15:91–101

    PubMed  Google Scholar 

  • Gau, M. (1996). The relationship between prenatal stress, social support, spiritual well-being, and maternal-fetal attachment for pregnant women. Dissertations Abstracts International 58:02B

    Google Scholar 

  • Grace J. T. (1989). Development of maternal-fetal attachment during pregnancy. Nursing Research 38:228–232

    Article  PubMed  Google Scholar 

  • Hazan C., Shaver P. R. (1994). Attachment as an organizational framework for research on close relationships. Psychological Inquiry 5(1):1–22

    Article  Google Scholar 

  • Heidrich S. M., Cranley M. S. (1989). Effect of fetal movement, ultrasound scans, and amniocentesis on maternal-fetal attachment. Nursing Research 38:81–84

    Article  PubMed  Google Scholar 

  • Hinz, J. G. (1997). Prediction of child abuse of pregnant teens: Social support, conflict, attachment (adolescent pregnancy). Dissertations Abstracts International 59:07B

    Google Scholar 

  • House J. S. (1981). Work stress and social support. Reading, MA: Addison-Wesley

    Google Scholar 

  • Hudson W. W. (1993). Child’s attitude toward mother (CAM). Tempe, AZ: WALMYR Publishing Co

    Google Scholar 

  • Hutchison E. D. (2003). Dimensions of human behavior: The changing life course. Thousand Oaks, CA: Sage Publications

    Google Scholar 

  • Huth-Bocks A. C., Levendosky A. A., Theran S. A., Bogat G. A. (2004). The impact of domestic violence on mothers’ prenatal representations of their infants. Infant Mental Health Journal 25(2):79–98

    Article  Google Scholar 

  • James, D. C. (1997) Prenatal fetal attachment, prenatal maternal confidence, postbirth maternal confidence, and depressive symptoms: A correlation study of adolescents mothers social support. Dissertation Abstracts International 58:08B

    Google Scholar 

  • Kahn R. L., Antonucci T. C. (1980). Convoys over the life course: Attachment, roles, and social support. In: Baltes P., Brim O. (eds) Life-span development and behavior. Academic Press, San Diego, CA, pp. 253–286

    Google Scholar 

  • Kemp V. H., Page C. K. (1987). Maternal prenatal attachment in normal and high-risk pregnancies. Journal of Obstetric Gynecological and Neonatal Nursing 16:179–184

    Article  Google Scholar 

  • Kobak R. R., Cole H. E., Ferenz-Gillies R., Fleming W. S. (1993). Attachment and emotion regulation during mother–teen problem solving: A control theory analysis. Child Development 64:231–245

    Article  PubMed  Google Scholar 

  • Kobak R. R., Sceery A. (1988). Attachment in adolescence: Working models, affect regulation, and representations of self and others. Child Development 59:135–146

    Article  PubMed  Google Scholar 

  • Koniak-Griffin D. (1988). The relationship between social support, self-esteem, and maternal-fetal attachment in adolescents. Research in Nursing and Health 11(4):269–278

    Article  PubMed  Google Scholar 

  • Lazarus R. S. (1966). Psychological stress and the coping process. New York: McGraw-Hill

    Google Scholar 

  • Leifer M. (1977). Psychological changes accompanying pregnancy and motherhood. Genetic Psychology Monographs 95:55–96

    PubMed  Google Scholar 

  • Leifer M. (1980). Psychological effects of motherhood: Study of first pregnancy. New York: Praeger

    Google Scholar 

  • Levitt M. J. (1991). Attachment and close relationships: A life span perspective. In: Gerwitz J. L., Kurtines W. F. (eds) Intersections with attachment. Erlbaum, Hillsdale, NJ, pp. 183–206

    Google Scholar 

  • Levitt, M. J. (1994). The support expectations index. Unpublished measurement

  • Levitt M. J., Coffman S., Guacci-Franco N., Loveless S. (1994). Attachment relations and life transitions: An expectancy model. In: Sperling M. B, Berman W. H. (eds) Attachment in adults: Clinical and developmental perspectives. Guilford, New York, pp. 232–255

    Google Scholar 

  • Levitt M. J., Guacci-Franco N., Levitt J. L. (1993). Convoys of social support in childhood and early adolescence: Structure and function. Development Psychology 29(5):811–818

    Article  Google Scholar 

  • Levitt M. J., Guacci-Franco N., Weber R. A. (1992). Intergenerational support, relationship quality, and well-being: A bicultural analysis. Journal of Family Issues 13(4):465–481

    Article  Google Scholar 

  • Litt, L. C. (1996). Prenatal attachment and body image in first pregnancy: Relationship to self and object representation. Dissertation Abstracts International 57:07B

  • LoBiondo-Wood, G. (1985). The progression of physical symptoms in pregnancy and the development of maternal-fetal attachment. Dissertation Abstracts International 46:2625–13

  • Lounds J. J., Borkowski J. G., Whitman T. L., Maxwell S. E., Weed K. (2005). Adolescent pregnancy and attachment during infancy and early childhood. Parenting: Science and Practice, 5(1):91–118

    Google Scholar 

  • MacDorman, M. F., & Atkinson, J. (1999). Infant mortality statistics from 1997 Birth/Infant Data Set-1995 Period Date. U.S. Department of Health and Human Services, National Vital Statistics Report (DHHS Publication No. PHS 99–1120). Hyattsville, MD: U.S. Government Printing Office

  • Main M. (1990). Metacognitive knowledge, metacognitive monitoring, and singular (coherent) vs. multiple (incoherent) model of attachment. In: Parkes C. M., Hinde J. S., Morris P. (eds) Attachment across the life cycle. Routledge, London, pp. 127–159

    Google Scholar 

  • Main M., Hesse E. (1990). Parent’s unresolved traumatic experiences are related to infant disorganized attachment status: Is frightened and frightening parental behaviors the linking mechanism? In: Greenberg M., Cichetti D., Cummings M. (eds) Attachment in the preschool years. University of Chicago Press, Chicago, pp. 161–182

    Google Scholar 

  • Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood, and adulthood: A move to the level of representation. In: Bretherton, I., & Waters, E. (Eds.), Growing points of Attachment Theory and research, Monographs of the Society for Research in Child Development, serial no. 209(1–2): 66–104. Chicago: University of Chicago Press

  • Main M., Solomon J. (1990). Precursors for identifying infants as disorganized/disoriented during the Aisnworth Strange Situation. In: Greenberg M., Cichetti D., Cummings M. (eds) Attachment in the preschool years. University of Chicago Press, Chicago, pp. 121–160

    Google Scholar 

  • Mathews, S. V. (1999). The relationship between adult attachment style, social support, and prenatal attachment. Dissertation Abstracts International 60:4B

  • Mercer R. T., Ferketich S., May K., De Joseph J., Sollid D. (1988). Further exploration of maternal and paternal fetal attachment. Research in Nursing and Health, 11(2): 83–95

    Article  PubMed  Google Scholar 

  • Muller, M. E. (1989). The development and testing of the Muller Prenatal Attachment Inventory. Dissertation Abstracts International 50:08B (UMI no. 8926411)

  • Muller M. E., Ferketich S. (1992). Factor analysis of the maternal fetal attachment scale. Nursing Research 2(3):144–147

    Google Scholar 

  • Nunnally J. C. (1994). Psychometric theory. New York: McGraw-Hill

    Google Scholar 

  • Rosenberg, M. (1994). Rosenberg self-esteem scale (RSE). In J. Fischer, & K. Corcoran (Eds.), Measures for clinical practice (Vol. 1), Couples, families, and children (p. 518). New York: The Free Press

  • Rubin R. (1973). Liking and loving. New York: Holt, Rinehart, Winston

    Google Scholar 

  • Rubin R. (1975). Maternal tasks of pregnancy. Maternal-Child Nursing Journal 4:143–153

    PubMed  Google Scholar 

  • Rubin, A., & Babbie, E. (Eds.) (2005). Research methods for Social Work. Belmont, CA: Brooks/Cole Publishing Company

  • St. John, B. L. W. (2002). The relationships among prenatal attachment, social support, prenatal care utilization and the nutritional status of women. Dissertation Abstracts International 63:03B

  • Shieh, W. H. (1998). Maternal-fetal attachment in illicit-drug using pregnant women. Dissertation Abstracts International 59:07B

  • Siddiqui A., Hagglof B. (1999). An exploration of prenatal attachment in Swedish expectant women. Journal of Reproductive & Infant Psychology 17:369–380

    Google Scholar 

  • Slade A., Cohen L. (1996). The process of parenting and the remembrance of things past. Infant Mental Health Journal 17(3):217–238

    Article  Google Scholar 

  • Solomon J., George C. (1996). Defining the caregivers system: Toward a theory of caregiving. Infant Mental Health Journal 17(3):183–197

    Article  Google Scholar 

  • Sroufe L. A., Egeland B., Carlson E. A., Collins W. A. (2005). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. New York: Guilford Press

    Google Scholar 

  • Tyler, C. L. (1992). Maternal fetal attachment in native Americans. Unpublished master’s thesis, Arizona State University at Tempe

  • U.S. Department of Health and Human Services. (2000). Healthy people 2010: National health promotion and disease prevention objectives (DHSS Publication No. PHS 91-50212). Washington, DC: U.S. Government Printing Office

  • U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (2001). Adolescent births. Retrieved June 10, 2002, from http://www.childstats.gov/ac2001/hlthtxt.asp

  • U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (June 6, 2002a). Births: Preliminary data for 2001. Retrieved August 10, 2002, from http://www.cdc.gov/nchs/releases/02news/birthlow.htm

  • U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics (2005). Teen births http://www.cdc.gov/nchs/fastats/teenbrth.htm

  • U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Immunization Program and National Center for Health Statistics (2004). America’s children 2004. Retrieved July 18, 2004 from http://childstats.gov/ac2004/health9.asp

  • U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Vital Statistics Reports (May 30, 2002b). Teenage births in the United States: State trends, 1991–2000, an update, 50. Retrieved May 23, 2003, from http://www.cdc.gov/nchs

  • van IJzendoorn M. H. (1995). Adult attachment representations, parental responsiveness, and infant attachment: A meta-analysis on the predictive validity of the Adult Attachment Interview. Psychological Bulletin 117:387–403

    Article  PubMed  Google Scholar 

  • van IJzendoorn M. H., Schuengel C., Bakermans-Kranenburg M. (1999) Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology 11:225–250

    Article  PubMed  Google Scholar 

  • Ventura, S. J., Mosher, W. D., Curtin, S. C., Abna, J. C., & Henshaw, S. (2004, June 15). Estimated pregnancy rates for the United States, 1990–2000: An update. National Vital Statistics Report, 52(23). Hyattsville, Maryland: National Center for Health Statistics

  • Vito, K. O. (1986). The development of maternal fetal attachment and the association of selected variables. Dissertation Abstracts International 47:998-B (DAI 47, No. 03B:0098, p. 00190)

  • Ward M. J., Carlson E. A. (1995). Associations among adult attachment representations, maternal sensitivity, and infant–mother attachment in a sample of adolescent mothers. Child Development 1:69–79

    Article  Google Scholar 

  • Wayland J., Tate S. (1993). Maternal-fetal attachment and perceived relationships with important others in adolescents. Birth 20(4):198–203

    Article  PubMed  Google Scholar 

  • Weinfield N., Sroufe L. A., Egeland B. (2000). Attachment from infancy to young adulthood in a high risk sample: Continuity, discontinuity, and their correlates. Child Development 71:695–702

    Article  PubMed  Google Scholar 

  • Whitman T. L., Borkowski J. G., Keogh D. A., Weed K. (2001). Interwoven lives: Adolescent mothers and their children. Mahwah: NJ: Lawrence Erlbaum Associates, Inc

    Google Scholar 

  • Wilson, T. A. (1990). A comparison of maternal prenatal attachment between Anglo and Mexican American primigravidae. Masters Abstracts International 29(02):0290 (UMI no. 61342684)

    Google Scholar 

  • Zachariah R. (1994). Maternal-fetal attachment: Influence of mother–daughter and husband–wife relationships. Research in Nursing and Health 17(1):37–44

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

The author acknowledges the invaluable support of Toby Berman–Rossi in making this study possible.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Janis B. Feldman Ph.D., LCSW.

Additional information

Janis B. Feldman is an Assistant Professor, University, of Texas-Pan American.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Feldman, J.B. The Effect of Support Expectations on Prenatal Attachment: An Evidence-Based Approach for Intervention in an Adolescent Population. Child Adolesc Soc Work J 24, 209–234 (2007). https://doi.org/10.1007/s10560-007-0082-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10560-007-0082-0

Keywords

Navigation