Maternal-Fetal Attachment (MFA) in the Context of Pregnancy Adaptation: A Literature Review of Internal and External Factors Affecting Mothers

Authors

  • Umi Aniroh Universitas Ngudi Waluyo
  • Tina Mawardika Universitas Ngudi Waluyo

DOI:

https://doi.org/10.47134/phms.v3i3.629

Keywords:

Maternal Fetal Attachment, Pregnancy Adaptation, Maternal Mental Health, Social Support, Prenatal Bonding

Abstract

This study aims to analyze Maternal Fetal Attachment (MFA) within the context of pregnancy adaptation by examining the influence of internal and external maternal factors through a qualitative descriptive literature approach. The research employs a library study method using secondary data sources, including peer reviewed journal articles and relevant academic documents, collected through systematic literature search and analyzed using thematic analysis, data reduction, categorization, and inductive interpretation. The findings reveal that MFA is a multidimensional construct influenced by internal factors such as maternal mental health, particularly depression and anxiety, as well as positive psychological states, and external factors including social and family support. Pregnancy adaptation emerges as a key mediating process that connects these factors to the quality of maternal fetal bonding. The study also highlights that strong MFA contributes to positive infant developmental outcomes, especially in emotional regulation and adaptive behavior. These findings imply that maternal well being and supportive social environments are essential components in strengthening prenatal attachment. In conclusion, this study contributes to the theoretical understanding of MFA as a biopsychosocial process and provides practical insights for integrating mental health screening and family centered interventions in antenatal care to improve maternal and child health outcomes.

References

Abraham, D., & P, P. (2024). A methodological framework for descriptive phenomenological research. Western Journal of Nursing Research. https://doi.org/10.1177/01939459241308071 DOI: https://doi.org/10.1177/01939459241308071

Annamalai, P., Balakrishnan, R., & Babu, P. D. (2026). Prevalence of depression and anxiety disorders among pregnant women. Cureus. https://doi.org/10.7759/cureus.103511 DOI: https://doi.org/10.7759/cureus.103511

Ballesteros Andrés, L. X., et al. (2025). Positive mental health, anxiety and prenatal bonding: A contextual approach. Healthcare. https://doi.org/10.3390/healthcare13243300 DOI: https://doi.org/10.3390/healthcare13243300

Bandaranayake, P. (2024). Application of grounded theory methodology in library and information science research: An overview. Sri Lanka Library Review. https://doi.org/10.4038/sllr.v38i2.70 DOI: https://doi.org/10.4038/sllr.v38i2.70

Belotto, M. (2018). Data analysis methods for qualitative research: Managing the challenges of coding, interrater reliability, and thematic analysis. The Qualitative Report. https://doi.org/10.46743/2160-3715/2018.3492 DOI: https://doi.org/10.46743/2160-3715/2018.3492

Bingham, A. (2023). From data management to actionable findings: A five phase process of qualitative data analysis. International Journal of Qualitative Methods. https://doi.org/10.1177/16094069231183620 DOI: https://doi.org/10.1177/16094069231183620

Branjerdporn, G., Meredith, P., Wilson, T., & Strong, J. (2022). Infant developmental outcomes: Influence of prenatal maternal fetal attachment, adult attachment, maternal well being, and perinatal loss. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph19042433 DOI: https://doi.org/10.3390/ijerph19042433

Brekalo, M., Vukšić, N., Matijaš, M., Žutić, M., & Nakić Radoš, S. (2025). How to measure maternal foetal bonding. Psihologijske teme, 34(3). https://doi.org/10.31820/pt.34.3.9 DOI: https://doi.org/10.31820/pt.34.3.9

Camarneiro, A., Roberto, M. S., & Justo, J. (2024). Explaining maternal antenatal attachment by psychological, clinical and sociodemographic factors: A path analysis study. BMC Pregnancy and Childbirth. https://doi.org/10.1186/s12884-024-06836-x DOI: https://doi.org/10.1186/s12884-024-06836-x

Cervellione, B., Lombardo, E. M. C., Geraci, S., & Iacolino, C. (2025). Prenatal bonding and early emotion regulation in infancy and toddlerhood: A systematic review. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2025.1700636 DOI: https://doi.org/10.3389/fpsyg.2025.1700636

Doyle, L., McCabe, C., Keogh, B., Brady, A., & McCann, M. (2019). An overview of the qualitative descriptive design within nursing research. Journal of Research in Nursing. https://doi.org/10.1177/1744987119880234 DOI: https://doi.org/10.1177/1744987119880234

Ertmann, R., Bang, C., Kriegbaum, M., Væver, M., Kragstrup, J., Siersma, V., Wilson, P., Lutterodt, M., & Smith Nielsen, J. (2021). What factors are most important for the development of the maternal fetal relationship? A prospective study among pregnant women in Danish general practice. BMC Psychology, 9, Article 2. https://doi.org/10.1186/s40359-020-00499-x DOI: https://doi.org/10.1186/s40359-020-00499-x

Fife, S., & Gossner, J. (2024). Deductive qualitative analysis: Evaluating, expanding, and refining theory. International Journal of Qualitative Methods. https://doi.org/10.1177/16094069241244856 DOI: https://doi.org/10.1177/16094069241244856

Granikov, V., Hong, Q., Crist, E., & Pluye, P. (2020). Mixed methods research in library and information science: A methodological review. Library and Information Science Research. https://doi.org/10.1016/j.lisr.2020.101003 DOI: https://doi.org/10.1016/j.lisr.2020.101003

Jimenez, S., Berbegal Mirabent, J., & De La Torre, R. (2024). How do university libraries contribute to the research process. The Journal of Academic Librarianship. https://doi.org/10.1016/j.acalib.2024.102930 DOI: https://doi.org/10.1016/j.acalib.2024.102930

McNamara, J., Townsend, M. L., & Herbert, J. S. (2019). A systematic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding. PLoS ONE. https://doi.org/10.1371/journal.pone.0220032 DOI: https://doi.org/10.1371/journal.pone.0220032

Pellerone, M., Martinez Torvisco, J., Razza, S. G., Commodari, E., & Miccichè, S. (2023). Precursors of prenatal attachment and anxiety during pregnancy in women who procreate naturally and pregnant women following assisted reproduction technology. International Journal of Environmental Research and Public Health, 20(20), Article 6945. https://doi.org/10.3390/ijerph20206945 DOI: https://doi.org/10.3390/ijerph20206945

Pohárnok, M., Kopcsó, K., & Polgár, P. I. (2022). Structure and correlates of maternal fetal attachment scale. Midwifery. https://doi.org/10.1016/j.midw.2022.103422 DOI: https://doi.org/10.1016/j.midw.2022.103422

Pratt, M. (2025). On the evolution of qualitative methods in organizational research. Annual Review of Organizational Psychology and Organizational Behavior. https://doi.org/10.1146/annurev-orgpsych-111722-032953 DOI: https://doi.org/10.1146/annurev-orgpsych-111722-032953

Racine, N., Plamondon, A., Hentges, R. F., Tough, S., & Madigan, S. (2019). Dynamic and bidirectional associations between maternal stress, anxiety, and social support: The critical role of partner and family support. Journal of Affective Disorders, 252, 19 to 24. https://doi.org/10.1016/j.jad.2019.03.083 DOI: https://doi.org/10.1016/j.jad.2019.03.083

Røhder, K., Væver, M. S., Aarestrup, A. K., Jacobsen, R. K., Smith Nielsen, J., & Schiøtz, M. (2020). Maternal fetal bonding among pregnant women at psychosocial risk: The roles of adult attachment style, prenatal parental reflective functioning, and depressive symptoms. PLoS ONE, 15(9), Article e0239208. https://doi.org/10.1371/journal.pone.0239208 DOI: https://doi.org/10.1371/journal.pone.0239208

Rollè, L., Giordano, M., Santoniccolo, F., & Trombetta, T. (2020). Prenatal attachment and perinatal depression: A systematic review. International Journal of Environmental Research and Public Health, 17(8), Article 2644. https://doi.org/10.3390/ijerph17082644 DOI: https://doi.org/10.3390/ijerph17082644

Rusanen, E., Vierikko, E. M., Lahikainen, A. R., Pölkki, P., & Paavonen, E. J. (2025). Maternal postnatal bonding and its risk factors: A longitudinal study. Child and Adolescent Psychiatry and Mental Health, 19, Article 984. https://doi.org/10.1186/s13034-025-00984-4 DOI: https://doi.org/10.1186/s13034-025-00984-4

Togia, A., & Malliari, A. (2017). Research methods in library and information science. https://doi.org/10.5772/intechopen.68749 DOI: https://doi.org/10.5772/intechopen.68749

Trombetta, T., Giordano, M., Santoniccolo, F., Vismara, L., Della Vedova, A. M., & Rollè, L. (2021). Pre natal attachment and parent to infant attachment: A systematic review. Frontiers in Psychology, 12, Article 620942. https://doi.org/10.3389/fpsyg.2021.620942 DOI: https://doi.org/10.3389/fpsyg.2021.620942

Varsha, S., Manoj, R., & Babu, S. (2026). The impact of prenatal anxiety on maternal fetal attachment: A quantitative correlational study. International Journal for Multidisciplinary Research, 8(2). https://doi.org/10.36948/ijfmr.2026.v08i02.71721 DOI: https://doi.org/10.36948/ijfmr.2026.v08i02.71721

Vega Sanz, M., et al. (2023). Pregnancy adjustment and perinatal depression. American Journal of Perinatology. https://doi.org/10.1055/s-0043-1776062 DOI: https://doi.org/10.1055/s-0043-1776062

Vila Henninger, L., et al. (2022). Abductive coding: Theory building and qualitative reanalysis. Sociological Methods and Research. https://doi.org/10.1177/00491241211067508 DOI: https://doi.org/10.1177/00491241211067508

Wang, C., et al. (2026). Depressive symptoms and social support trajectories. International Journal of Women’s Health. https://doi.org/10.2147/IJWH.S570352 DOI: https://doi.org/10.2147/IJWH.S570352

Wu, W. R., & Yu, P. J. (2025). Advancing maternal well being: Development of a clinic based instrument for evaluating healthy adaptation to pregnancy. International Journal of Nursing Practice. https://doi.org/10.1111/ijn.70059 DOI: https://doi.org/10.1111/ijn.70059

Wu, W. R., et al. (2024). Pregnancy adaptation and maternal fetal bonding. BMC Nursing. https://doi.org/10.1186/s12912-024-02009-5 DOI: https://doi.org/10.1186/s12912-024-02009-5

Zhang, L., et al. (2021). Prenatal depression in women in the third trimester: Prevalence and relationship with maternal fetal attachment. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2020.602005 DOI: https://doi.org/10.3389/fpubh.2020.602005

Downloads

Published

2026-04-23

How to Cite

Aniroh, U., & Mawardika, T. (2026). Maternal-Fetal Attachment (MFA) in the Context of Pregnancy Adaptation: A Literature Review of Internal and External Factors Affecting Mothers. Health & Medical Sciences, 3(3), 12. https://doi.org/10.47134/phms.v3i3.629

Issue

Section

Articles

Similar Articles

1 2 3 4 5 > >> 

You may also start an advanced similarity search for this article.