Maternal and Child Health Journal

, Volume 13, Issue 4, pp 539–549 | Cite as

Mother-to-Infant Emotional Involvement at Birth

  • Bárbara Figueiredo
  • Raquel Costa
  • Alexandra Pacheco
  • Álvaro Pais


Objectives To study mother-to-infant emotional involvement at birth, namely factors (socio-demographics, previous life events, type of delivery, pain at childbirth, support from partner, infant characteristics, early experiences with the newborn, and mother’s mood) that interfere with the mother’s positive, negative and not clear emotions toward the newborn. Methods The Bonding Scale (an extended Portuguese version of the ‘New Mother-to-Infant Bonding Scale’) and the Edinburgh Postnatal Depression Scale were administrated during the first after delivery days to 315 mothers recruited at Júlio Dinis Maternity Hospital (MJD, Porto, Portugal). Results A worse emotional involvement with the newborn was observed when the mother was unemployed, unmarried, had less than grade 9, previous obstetrical/psychological problems or was depressed, as well as when the infant was female, had neonatal problems or was admitted in the intensive care unit. Lower total bonding results were significantly predicted when the mother was depressed and had a lower educational level; being depressed, unemployed and single predicted more negative emotions toward the infant as well. No significant differences in the mother-to-infant emotional involvement were obtained for events related to childbirth, such as type of delivery, pain and partner support, or early experiences with the newborn; these events do not predict mother’s bonding results either. Conclusion The study results support the need for screening and supporting depressed, unemployed and single mothers, in order to prevent bonding difficulties with the newborn at birth.


Bonding Depression Emotional involvement Infant Mother 



We would like to thank the mothers that participated in this study. This research was supported by a grant from the Human Development and Health Service of the Calouste Gulbenkian Foundation (Ref.48914) and a grant from the Bial Foundation (Ref.58/02).


  1. 1.
    Winnicott, D. (1957). The child, the family, and the outside world classics in child development. USA: Winnicott.Google Scholar
  2. 2.
    Klaus, M. H., & Kennell, J. H. (1976). Maternal-infant bonding. Saint Louis: The C. V. Mosby Company.Google Scholar
  3. 3.
    Kennell, J. H., Trause, M. A., & Klaus, M. H. (1975). Evidence for a sensitive period in the human mother. In Ciba Foundation (Ed.), Parent-infant interaction (pp. 87–102), Vol 33. Amsterdam: Association Scientific Publishers.Google Scholar
  4. 4.
    Stern, D. (1995). The motherhood constellation. New York, NY: Harper Collins.Google Scholar
  5. 5.
    George, C., & Solomon, J. (1999). Attachment and caregiving: The caregiving behavioral system. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment: Theory, research and clinical applications (pp. 649–667). New York, NY: The Guilford Press.Google Scholar
  6. 6.
    Bowlby, J. (1958). The nature of the child’s tie to his mother. International Journal of Psychoanalytic, 39, 350–373.Google Scholar
  7. 7.
    Klaus, M. H., Kennell, J. H., & Klaus, P. H. (1995). Bonding: Building the Foundations of Secure Attachment and Independence. USA: Addison Wesley Publishing Company.Google Scholar
  8. 8.
    Fleming, A. S., O’Day, D. H., & Kraemer, G. W. (1999). Neurobiology of mother-infant interactions: Experience and central nervous system plasticity across development and generations. Neuroscience Biobehavioral Review, 235, 6736–6785.Google Scholar
  9. 9.
    Eibl-Eibesfeldt, I. (1971). Love and Hate: The natural history of behavior patterns. New York, NY: Holt, Rinehart, & Winston, Inc.Google Scholar
  10. 10.
    Richards, M. P. M. (1971). Social interaction in the first weeks of human life. Psychiatric Neurology Neurochirurgia, 74, 35–42.Google Scholar
  11. 11.
    Figueiredo, B., Costa, R., Marques, A., Pacheco, A., & Pais, A. (2007). Mother and father-to-infant initial emotional involvement. Early Child Development and Care, 177(5), 521–532.CrossRefGoogle Scholar
  12. 12.
    Fleming, A. S., Rubble, D., Krieger, H., & Wong, P. Y. (1997). Hormonal and experiential correlates of maternal responsiveness during pregnancy and the puerperium in human mothers. Hormone and Behavior, 31, 145–158.CrossRefGoogle Scholar
  13. 13.
    Taylor, A., Atkins, R., Kumar, R., Adams, D., & Glover, V. (2005). Mother-to-infant bonding scale: Links with early maternal mood. Archives of Women’s Mental Health, 81, 45–51.CrossRefGoogle Scholar
  14. 14.
    Figueiredo, B., Marques, A., Costa, R., Pacheco, A., & Pais, A. (2005). Bonding: Escala para avaliar o envolvimento emocional dos pais com o bebé. Psychological, 40, 133–154.Google Scholar
  15. 15.
    Fleming, A. S., Ruble, D. N., Flett, G., & Shaul, D. L. (1988). Postpartum adjustment in first-time mothers: Relations between mood, maternal attitudes and mother infant interactions. Development Psychology, 241, 71–81.CrossRefGoogle Scholar
  16. 16.
    Troy, N. W. (1993). Early contact and maternal attachment among women using public health care facilities. Applied Nursing Research, 64, 161–166.CrossRefGoogle Scholar
  17. 17.
    Troy, N. W. (1995). The time of first holding of the infant and maternal self-esteem related to emotions of maternal attachment. Women Health, 223, 59–72.Google Scholar
  18. 18.
    Chalmers, B., Samarskaya, M. E., Tkatchenko, E., & Wallington, T. (1998). Women’s perceptions of birth in St Petersburg, Russian Federation. Journal of Reproductive Infant Psychology, 16, 243–258.CrossRefGoogle Scholar
  19. 19.
    MacFarlane, J. A., Smith, D. M., & Garrow, D. H. (1978). The relationship between mother and neonate. In S. Kitzinger & J. A. Davis (Eds.), The place of birth. New York, NY: Oxford University Press.Google Scholar
  20. 20.
    Newton, N., & Newton, M. (1962). Mother’s reaction to their newborn babies. Journal of the American Medical Association, 181, 206–210.PubMedGoogle Scholar
  21. 21.
    Robson, K. S., & Kumar, R. (1980). Delayed onset of maternal affection after childbirth. The British Journal of Psychiatry, 136, 347–353.PubMedCrossRefGoogle Scholar
  22. 22.
    Robson, K. S., & Moss, H. (1970). Patterns and determinants of maternal attachment. Journal of Pediatric, 77, 976–985.CrossRefGoogle Scholar
  23. 23.
    Insel, T. R. (1992). Oxytocin—A neuropeptide for affiliation: evidence from behavioral, receptor autoradiographic, and comparative studies. Psychoneuroendocrinology, 171, 3–35.CrossRefGoogle Scholar
  24. 24.
    Insel, T. R. (1997). A neurobiological basis of social attachment. American Journal of Psychiatry, 1546, 726–735.Google Scholar
  25. 25.
    Neumann, I. D. (2003). Brain mechanisms underlying emotional alterations in the peripartum period in rats. Depression and Anxiety, 17(3), 111–121.PubMedCrossRefGoogle Scholar
  26. 26.
    Isabella, R. A. (1994). Origins of maternal role satisfaction and its influences upon maternal interactive behavior and infant-mother attachment. Infant Behavior and Development, 17, 381–387.CrossRefGoogle Scholar
  27. 27.
    Isabella, R. A., & Belsky, J. (1985). Marital change during the transition to parenthood and security of infant-parent attachment. Journal of Family Issues, 64, 505–522.CrossRefGoogle Scholar
  28. 28.
    Edelstein, R. S., Alexander, K. W., Shaver, P. R., Schaaf, J. M., Quas, J. A., Lovas, G. S., & Goodman, G. S. (2004). Adult attachment style and parental responsiveness during a stressful event. Attachment & Human Development, 61, 31–52.CrossRefGoogle Scholar
  29. 29.
    Slade, A., Belsky, J., Aber, J. L., & Phelps, J. L. (1999). Mothers’ representations of their relationships with their toddlers: Links to adult attachment and observed mothering. Development of Psychology, 353, 611–619.CrossRefGoogle Scholar
  30. 30.
    Krpan, K. M., Coombs, R., Zinga, D., Steiner, M., & Fleming, A. S. (2005). Experiential and hormonal correlates of maternal behavior in teen and adult mothers. Hormones and Behavior, 471, 112–122.CrossRefGoogle Scholar
  31. 31.
    Feldman, R., Weller, A., Leckman, J. F., Kuint, J., & Eidelman, A. (1999). The nature of the mother’s tie to her infant: Maternal bonding under conditions of proximity, separation and potential loss. Journal of Child Psychology and Psychiatry, 406, 929–939.CrossRefGoogle Scholar
  32. 32.
    Kumar, R. C. (1997). “Anibody’s child”: Severe disorders of mother-to-infant bonding. The British Journal Psychiatry, 171, 175–181.CrossRefGoogle Scholar
  33. 33.
    Carek, D. J., & Capelli, A. J. (1981). Mother’s reactions to their newborn infants. Journal of the American Academy of Child Psychiatry, 20, 16–31.PubMedCrossRefGoogle Scholar
  34. 34.
    Robson, K. S. (1967). The role of eye-eye contact in maternal infant attachment. Journal of Child Psychology Psychiatry, 8, 13–25.CrossRefGoogle Scholar
  35. 35.
    Cummins, L. H., Scrimshaw, S. C. M., & Engle, P. L. (1988). Views of cesarean birth among primiparous women of Mexican origin in Los Angeles. Birth, 15, 164–170.PubMedCrossRefGoogle Scholar
  36. 36.
    DiMatteo, M. R., Morton, S. C., Lepper, H. S., Damush, T. M., Carney, M. F., Pearson, M., & Kahn, K. L. (1996). Cesarean childbirth and psychosocial outcomes: A meta-analysis. Health Psychology, 154, 303–324.CrossRefGoogle Scholar
  37. 37.
    Garel, M., Lelong, N., & Kaminski, M. (1987). Psychological consequences of caesarean childbirth in primiparas. Journal of Psychosomaic Obstetrics and Gynecology, 63, 197–209.CrossRefGoogle Scholar
  38. 38.
    Marut, J. S., & Mercer, R. T. (1979). Comparison of primiparas’ perceptions of vaginal delivery and cesarean births. Nursing Research, 285, 260–266.Google Scholar
  39. 39.
    Tulman, L. J. (1986). Initial handling of newborn infants by vaginal delivery and cesarean-delivered mothers. Nursing Research, 35, 296–300.PubMedCrossRefGoogle Scholar
  40. 40.
    Kearney, M. H., Cronenwett, L. R., & Reinhart, R. (1990). Caesarean delivery and breastfeeding outcomes. Birth, 17, 97–103.PubMedCrossRefGoogle Scholar
  41. 41.
    Taylor, A., Littlewood, J., Adams, D., Doré, C., & Glover, V. (1994). Serum cortisol levels are related to moods of elation and dysphoria in new mothers. Psychiatry Research, 54, 241–247.PubMedCrossRefGoogle Scholar
  42. 42.
    Ransjo-Arvidson, A. B., Matthiesen, A. S., Lilja, G., Nissen, E., Widstrom, A. M., & Uvnas-Moberg, K. (2001). Maternal analgesia during labor disturbs newborn behavior: Effects on breastfeeding, temperature, and crying. Birth, 281, 5–12.CrossRefGoogle Scholar
  43. 43.
    Sepkoski, C. M., Lester, B. M., Ostheimer, G. W., & Brazelton, T. B. (1992). The effects of maternal epidural anesthesia on neonatal behavior during the first month. Development Medical and Child Neurology, 3412, 1072–1080.Google Scholar
  44. 44.
    Huckabay, L. M. (1999). The effect on bonding behavior of giving a mother her premature baby’s picture. Scholarly Inquiry for Nursing Practice, 134, 349–362.Google Scholar
  45. 45.
    Widstrom, A. M., Wahlberg, V., Matthiesen, A. S., Eneroth, P., Uvnas-Moberg, K., Werner, S., & Winberg, J. (1990). Short-term effects of early suckling and touch of the nipple on maternal behaviour. Early Human Development, 213, 153–163.CrossRefGoogle Scholar
  46. 46.
    Gomes-Pedro, J., Bento de Almeida, J., Silveira da Costa, C., & Barbosa, A. (1984). Influence of early mother-infant contact on dyadic behaviour during the first month of life. Development Medical and Child Neurology, 265, 657–664.Google Scholar
  47. 47.
    Simpson, J. A. (1999). Attachment theory in modern evolutionary perspective. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment (pp. 115–140). New York, NY: Guilford Press.Google Scholar
  48. 48.
    Lee, R. E. (1995). Women look at their experience of pregnancy. Infant Mental Health Journal, 163, 192–205.CrossRefGoogle Scholar
  49. 49.
    Field, T. (1990). Infancy. Cambridge: Harvard University Press.Google Scholar
  50. 50.
    Lozoff, B., Jordan, B., & Malone, S. (1988). Childbirth in cross-cultural perspective. Marriage & Family Review, 123–124, 35–60.CrossRefGoogle Scholar
  51. 51.
    Brazelton, T. B., & Cramer, B. G. (1990). Earliest relationship: Parents, infants, and the drama of early attachment. New York: Addison-Wesley Publishing.Google Scholar
  52. 52.
    Figueiredo, B., Costa, R., Pacheco, A., Conde, A., & Teixeira, C. (2007). Anxiété, dépression et investissement émotionnel de l’enfant pendant la grossesse. Devenir, 19(3), 243–260.CrossRefGoogle Scholar
  53. 53.
    Lawson, K. L., & Turriff-Jonasson, S. I. (2006). Maternal serum screening and psychosocial attachment to pregnancy. Journal of Psychosomatic Research, 60(4), 371–378.PubMedCrossRefGoogle Scholar
  54. 54.
    Righetti, P. L., Dell’Avanzo, M., Grigio, M., & Nicolini, U. (2005). Maternal/paternal antenatal attachment and fourth-dimensional ultrasound technique: A preliminary report. The British Journal of Psychiatry, 96, 129–137.Google Scholar
  55. 55.
    Niven, C. (1988). Labor pain: Long-term recall and consequences. Journal of Reproductive Infant Psychology, 6, 83–87.CrossRefGoogle Scholar
  56. 56.
    Thune-Larsen, K. B., & Moller-Pedersen, K. (1988). Childbirth experience and postpartum emotional disturbance. Journal of Reproductive Infant Psychology, 64, 229–240.CrossRefGoogle Scholar
  57. 57.
    Augusto, A., Kumar, R., Calheiros, J. M., Matos, E., & Figueiredo, E. (1996). Post-natal depression in an urban area of Portugal: Comparision of childbearing women and matches controls. Psychological Medicine, 26, 135–141.PubMedGoogle Scholar
  58. 58.
    Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150, 782–786.PubMedCrossRefGoogle Scholar
  59. 59.
    Figueiredo, B. (1997). Postpartum depression, mother-infant interaction and child development, Unpublished doctoral dissertation, Minho University, Braga.Google Scholar
  60. 60.
    Areias, M. E., Kumar, R., Barros, H., & Figueiredo, E. (1996). Comparative incidence of depression in women and men, during pregnancy and after childbirth. Validation of the Edinburgh Postnatal Depression Scale in Portuguese mothers. The British Journal of Psychiatry, 169(1), 30–35.PubMedCrossRefGoogle Scholar
  61. 61.
    Dragonas, T. G. (1992). Greek fathers’ participation in labor and care of the infant. Scandinavian Journal of Caring Science, 63, 151–159.Google Scholar
  62. 62.
    Klaus, M. H., & Kennell, J. H. (1992). Pregnancy, birth and the first days of life. In M. D. Levine, W. B. Carey, & A. C. Crocker (Eds.), Developmental-behavioral pediatrics (pp. 16–26). Philadelphia, PA: WB Saunders Co.Google Scholar
  63. 63.
    Brown, J. V., Bakeman, R., Snyder, P. A., Fredrickson, W. T., Morgan, S. T., & Hepler, R. (1975). Interactions of black inner-city mothers with their newborn infants. Child Development, 463, 677–686.CrossRefGoogle Scholar
  64. 64.
    Craig, S., Tyson, J. E., Samson, J., & Lasky, R. E. (1982). The effect of early contact on maternal perception of infant behavior. Early Human Development, 62, 197–204.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Bárbara Figueiredo
    • 1
  • Raquel Costa
    • 1
  • Alexandra Pacheco
    • 1
  • Álvaro Pais
    • 2
  1. 1.Department of PsychologyUniversity of MinhoBragaPortugal
  2. 2.Department of AnaesthesiologyJúlio Dinis Maternity HospitalPortoPortugal

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