The effect of unintended pregnancy on the development of parental-fetal attachment: a prospective cohort study

A strong parental (maternal/ paternal)-fetal attachment predicts a stronger parental-infant attachment after the child is born. An unintended pregnancy has been associated with weakened development of a maternal-fetal attachment. However, the knowledge of association between an unintended pregnancy and the development of a paternal-fetal attachment is scarce. This study aims to investigate the development of a parental-fetal attachment during the pregnancy among parents who have intended and unintended pregnancies.

This study is part of The Central Satakunta Maternity and Child Health Clinic (KESALATU) Study, which is a prospective follow-up study in the primary health care sector of the Satakunta region in Southwest Finland. Families were recruited during their first maternity clinic visit between September 1, 2016 and December 31, 2019. In the self-report questionnaire, parents separately reported whether the pregnancy was planned or unplanned. Parents completed the Maternal/Paternal Antenatal Attachment Scale (MAAS/PAAS) self-report questionnaire three times during the pregnancy. In the first trimester of pregnancy, 211 mothers and 152 partners participated in the study; in the second trimester, 199 and 140; and in the third trimester, 170 and 116, respectively. Repeated measures models were used to estimate the association between intended versus unintended pregnancy and the scores of maternal/paternal-fetal attachment throughout their pregnancies.

Paternal-fetal attachment scores were significantly higher throughout the pregnancy among partners with an intended pregnancy compared to those with an unintended pregnancy (b = 4.23, 95% confidence interval (CI) = 0.82-7.64, p = 0.015). There was no significant difference in the development of the attachment as the pregnancy progressed between the groups (p = 0.104). There was no significant difference in the maternal-fetal attachment (b = 0.12, CI = -2.86-3.10, p = 0.938), nor its development during the pregnancy between the groups (p = 0.405). Both the paternal-fetal and maternal-fetal attachments predictably strengthened as the pregnancy progressed regardless of whether the pregnancy was intended or unintended.

The paternal-fetal attachment was significantly weaker throughout the pregnancy among partners who reported an unintended pregnancy. Thus, it is crucial for maternity clinics to provide comprehensive support to the entire family, aiming to enhance both the parental-fetal attachment and its development.