Parents’ experiences of conceptualising and relating to their unborn child : a constructivist grounded theory

Antenatal thoughts and feelings about the fetus are thought to be somewhat predictive of the later parent-child relationship. The parental-fetal tie is, however, poorly understood. The field is plagued by disagreement in existing conceptualisations, conflicting results in efforts to identify predictors, correlates and consequences of the tie, and a dearth of research looking into the phenomenon from a paternal perspective. In response to these issues, the purpose of the current study was to construct a substantive theory of expectant parents’ fetal conceptual and relational experiences.Following the receipt of ethical approval, constructivist grounded theory was used to explore data generated through semi-structured individual interviews conducted with a purposive and theoretical sample of nine first-time expectant mothers and their male partners, in early, middle and late pregnancy. Data analysis, involving techniques of coding, constant comparison and memo-writing, resulted in the development of a theoretical model.The parental-fetal tie is characterised as an evolving phenomenon which takes a convoluted and individualised path to reach maturation. Coming to think of the fetus as a known other and as part of the intimate family unit are vital in achieving a sense of relatedness. An increasingly tangible fetus facilitates such an outlook. Nevertheless, the development of the tie is limited by restricted access to the unborn child, as well as by difficulties in perceiving fetal reciprocity.The results suggest that expectant mothers and fathers conceptualise and connect to the unborn child in comparable ways, despite physical disparities in the pregnancy experience. Given the nature of the tie, it is thought that assessing it through self-report instruments may not be feasible. Providing inclusive care to the parental dyad will encourage engagement with the fetus. Further longitudinal research spanning the transition to parenthood is needed to understand the postpartum sequelae of the processes observed antenatally

A narrative review of interventions addressing the parental-fetal relationship

Background Expectant parents develop varying degrees of emotional affiliation with the unborn child. Interventions supporting this relationship may be beneficial given its link to maternal health behaviour during pregnancy, as well as the parental–infant bond after birth. Aim To identify and describe the effects of programmes and strategies that have addressed the parental–fetal relationship. Method English-language primary studies, published between 2005–2015, were identified and their methodological quality was assessed. Databases used included CINAHL, Cochrane Library, MEDLINE, PsycINFO and Web of Science. Key search terms included maternal/paternal–fetal attachment, prenatal bond, parental–fetal relationship and intervention. RCTs, non-RCTs, observational and non-comparative studies, before and after studies and case studies were included. Findings Twenty-seven papers were included. Studies evaluated the effects of various strategies, including ultrasound and screening procedures, fetal awareness interventions, social and psychological support techniques, educational programmes and relaxation strategies. Results are inconsistent due to the diversity of interventions and significant variation in methodological quality. Conclusion There is insufficient evidence to support definitive conclusions regarding the efficacy of any included intervention. A number of limitations, such as non-probability sampling, lack of blinding, and insufficient follow-up weaken the evidence. The inclusion of fathers in only three studies reflects the overall neglect of men in research regarding the prenatal relationship. Further in-depth study of the nature of the maternal/paternal–fetal relationship may be needed in order to allow for the identification of interventions that are consistently beneficial and worthwhile