Effectiveness of a prenatal behavior change communication intervention on maternal-fetal bonding: A randomized controlled trial in a tertiary care setting.

PROBLEM: Maternal-fetal attachment (MFA) plays a critical role in determining maternal health and influencing child developmental outcomes. However, structured behavioral interventions designed to enhance MFA are seldom included in antenatal care practices. BACKGROUND: MFA forms the foundation of the maternal-child bond. This early relationship is critical for maternal mental health and serves as a precursor to the child's socio-emotional and behavioral development. AIM: This study aimed to determine whether a behavioral communication intervention could enhance maternal-fetal attachment. METHODS: A total of 450 expectant mothers were recruited and randomly assigned to two test groups and one control group in a 3-arm trial (1:1:1). The Maternal-Fetal Attachment Scale (MFAS) and Prenatal Attachment Inventory (PAI) were used to measure MFA at baseline and post-intervention. RESULTS: MFA scores increased across groups over time. Test Group 2, which received additional interactive supportive talk therapy, demonstrated a statistically significant enhancement in MFA measured by the PAI (p < 0.001) versus the control group. However, MFAS score changes for Test Group 2 were not significant (p = 0.064). Test Group 1 showed no significant differences on either scale compared to the control group. DISCUSSION: MFA showed a steady increase throughout pregnancy in the intervention groups, especially in those receiving a blend of psychological and cognitive-behavioral support, demonstrating notably greater improvements beyond natural progression. CONCLUSION: This study emphasizes the benefits of combining supportive talk therapy and behavioral communication therapy to enhance mother-fetal attachment. Strengthening MFA may be crucial for fostering optimal psychological, behavioral, and cognitive development in offspring.