Investigating Associations between Maternal Mindfulness, Mental Health, Interoception and Mother-Infant Relationship during Pregnancy and Post-Partum in a Non-Clinical Community Sample

Pregnancy and the postpartum period are times of significant transition for women, with changes in maternal physical and mental health. The relationship between a mother and her infant has been recognised as laying the foundation for later child development. There is considerable evidence that this early relationship is influenced by a woman’s wellbeing during pregnancy and in the early post-partum period. Mindfulness has been found to have positive health outcomes, primarily in reducing maternal stress, anxiety, and depression. However, there remains a need for considering the influence of mindfulness on the mother-infant relationship during pregnancy and the first trimester post-partum. Given the limited research on interoception in pregnancy, this maternal variable was included to acknowledge the importance of embodiment in maternal mindfulness, mental health, and mother-infant relationship. Its relevance was assessed through the associations with all the other measures. This study was the first to explore associations between maternal mindfulness, mental health (depression, anxiety, and stress), interoception, and mother-infant relationship during pregnancy and post-partum across three time points in a non-clinical community sample. This can provide possible avenues for assessment and support strategies by pre and perinatal healthcare practitioners. Women were assessed at 20+ weeks gestation (110), approximately 36-week gestation (72) and 10-12 weeks postpartum (67). Their age ranged from 18 to 47 (M = 33.22). The majority were from Australia and the rest from New Zealand, UK, USA, and Canada. They were from middle to upper class socioeconomic background and from high school/equivalent to doctoral degree educational level, with the majority holding a bachelor’s degree. The maternal variables were assessed with self-report questionnaires. Changes in the maternal variables during pregnancy and postpartum across three timepoints were analysed using ANOVA. Correlations were investigated using Pearson correlational analyses. Maternal depression and anxiety significantly decreased from pregnancy to postpartum with p = 0.035 for the difference in depressive scores (EPDS) and p = 0.012 for the difference in anxiety scores (DASS-21 subscale). Mother-infant relationship during pregnancy increased from the second to the third trimester of gestation, with p = 0.004 for the difference in maternal-foetal attachment scores. Significant correlations were found between all maternal variables across the three timepoints. Mindfulness and interoception positively correlated with mother-infant relationship during pregnancy and postpartum and negatively correlated with maternal depression, anxiety, and stress. A power analysis was conducted using G*Power calculation by Tabachnick & Fidell. The sample size required to estimate a medium effect was 100 participants, with power set at 0.95 and an alpha at 0.05. The current sample size (N 110) satisfied this to get meaningful results. The decrease in depression and anxiety post childbirth may confirm untested speculation in the literature that pregnancy, childbirth, and the transition to motherhood may not necessarily represent a risk factor for mental health but enrichment of identity and mitigation of mild/moderate depression in a non-clinical sample. Maternal mindfulness, mental health, and interoception may have an important impact on the quality of mother-infant relationship during pregnancy and post-partum, with potential consequences on infant development and wellbeing. The findings of this study have significant implication for prenatal support programs aiming to reduce the risk for postnatal psychological disorders and mother-infant relationship difficulties by promoting mother-infant relationship and maternal embodiment through interoception and wellbeing during pregnancy. Pre and perinatal practitioners and therapists working in a range of healthcare and clinical settings may support pregnant women through mindfulness relationship-based programs to promote mindfulness, interoception, and their relationship with their developing infant in utero and post-partum, thus impacting infant healthy development. Future research with larger sample sizes is needed to increase the statistical power to detect smaller effect sizes. Furthermore, the use of objective or observational measures should be considered for future studies to represent a stronger study design.

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