Abstract
The aim of the study is to examine the relationship between spiritual well-being, prenatal stress and attachment level of Turkish women conceiving spontaneously or with assisted reproductive techniques (ART). The comparative descriptive study type was conducted between November 2021 and June 2022 with 202 pregnant women, including 87 women conceiving with ART and 115 women conceiving spontaneously, who applied for routine prenatal care checkup in a state hospital in the west of Turkey. Both groups have a high level of spiritual well-being. Pregnant women in the ART group experience higher prenatal distress (9.6% for spontaneous, 12.6% for ART, p = 0.487) and low level of attachment (69.72 ± 7.98 for spontaneous, 66.24 ± 8.88 for ART, p = 0.006) compared to the other group. Additionally, as insufficient partner involvement in the prenatal process increases in pregnant women in both groups, prenatal attachment decreases. It is extremely important that midwives and nurses evaluate the spiritual well-being of pregnant women and provide holistic care in line with their spiritual needs.
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References
American society for reproductive medicine practice committee. (2022). Infertility. https://www.asrm.org/topics/topics-index/infertility/
Baor, L., & Soskolne, V. (2010). Mothers of IVF and spontaneously conceived twins: A comparison of prenatal maternal expectations, coping resources and maternal stress. Human Reproduction, 25(6), 1490–1496. https://doi.org/10.1093/humrep/deq045
Bennington, L. K. (2012). The relationship among maternal–infant bonding, spirituality, and maternal perception of the childbirth experience. Journal of Obstetric Gynecologic and Neonatal Nursing, 41, 137. https://doi.org/10.25772/4B9M-K487
Bilgiç, G., & Çıtak Bilgin, N. (2021). Relationship between fear of childbirth and psychological and spiritual well-being in pregnant women. Journal of Religion and Health, 60(1), 295–310. https://doi.org/10.1007/s10943-020-01087-4
Boz, İ, Özçetin, E., & Teskereci, G. (2018). Becoming a mother after infertility: A theoretical analysis. Current Approaches in Psychiatry, 10(4), 506–521. https://doi.org/10.18863/pgy.382342
Çapık, A., & Pasinlioğlu, T. (2015). Validity and reliability study of the Tilburg pregnancy distress scale into Turkish. Journal of Psychiatric and Mental Health Nursing, 22(4), 260–269. https://doi.org/10.1111/jpm.12211
Casu, G., Ulivi, G., Zaia, V., Fernandes Martins, M. D. C., Parente Barbosa, C., & Gremigni, P. (2018). Spirituality, infertility-related stress, and quality of life in Brazilian infertile couples: Analysis using the actor-partner interdependence mediation model. Research in Nursing and Health, 41(2), 156–165. https://doi.org/10.1002/nur.21860
Chehrazi, M., Faramarzi, M., Abdollahi, S., Esfandiari, M., & Shafie Rizi, S. (2021). Health promotion behaviours of pregnant women and spiritual well-being: Mediatory role of pregnancy stress, anxiety and coping ways. Nursing Open, 8(6), 3558–3565. https://doi.org/10.1002/nop2.905
Chen, C. J., Chen, Y. C., Sung, H. C., Kuo, P. C., & Wang, C. H. (2011). Perinatal attachment in naturally pregnant and infertility-treated pregnant women in Taiwan. Journal of Advanced Nursing, 67(10), 2200–2208. https://doi.org/10.1111/j.1365-2648.2011.05665.x
Darwiche, J., Lawrence, C., Vial, Y., Wunder, D., Stiefel, F., Germond, M., Despland, J. N., & De Roten, Y. (2014). Anxiety and psychological stress before prenatal screening in first-time mothers who conceived through IVF/ICSI or spontaneously. Women & Health, 54(5), 474–485. https://doi.org/10.1080/03630242.2014.897677
Darwiche, J., Milek, A., Antonietti, J. P., & Vial, Y. (2019). Partner support during the prenatal testing period after assisted conception. Women and Birth, 32(2), 264–271. https://doi.org/10.1016/j.wombi.2018.07.006
Doğru, S. (2022). The effect of spiritual situations on quality of life in COVID-19 outbreak process of pregnant woman [Master dissertation, Aydın Adnan Menderes University]. Councıl of Higher Education Thesis Center. http://hdl.handle.net/11607/4749
Dolatian, M., Mahmoodi, Z., Dilgony, T., Shams, J., & Zaeri, F. (2017). The structural model of spirituality and psychological well-being for pregnancy-specific stress. Journal of Religion and Health, 56(6), 2267–2275. https://doi.org/10.1007/s10943-017-0395-z
Duran, S., & Öz Can, Y. (2023). The association between spirituality and hope among Turkish women undergoing infertility treatment. Journal of Religion and Health, 62(2), 764–777. https://doi.org/10.1007/s10943-022-01689-0
Durmuş, M., Öztürk, Z., Şener, N., & Eren, S. Y. (2022). The relationship between the fear of COVID-19, depression, and spiritual well-being in pregnant women. Journal of Religion and Health, 61(1), 798–810. https://doi.org/10.1007/s10943-021-01448-7
Ekşi, H., & Kardaş, S. (2017). Spiritual well-being: Scale development and validation. Spiritual Psychology and Counseling, 2(1), 73–88. https://doi.org/10.12738/spc.2017.1.0022
Furmli, H., Seeto, R. A., Hewko, S. L., Dalfen, A., Jones, C. A., Murphy, K. E., & Bocking, A. (2019). Maternal mental health in assisted and natural conception: A prospective cohort study. Journal of Obstetrics and Gynaecology Canada, 41(11), 1608–1615. https://doi.org/10.1016/j.jogc.2019.03.002
García Blanco, A., Diago, V., Hervás, D., Ghosn, F., Vento, M., & Cháfer Pericás, C. (2018). Anxiety and depressive symptoms, and stress biomarkers in pregnant women after in vitro fertilization: A prospective cohort study. Human Reproduction, 33(7), 1237–1246. https://doi.org/10.1093/humrep/dey109
Gau, M. L. (1996). The relationships between prenatal stress, social support, spiritual well-being, and maternal-fetal attachment for pregnant women [Master dissertation, University of Maryland]. http://hdl.handle.net/10713/1501
Göcen, G. (2015). A qualitative study on the process of religious life and religious coping of the women who had IVF treatment. Journal of Faculty of Theology Istanbul University, 32, 165–216.
Gomes, S. C., Teodoro, L. P. P., Pinto, A. G. A., Oliveira, D. R., Quirino, G. S., & Pinheiro, A. K. B. (2018). Rebirth of childbirth: Reflections on medicalization of the Brazilian obstetric care. Revista Brasileira De Enfermagem, 71(5), 2594–2598. https://doi.org/10.1590/0034-7167-2017-0564
Gourounti, K. (2016). Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review. Women & Health, 56(1), 98–118. https://doi.org/10.1080/03630242.2015.1074642
Hassan, S. M., Leavey, C., & Rooney, J. S. (2019). Exploring english speaking Muslim women’s first-time maternity experiences: A qualitative longitudinal interview study. BMC Pregnancy and Childbirth, 19(1), 156. https://doi.org/10.1186/s12884-019-2302-y
Heidari, T., Ziaei, S., Ahmadi, F., Mohammadi, E., & Hall, J. (2015). Maternal experiences of their unborn child’s spiritual care: Patterns of abstinence in Iran. Journal of the American Holistic Nurses Association, 33(2), 146–160. https://doi.org/10.1177/0898010114551416
Huang, M. Z., Sun, Y. C., Gau, M. L., Puthussery, S., & Kao, C. H. (2019). First-time mothers experiences of pregnancy and birth following assisted reproductive technology treatment in Taiwan. Journal of Health, Population, and Nutrition, 38(1), 10. https://doi.org/10.1186/s41043-019-0167-3
Kavlak, O., Çetinkaya, E., Kazankaya, F., Mısırlı, S., & İyik Aksakal, B. (2021). Prenatal bonding in women becoming pregnant after infertility treatment. Journal of Continuing Medical Education, 30(1), 25–31. https://doi.org/10.17942/sted.422876
Kayabaşı, Ö., & Sözbir Yaman, Ş. (2022). The relationship between quality of life, perceived stress, marital satisfaction in women conceived through ART. Journal of Reproductive and Infant Psychology, 40(2), 108–117. https://doi.org/10.1080/02646838.2020.1788211
Keegan, M. B. (2021). Spirituality in pregnancy. Clinical Obstetrics and Gynecology, 64(3), 704–711. https://doi.org/10.1097/GRF.0000000000000633
Keskin, G., & Yıldız, H., (2015, September 17–19). Psychosocial health of women who have gotten pregnant naturally or through assisted reproductıve Technologies [Oral presentation]. The 22nd World Congress on Controversies in Obstetrics, Gynecology & Infertility, Budapest, Hungary.
McMahon, C. A., Boivin, J., Gibson, F. L., Hammarberg, K., Wynter, K., Saunders, D., & Fisher, J. (2011). Age at first birth, mode of conception and psychological wellbeing in pregnancy: Findings from the parental age and transition to parenthood Australia (PATPA) study. Human Reproduction, 26(6), 1389–1398. https://doi.org/10.1093/humrep/der076
Mohammadi Rizi, S., Mohebi Dehnavi, Z., Torabi, F., & Mohammadi Rizi, S. (2017). The relationship between spiritual intelligence and fear of childbirth in low–risk pregnant women. Journal of Babol University of Medical Sciences, 19(9), 26–31. https://doi.org/10.22088/jbums.19.9.26
Muller, M. E. (1993). Development of the prenatal attachment inventory. Western Journal of Nursing Research, 15(2), 199–211. https://doi.org/10.1177/019394599301500205
Nodoushan, R. J., Alimoradi, H., & Nazari, M. (2020). Spiritual health and stress in pregnant women during the COVID-19 pandemic. SN Comprehensive Clinical Medicine, 2(12), 2528–2534. https://doi.org/10.1007/s42399-020-00582-9
Okuducu, N. Y., & Yorulmaz, H. (2020). Quality of life in women diagnosed with infertility. Comprehensive Medicine, 12(1), 13–20. https://doi.org/10.5222/iksstd.2020.76093
Pakzad, M., Dolatian, M., Jahangiri, Y., Nasiri, M., & Dargah, F. A. (2018). The correlation between ıslamic lifestyle and pregnancy-specific stress: A cross-sectional, correlational study. Macedonian Journal of Medical Sciences, 6(6), 1163–1167. https://doi.org/10.3889/oamjms.2018.104
Pellerone, M., & Miccichè, S. (2014). Prenatal attachment and anxiety: Women who decide to try in vitro fertilization and women who procreate naturally. Psychology Research, 4(6), 419–427. https://doi.org/10.17265/2159-5542/2014.06.002
Pop, V. J., Pommer, A. M., Pop Purceleanu, M., Wijnen, H. A., Bergink, V., & Pouwer, F. (2011). Development of the Tilburg pregnancy distress scale: The TPDS. BMC Pregnancy and Childbirth, 11, 80. https://doi.org/10.1186/1471-2393-11-80
Ranjbar, F., Warmelink, J. C., & Gharacheh, M. (2020). Prenatal attachment in pregnancy following assisted reproductive technology: A literature review. Journal of Reproductive and Infant Psychology, 38(1), 86–108. https://doi.org/10.1080/02646838.2019.1705261
Ranjbar, F., Akhondi, M. M., Borimnejad, L., Ghaffari, S. R., & Behboodi Moghadam, Z. (2015). Paradox of modern pregnancy: A phenomenological study of women’s lived experiences from assisted pregnancy. Journal of Pregnancy. https://doi.org/10.1155/2015/543210
Ranjbar, F., Catja, W. J., Mousavi, R., & Gharacheh, M. (2022). Maternal-fetal attachment and anxiety in pregnant women who conceived through assisted reproductive technology: A longitudinal study. International Journal of Reproductive Biomedicine, 19(12), 1075–1084. https://doi.org/10.18502/ijrm.v19i12.10058
René, C., Landry, I., Montigny, De., & Francine. (2022). Couples experiences of pregnancy resulting from assisted reproductive technologies: A qualitative meta-synthesis. International Journal of Nursing Studies Advances, 4, 100059. https://doi.org/10.1016/j.ijnsa.2021.100059
Rezaei, S. M., Mahmood Mosavinezhad, S., & Ansari, B. (2020). The role of spiritual experiences in feeling of failure and infertility stress among infertile women. Health, Spirituality and Medical Ethics, 7(4), 41–49. https://doi.org/10.52547/jhsme.7.4.41
Saadat, A. (2017). Prenatal attachment levels of women getting pregnant naturally or through in vitro fertilization [Master dissertation, Ege University]. Councıl of Higher Education Thesis Center. https://acikbilim.yok.gov.tr/handle/20.500.12812/353023
Seymenler, S., & Siyez, D. M. (2018). Infertility counseling. Current Approaches in Psychiatry, 10(2), 186–197. https://doi.org/10.18863/pgy.358095
Tai, W., Hu, L., & Wen, J. (2022). Maternal and neonatal outcomes after assisted reproductive technology: A retrospective cohort study in China. Frontiers in Medicine, 9, 837762. https://doi.org/10.3389/fmed.2022.837762
Taylor, L. C. (2018). The experience of infertility among African American couples. Journal of African American Studies, 22(4), 357–372. https://doi.org/10.1007/s12111-018-9416-6
Tork Zahrani, S., Haji-Rafiei, E., Hajian, S., Alavi Majd, H., & Izadi, A. (2020). The correlation between spiritual health and maternal-fetal attachment behaviors in pregnant women referring to the health centers in Qazvin Iran. International Journal of Community Based Nursing & Midwifery, 8(1), 84–91. https://doi.org/10.30476/IJCBNM.2019.81668.0
Tuncel Topaç, N., & Süt, K. H. (2019). The effect of anxiety, depression and prenatal distress levels in pregnancy on prenatal attachment. The Journal of Gynecology-Obstetrics and Neonatology, 16(1), 9–17.
World Health Organization. (2022). Infertility. https://www.who.int/health-topics/infertility#tab=tab_1
Yılmaz, S. D., & Beji, K. N. (2013). Turkish version of prenatal attachment inventory: A study of reliability and validity. Journal of Anatolia Nursing and Health Sciences, 16(2), 103–109.
Yoshimasu, K., Sato, A., Miyauchi, N., Tsuno, K., Nishigori, H., Nakai, K., Arima, T., & Japan Environment and Children’s Study Group. (2017). Lack of association between receiving ART treatment and parental psychological distress during pregnancy: Preliminary findings of the Japan Environment and Children’s Study. Reproductive Biomedicine & Society Online, 5, 5–16. https://doi.org/10.1016/j.rbms.2017.09.002
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by BC and DB. The first draft of the manuscript was written by BC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Cap, B., Bilgic, D. & Pala, H.G. Investigation of the Relationship Between Spiritual Well-Being, Prenatal Stress and Attachment Level of Turkish Women Conceiving Spontaneously or with Assisted Reproductive Techniques. J Relig Health (2023). https://doi.org/10.1007/s10943-023-01918-0
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DOI: https://doi.org/10.1007/s10943-023-01918-0