The relationship between prenatal attachment and spiritual well-being in high-risk pregnant women in Turkey: A cross-sectional study

Year 2025, Volume: 6 Issue: 3, 249 - 259, 30.09.2025

Gizem Çıtak , Zeynep Polat

Abstract

Purpose: This cross-sectional study aimed to examine the relationship between prenatal attachment and spiritual well-being in high-risk pregnant women in Turkey.
Material and Methods: Data were collected between February and April 2025 from 123 participants at the obstetrics outpatient clinic and wards of a training and research hospital. Participants completed a Personal Information From, the Prenatal Attachment Inventory (PAI), and the Three-Factor Spiritual Well-Being Scale (3F-SWB).
Results: High levels of prenatal attachment and spiritual well-being were observed among participants. Prenatal attachment was significantly associated with age, planned pregnancy, and psychological status, while spiritual well-being was significantly related to family structure and psychological status. Moreover, a moderate, positive, and statistically significant correlation was found between prenatal attachment and spiritual well-being.
Conclusion: These findings highlight the importance of integrating spiritual and emotional support services into midwifery care for high-risk pregnancies.

Keywords

Midwifery , Spiritual Well-being , Prenatal Attachment , High-risk Pregnancy

Türkiye’de yüksek riskli gebelerde prenatal bağlanma ile spiritüel iyi oluş arasındaki ilişki

Abstract

Amaç: Bu kesitsel çalışma, Türkiye’de yüksek riskli gebelerde prenatal bağlanma ile spiritüel iyi oluş arasındaki ilişkiyi incelemeyi amaçlamıştır.

Gereç ve Yöntem: Veriler, 2025 yılı Şubat–Nisan ayları arasında bir eğitim ve araştırma hastanesinin kadın doğum polikliniği ve servislerinde bulunan 123 katılımcıdan toplanmıştır. Katılımcılara Kişisel Bilgi Formu, Prenatal Bağlanma Envanteri (PAI) ve Üç Faktörlü Spiritüel İyi Oluş Ölçeği (3F-SWB) uygulanmıştır.

Bulgular: Katılımcıların prenatal bağlanma ve spiritüel iyi oluş düzeylerinin yüksek olduğu bulunmuştur. Prenatal bağlanmanın yaş, planlı gebelik ve psikolojik durum ile anlamlı bir şekilde ilişkili olduğu; spiritüel iyi oluşun ise aile yapısı ve psikolojik durum ile anlamlı bir şekilde ilişkili olduğu saptanmıştır. Ayrıca prenatal bağlanma ile spiritüel iyi oluş arasında orta düzeyde, pozitif ve istatistiksel olarak anlamlı bir ilişki bulunmuştur.

Sonuç: Bu bulgular, yüksek riskli gebeliklerde ebeveyn bakımına spiritüel ve duygusal destek hizmetlerinin entegre edilmesinin önemini vurgulamaktadır.

Keywords

Ebelik , Spiritüel iyi oluş , Prenatal Bağlanma , Yüksek riskli gebelikler

References

• Abdollahpour, S., Khosravi, A. (2018). Relationship between spiritual intelligence with happiness and fear of childbirth in Iranian pregnant women. Iranian Journal of Nursing and Midwifery Research, 23(1), 45– 50. https://doi.org/10.4103/ijnmr.IJNMR_39_16
• Alkaş, Ü., Varşoğlu, Y. (2023). Anxiety and prenatal attachment in primiparous pregnant women: Effects of the pandemic period. Journal of Women’s Health Nursing, 9(1), 1–11. https://dergipark.org.tr/tr/download/articlefile/ 2767516
• Ataman, H., Akarsu, Ö., Budak, M. İ. (2022). Determining the relationship between marital adjustment and prenatal attachment in high-risk third-trimester pregnant women. Turkish Journal of Family Medicine and Primary Care, 16(4), 670–680. https://doi.org/10.21763/tjfmpc.1097177
• Atasever, İ., Çelik, A. S. (2018). The effect of prenatal stress on maternal and child health. Anatolian Journal of Nursing and Health Sciences, 21(1), 60–68. https://dergipark.org.tr/tr/download/articlefile/ 464386
• Aykaç, E. G. (2021). Relationship between temperament traits and prenatal attachment characteristics, depression, and anxiety levels in pregnant women [Master’s thesis]. Istanbul Gelisim University. https://acikerisim.gelisim.edu.tr/items/07fab53f 435f-4e24-a1ea-9ed5ac9d2e36
• Baltacı, D., Vatansever, Z. (2022). Evaluation of anxiety, stress and spiritual well-being in pregnant women with spontaneous and assisted reproduction pregnancies. Turkish Journal of Obstetrics and Gynecology, 19(3), 190–196. https://doi.org/10.4274/tjod.galenos.2022.22062
• Baş Durdu, C. (2025). The relationship between personality traits, social media use, and prenatal attachment in pregnant women [Master’s thesis]. Sakarya University, Institute of Health Sciences.
• Ben Taleb, Z., Bahelah, R., Fouad, F. M., Coutts, A., Wilcox, M., & Maziak, W. (2015). Syria: Health in a country undergoing tragic transition. International Journal of Public Health, 60(Suppl 1), S63–S72. https://doi.org/10.1007/s00038-014-0586-2
• Bilgiç, G. (2019). Relationship between fear of childbirth and psychological and spiritual well-being in pregnant women [Master’s thesis]. Bolu Abant İzzet Baysal University. https://tez.yok.gov.tr/UlusalTezMerkezi/tezDetay.jsp ?id=ND0CSFCwOxywlNYoY8lFg& no=aHIX55VDi0YAhbVbzV6ggg
• Buldur, A. H., & Göcen, G. (2021). Examination of the religious, spiritual, and psychological conditions of women during the process of unplanned pregnancy. Journal of Values Education, 19(42), 337–374. https://doi.org/10.34234/ded.1009333
• Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.).
• Hillsdale, NJ: Erlbaum.Davison, S. N., & Jhangri, G. S. (2013). The relationship between spirituality, psychosocial adjustment to illness, and health-related quality of life in patients with advanced chronic kidney disease. Journal of Pain and Symptom Management, 45(2), 170–178. https://doi.org/10.1016/j.jpainsymman.2012.02.019
• Dunn, L. L., Handley, M. C., & Shelton, M. M. (2007). Spiritual well-being, anxiety, and depression in antepartal women on bedrest. Issues in Mental Health Nursing, 28(11), 1235–1246. https://doi.org/10.1080/01612840701526104
• Edis, E. K., & Bal, S. (2024). Life satisfaction, psychological resilience, and spiritual well-being levels of pregnant women. Spiritual Psychology and Counseling, 9(3), 241–257. https://doi.org/10.37898/spiritualpc.1449307
• Ekşi, H., & Kardaş, S. (2017). Spiritual well-being: Scale development and validation. Spiritual Psychology and Counseling, 2, 73–88. https://doi.org/10.12738/spc.2017.1.0022
• Elkin, N. (2015). Prenatal attachment levels of pregnant women and factors affecting them. STED, 24(4), 230– 236. https://dergipark.org.tr/tr/download/articlefile/ 1906958
• Emmons, R. A. (2000). Is spirituality an intelligence? Motivation, cognition, and the psychology of ultimate concern. International Journal for the Psychology of Religion, 10(1), 3–26. https://doi.org/10.1207/S15327582IJPR1001_2
• Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.
• George, M. (2006). Practical application of spiritual intelligence in the workplace. Human Resource Management International Digest, 14(5), 3–5. https://doi.org/10.1108/09670730610678181
• Göcen, G. (2013). The relationship between psychological well-being and religious orientation within the framework of positive psychology: A study on adults. Social Sciences, 7(13), 97–130. https://isamveri.org/pdfdrg/D03402/2013_7_13/201 3_7_13_GOCENG.pdf
• Izadi, F., Golmakani, N., Hashemian, M., & Modares Gharavi, M. (2020). The relationship between spiritual health and maternal-fetal attachment in pregnant women. Iranian Journal of Nursing and Midwifery Research, 25(6), 501–505. https://doi.org/10.4103/ijnmr.IJNMR_212_19
• Kartal, Y., & Karaman, T. (2018). The effect of childbirth preparation education on prenatal attachment and depression risk in pregnant women. Zeynep Kamil Medical Bulletin, 49(1), 85–91. https://doi.org/10.16948/zktipb.321210
• Kurnaz, F., & Türkmen Çevik, F. (2019). Prenatal attachment scale: Reliability and validity study. Hacettepe University Faculty of Health Sciences Journal, 6(2), 112–138. https://doi.org/10.21020/husbfd.453796
• Küçükkaya, B., Dindar, İ., Erçel, Ö., & Yılmaz, E. (2018). Pregnant women's concerns about birth and postpartum periods according to pregnancy trimesters. Journal of Academic Research in Nursing (JAREN), 4(1), 28–36. https://doi.org/10.5222/jaren.2018.028
• Muller, M. E., & Ferketich, S. (1993). Factor analysis of the Maternal Fetal Attachment Scale. Nursing Research, 42(3), 144–147. https://pubmed.ncbi.nlm.nih.gov/8506162/
• Okanlı, A., Tortumluoğlu, G., & Kırpınar, İ. (2003). The relationship between perceived social support from family and problem-solving skills in pregnant women. Anadolu Psikiyatri Dergisi, 4, 98–105. https://search.trdizin.gov.tr/en/yayin/detay/20203
• Potur, D., Doğan Merih, Y., & Demirci, N. (2020). Evaluation of factors affecting prenatal attachment in primiparous and multiparous pregnant women. Journal of Academic Research in Nursing, 6(1). https://doi.org/10.5222/jaren.2020.65265
• Sidhu, A., & Dhamania, M. (2025). Spiritual health and maternal fetal attachment among pregnant women. Global Journal for Research Analysis, 12(1), 40–42. https://www.worldwidejournals.com/global-journal-forresearch- analysis-GJRA/fileview/spiritual-health-andmaternal- fetal-attachment-among-pregnantwomen_ January_2023_6008705982_1508691.pdf
• Smith, L., Webber, R., & Defrain, J. (2013). Spiritual wellbeing and its relationship to resilience in young people: A mixed methods case study. SAGE Open, 3(1), 1–16. https://doi.org/10.1177/2158244013492951
• Surbone, A., & Baider, L. (2010). The spiritual dimension of cancer care. Critical Reviews in Oncology/Hematology, 73(3), 228–235. https://doi.org/10.1016/j.critrevonc.2009.09.006
• Trombetta-Lima, M., Munhoz, T. N., Figueiredo, B., et al. (2021). Pre-natal attachment and parent-to-infant attachment: A systematic review. Frontiers in Psychology, 12, 620942. https://doi.org/10.3389/fpsyg.2021.620942
• Yılmaz, S. D., & Beji, N. K. (2010). Pregnant women’s levels of coping with stress, depression, and prenatal attachment, and the factors affecting these. Journal of General Medicine, 20(3). https://search.trdizin.gov.tr/tr/yayin/detay/132172