Pregnancy and subsequent motherhood are enjoyable and evolutionary events in the life of every woman [1] that make women undergo unwanted changes and these changes change their physical and mental needs [2]. The attachment of mother and baby is a warm, dynamic and emotional relationship between mother and baby [7] and is one of the main components of achieving maternal identity [8]. This emotional connection develops gradually over time [9]. This process begins before the baby is born and when the mother is aware of her pregnancy, and increases during pregnancy and continues until after delivery [10]. Therefore, it is necessary to pay attention to the factors that aggravate or reduce this issue. One of the most important factors in reducing the problems of this period is a suitable marital environment and having the emotional support of the spouse [14]. Support for those around us, defined as social support, is the understanding that the people we care about are important to us and will help us when we have a problem and make us feel good [15]. Having a sense of support from one's spouse has a positive effect on stressful issues in life and therefore has a positive effect on psychological and physical health [17]. Counseling Support for Couples-centeredness as a Short-Term Treatment Approach [29] with the aim of reducing postpartum marital conflicts by increasing couples 'communication skills and increasing spouses' support for new mothers in the postpartum period can lead to improving marital relationships, increasing the quality of mental and physical health of mothers and the attachment of mother and baby [30, 29]. The present study was designed and conducted with the aim of determining the effect of counseling on couple-centered support on understanding spousal support and mother-infant attachment in 2018-19.
 

The randomized clinical trial study was conducted in 2018-2019 in Urmia city, Iran. A group of 108 nulliparous women randomly allocated in intervention (54) and control (54) groups. The intervention group received 6 sessions of intervention based on spouse intervention and the control group received routine care. Data collection tools were personal information form, Spousal Support Perceived Questionnaire, and Maternal Baglanma Olcegi Questionnaire. Kolmogorov-Smirnov test, independent t-test and paired t-test were used.

Our results showed that the two groups were statistically similar in demographic features. According to the results, mean scores of perception of spouse support and attachment of mother and infant after counseling in intervention group were statistically significant compared with control group (P<0.05). In the intervention group, there was a statistically significant difference between the mean scores of spouse support and maternal attachment with infant before and after the intervention (P<0.05).

Table 1. Quantitative characteristics of spouse support variables and mother and infant attachment in two groups of intervention and control

The aim of this study was to investigate the effect of couple-centered support counseling on understanding spousal support and maternal and infant attachment. There was a significant increase in counseling and training compared to couples who had not been counseled and educated [35]. In confirmation of the results of the present study in the three dimensions of understanding spousal support (emotional, informational, instrumental) in this study in the emotional dimension, we can refer to Weis's study, which concluded that in the reassuring or encouraging the person will result in cognition of the presence of a supporter [36]. Other similar studies in McKee et al. showed that the presence of a partner with a pregnant woman and hearing positive sentences from the partner about pregnancy can provide adequate emotional support for pregnancy and postpartum period [37]. According to a study by Bost et al., the greater the volume of access to support resources, the easier it will be for women to adjust to the needs of the postpartum period and how to provide them [38]. Unequivocal studies on spousal support include the study of Donnellan, Bennett, and Soulsby, which showed that spousal and family support is not always sufficient. Also, in Sabiha Yedirira's study, there was no relationship between instrumental support and information about spouse support dimensions with marital satisfaction; however, in this study, there was a relationship between emotional support of spouse and expression of marital satisfaction [43]. Other inconsistent studies included Reid and Taylor's study, which found that support was beneficial for all women, but insufficient to deal with post-labor stress [44].

 

The results of the present study had a positive effect on couple-centered support counseling on increasing spousal support for new mothers and increasing maternal and neonatal attachment in first-born women. Using the results of this study, researchers suggest that health workers and other members of the healthcare group who are in contact with the mothers giving birth, use this type of counseling to increase spouses' support for the new mother and promote maternal mental health and increase the mother's attachment to the newborn. Born as a simple, inexpensive, and enjoyable home-based technique, they use part-time postpartum care to take steps to improve maternal and child health.


 

This article is the result of the dissertation of the master's degree student of midwifery counseling, approved by Urmia University of Medical Sciences with the code of ethics Ir.umsu.rec.1397.275 dated 9/7/1397. Researchers hereby thank the Vice Chancellor for Research of the University, professors and other esteemed staff of the Faculty of Nursing, Midwifery, as well as the selected health and medical centers of Urmia for their sincere cooperation.

 

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.