Adult attachment at the transition to motherhood: predicting worry, health care utility and relationship functioning

Abstract

Primary objective: To study (a) the associations between attachment styles, worry, and care utilisation in third trimester of first pregnancy (n = 567) and (b) the associations between third trimester attachment style and one year postpartum relationship satisfaction and parenting stress (n = 1069). Based on Bowlby’s attachment theory, we expected attachment anxiety and attachment avoidance to differ with regard to short-term appraisal of threat and interpersonal neediness, while the dimensions were expected to have similar deteriorating effect on longer-term outcomes in relationship functioning. Research design: A cross-sectional study nested within a randomised controlled trial. Methods and procedures: An assessment battery consisting of three scales at T1 and T2. Main outcome and results: Results confirmed that attachment anxiety was significantly associated with high pregnancy worry compared to attachment avoidance. None of the dimensions were associated with health care utility. Both attachment anxiety and attachment avoidance were associated with high parenting stress at one year postpartum, while only attachment anxiety was associated with low relationship satisfaction. Conclusion: These findings partly confirm conceptual distinctions between the two attachment dimensions, and point to adult attachment as an important factor in understanding the ways women cope with the challenges during the transition to motherhood.

Keywords:

• adult attachment
• transition to parenthood
• worry
• health care utility
• relationship functioning

Acknowledgements

This study was supported by grants from the Egmont Foundation, the Health Insurance Foundation, the National Board of Health, the Augustinus Foundation, and the Danish Midwifery Association.

We are indebted to all the women who took part in the study and to the midwives who collected the data.