The maternal-fetal relationship: conceptualisation, measurement, and application in practice

Pregnancy and the transition to parenthood involve great psychological adaptation, including the development of the woman's relationship with her unborn child - the maternal-fetal relationship (MFR). MFR manifests in a woman's thoughts, feelings, attitudes and behaviours towards her developing baby. Routine psychosocial assessment increasingly features in maternity care. Some argue for assessment to include MFR to target interventions towards those judged to have 'sub-optimal' MFR, to improve health-related behaviours, and optimise parenting and the child's social and emotional development. There is, however, inconsistency in how MFR has been conceptualised, raising questions about what 'sub-optimal' MFR might look like, and a lack of evidence on its associated risks, and amenability to intervention. To consider the implications of MFR for health professionals and clinical practice we outline what is meant by MFR, how it may be measured, what MFR influences and is influenced by, and why and when MFR may be measured.