About this trial
Pregnancy is a period of comprehensive adaptation for a woman in physiological, psychological, and social terms. During this process, physical and mental transformations occur due to hormonal changes; multifaceted changes emerge, such as adopting the role of motherhood, developing a new sense of identity, and adapting to increased responsibilities. These changes during pregnancy affect not only the mother but also the fetus. Especially from the 26th week of pregnancy onwards, with the development of the fetus's auditory and sensory perception capacity, a process of reciprocal interaction begins between mother and fetus. This early interaction forms the basis of prenatal bonding.Prenatal bonding is a dynamic process involving behaviors such as the mother developing emotional closeness towards the fetus, talking to it, making contact, and preparing for care. This bonding directly affects the post-natal mother-baby relationship. However, prenatal bonding is influenced by many factors such as anxiety, stress, history of psychiatric illness, pregnancy complications, socioeconomic status, social support, and previous pregnancy experiences. Women who have experienced prenatal loss (abortion, stillbirth, neonatal death) frequently experience increased anxiety, stress, and difficulty bonding in subsequent pregnancies. High levels of uncertainty, fear, and anxiety in these individuals can negatively impact both the pregnancy and postpartum periods. The literature indicates that women who have experienced prenatal loss have lower levels of prenatal bonding and increased risks of anxiety and depression compared to those who have had healthy pregnancies. Increased stress and anxiety during the prenatal period have also been shown to be associated with negative outcomes such as low birth weight, premature birth, and neurodevelopmental problems. Therefore, supporting psychological well-being during pregnancy is critically important.In this context, interventions aimed at strengthening the bond between mother and fetus are gaining importance. Haptonomy, as a touch-based approach, is a holistic method that supports the establishment of emotional bonds between mother, father, and fetus. This method aims to develop trust-based communication by prioritizing the physical and emotional acceptance of the individual's presence. In haptonomy practices, the goal is for expectant mothers to first increase their own bodily and emotional awareness, and then to establish a conscious interaction with the fetus. Studies show that haptonomy reduces stress, anxiety, and fear of childbirth in pregnant women, while increasing prenatal bonding levels. It is also reported to have positive effects on newborns, improving their adaptation to environmental stimuli. However, the number of studies on haptonomy is limited, and research is needed, particularly focusing on its effects in pregnant women who have experienced prenatal loss. The aim of this research is to examine the effect of haptonomy on prenatal bonding and anxiety levels in pregnant women who have experienced abortion. It is hypothesized that haptonomy may strengthen mother-fetus bonding by reducing negative emotions experienced during pregnancy after a loss. The findings are expected to contribute to evidence-based care approaches applicable to high-risk pregnancy groups.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Primiparous pregnant women with a history of abortion
Singleton pregnant women with a healthy pregnancy between 28 and 32 weeks
Women who conceived naturally
Pregnant women without psychiatric disorders
Disqualifiers
Pregnant women diagnosed with high-risk pregnancies during the study
Pregnant women who were included in the study but could not be reached
Pregnant women who did not continue with the treatment during the study
Trial design
Parallel
Treatments tested in this trial
Haptonomy
BehavioralThe intervention will be conducted at the antenatal clinic of a Training and Research Hospital. The training is planned to be conducted face-to-face in groups of 6-8 people in a suitable environment. Pregnant women included in the intervention group will receive a total of 5 haptonomy sessions, 2 sessions per week. Each haptonomy session is planned to last 45 minutes. Group rules will be determined before each training session begins. The training covers topics such as basic communication and bonding between mother and baby, energy work and visualization, baby communication through breathing techniques, baby communication through suggestion, and baby communication through touch techniques. The application program, determined according to the schedule, will continue until the last session is completed.
Treatment groups
Trial outcomes
Primary outcomes
Stirling Antenatal Anxiety Scale
Developed by Sinesi and colleagues in 2022, the Stirling Antenatal Anxiety Scale is used to assess the level of prenatal anxiety common in pregnant women. This scale is a 5-point Likert type and consists of 9 items. Scale responses are scored as follows: "never" = 0, "rarely" = 1, "sometimes" = 2, "frequently" = 3, "always" = 4. The Cronbach's Alpha coefficient is 0.88 in the original study and 0.87 in the Turkish validity and reliability study. The scale scores range from a minimum of 0 to a maximum of 36 points. A higher score indicates a higher level of anxiety experienced by pregnant women during the antenatal period.
Secondary outcomes
Prenatal Attachment Inventory
Developed by Müller in 1993, the Prenatal Attachment Inventory (PAI) is used to describe the emotions, thoughts, and situations experienced by women during pregnancy and to determine their level of attachment to the baby during the prenatal period. It consists of 21 items. Each item is scored on a 4-point Likert scale, ranging from 1 to 4: 1: Never, 2: Sometimes, 3: Frequently, 4: Always. The minimum score is 21, and the maximum is 84. A higher score indicates a higher level of attachment. In a validity and reliability study of the inventory by Dereli Yılmaz and Kızılkaya Beji (2013), the Cronbach Alpha value was found to be 0.84.
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