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UBC Theses and Dissertations

A methodological investigation of maternal-infant bonding Painter, Susan Lee 1978

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A METHODOLOGICAL INVESTIGATION OF MATERNAL-INFANT BONDING by SUSAN LEE PAINTER B.A.,„New Y o r k U n i v e r s i t y , 1969 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF THE FACULTY OF GRADUATE STUDIES Department o f P s y c h o l o g y We a c c e p t t h i s t h e s i s as c o n f o r m i n g t o the r e q u i r e d s t a n d a r d THE UNIVERSITY OF BRITISH COLUMBIA May, 1978 '(p*) Susan Lee P a i n t e r , 1978 MASTER OF ARTS i n In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of Brit ish Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the Head of my Department or by his representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of PRvrbnlosv The University of Brit ish Columbia 2075 W e s b r o o k P l a c e V a n c o u v e r , C a n a d a V6T 1W5 D a t e May 26, 1978 i i ABSTRACT A m e t h o d o l o g i c a l i n v e s t i g a t i o n o f m a t e r n a l - i n f a n t b o n d i n g was u n d e r -t a k e n w i t h t h e p u r p o s e o f d e v e l o p i n g i n s t r u m e n t s and measures f o r s t u d y i n g m a t e r n a l a t t a c h m e n t . The r e s e a r c h was l o n g i t u d i n a l , b a s e d upon t h e b e l i e f t h a t t h e bond between a mother and h e r i n f a n t d e v e l o p s g r a d u a l l y , b e g i n n i n g b e f o r e t h e i n f a n t ' s b i r t h and c o n t i n u i n g t h r o u g h t h e e a r l y p o s t p a r t u m p e r i o d and on i n t o i n f a n c y . E x i s t i n g r e s e a r c h on m a t e r n a l b e h a v i o u r , w h i c h has grown o u t o f t h e t h r e e f i e l d s o f d e v e l o p m e n t a l p s y c h o l o g y , e t h o l o g y and p e d i a t r i c s , was found t o be l i m i t e d i n scope and l a c k i n g i n adequate t o o l s f o r m e a s u r i n g n a t u r a l l y o c c u r r i n g m a t e r n a l - i n f a n t i n t e r a c t i v e b e h a v i o u r . The p r e s e n t r e s e a r c h was an a t t e m p t t o e x t e n d and improve upon e x i s t i n g r e s e a r c h by making a p r e l i m i n a r y e x p l o r a t i o n o f b o t h t h e w i d e range o f i n f l u e n c e s upon t h e m a t e r n a l - i n f a n t bond and t h e e q u a l l y w i d e range o f m a n i f e s t a t i o n s o f t h a t bond, a t t i t u d i n a l as w e l l as b e h a v i o u r a l . The i m p l i c i t model used as a b a s i s f o r t h i s r e s e a r c h was a c u m u l a t i v e one, i n w h i c h m a t e r n a l b e h a v i o u r i s v i e w e d as a r e s p o n s e n o t o n l y t o c o n c u r r e n t e v e n t s b u t t o p a s t e v e n t s as w e l l , and p r e s e n t b e h a v i o u r i s i n t u r n t h o u g h t t o i n f l u e n c e e v e n t s y e t t o come. The t i m e span under s t u d y was t h e two-month p e r i o d f r o m t h e l a s t month o f pregnancy t h r o u g h t h e f i r s t month o f t h e i n f a n t ' s l i f e . Twenty-seven p r i m i p a r o u s women were i n t e r v i e w e d d u r i n g t h e i r t h i r d t r i m e s t e r o f p r e g -nancy and q u e s t i o n n a i r e s c o n c e r n i n g p r e n a t a l a t t i t u d e s were a d m i n i s t e r e d ( P r e n a t a l Q u e s t i o n n a i r e and I n f a n t Temperament P r e d i c t i o n ) . I n f o r m a t i o n about l a b o u r , d e l i v e r y and t h e p o s t p a r t u m h o s p i t a l s t a y was t a k e n from h o s p i t a l r e c o r d s a f t e r t h e b i r t h . W h i l e i n h o s p i t a l , mothers f i l l e d o u t i i i t h e H o s p i t a l D i a r y , i n w h i c h t h e amount o f ti m e s p e n t w i t h t h e i n f a n t each day was r e c o r d e d . A t one month p o s t p a r t u m , q u e s t i o n n a i r e s were a g a i n a d m i n i -s t e r e d ( P o s t p a r t u m Q u e s t i o n n a i r e and I n f a n t Temperament R e p o r t ) , and a n a t u r a l i s t i c o b s e r v a t i o n o f m o t h e r - i n f a n t i n t e r a c t i v e b e h a v i o u r was made i n the' home ( B e h a v i o u r Record),. A f t e r t h e home v i s i t t h e o b s e r v e r f i l l e d o u t a s e t . o f e i g h t e e n M a t e r n a l Care R a t i n g S c a l e s d e v e l o p e d by A i n s w o r t h . Of t h e seven i n s t r u m e n t s used i n t h i s s t u d y , s i x were d e v e l o p e d s p e c i f i c a l l y f o r t h i s r e s e a r c h . The P r e n a t a l Q u e s t i o n n a i r e a d m i n i s t e r e d i n the t h i r d t r i m e s t e r o f pregnancy a s s e s s e d m a t e r n a l f e e l i n g s t o w a r d t h e p r e g -nancy, e x p e r i e n c e s i n p r e n a t a l c l a s s e s , s u p p o r t o f t h e husband o r p a r t n e r , p r e p a r a t i o n f o r l a b o u r and d e l i v e r y , c h i l d c a r e arrangements and p r e d i c t i o n o f p a r e n t - i n f a n t a t t a c h m e n t . The P o s t p a r t u m Q u e s t i o n n a i r e , w h i c h was f i l l e d o u t when t h e i n f a n t was one month o l d , was c o n c e r n e d w i t h l a b o u r and d e l i v e r y e x p e r i e n c e s , s u p p o r t o f husband o r p a r t n e r , s e l f - c o n f i d e n c e i n c a r e g i v i n g a b i l i t y , c a r e g i v i n g r o u t i n e s and r e p o r t o f p a r e n t - i n f a n t a t t a c h m e n t . The I n f a n t Temperament P r e d i c t i o n ( a d m i n i s t e r e d i n t h e p r e n a t a l p e r i o d ) was c o n -c e r n e d w i t h the a n t i c i p a t i o n o f i n f a n t b e h a v i o u r i n s p e c i f i c s i t u a t i o n s ; t h e I n f a n t Temperament R e p o r t ( a t one month p o s t p a r t u m ) was c o n c e r n e d w i t h m a t e r n a l r e p o r t o f a c t u a l i n f a n t b e h a v i o u r i n t h o s e same s i t u a t i o n s . The B e h a v i o u r R e c o r d was an o b s e r v a t i o n a l s y s t e m w h i c h employed f i f t e e n - s e c o n d t i m e i n t e r v a l s ; t w e n t y - e i g h t m a t e r n a l and seven i n f a n t b e h a v i o u r s were r e -co r d e d f o r one h o u r . These i n d i v i d u a l b e h a v i o u r c a t e g o r i e s were subsumed under n i n e b e h a v i o u r a l c o m p o s i t e s w h i c h were d e t e r m i n e d a. p r i o r i . The M a t e r n a l Care R a t i n g S c a l e s s e r v e d as a m o l a r assessment o f m a t e r n a l a t t i t u d e , e m o t i o n a l i n v o l v e m e n t and p e r c e p t i o n o f i n f a n t c a p a b i l i t y . D a t a g a t h e r e d u s i n g t h e s e i n s t r u m e n t s p r o v i d e d e v i d e n c e t h a t b o t h change and c o n t i n u i t y c h a r a c t e r i z e t h e development o f t h e m a t e r n a l - i n f a n t bond. Amid a g e n e r a l l a c k o f c o r r e l a t i o n i n m a t e r n a l a t t i t u d e s between t h e i v prenatal and postpartum periods, some areas assessed showed evidence of continuity. S p e c i f i c a l l y , the p r e d i c t i o n of parent-infant attachment i n the prenatal period was found to be correlated not only with postpartum report of attachment but also with observed s o c i a l - i n t e r a c t i v e ; as opposed to simply caregiving, behaviour at one month postpartum. The lack of c o r r e l a t i o n between the Infant Temperament P r e d i c t i o n and Report provided a d d i t i o n a l support for the general evidence of change from the prenatal to the: postpartum period. Neither the information taken from h o s p i t a l records, i . e . , length of labour, p e r i n a t a l medication, type of d e l i v e r y or i n f a n t outcome, nor the time spent with the infant i n h o s p i t a l during the,post-partum h o s p i t a l stay was found to be correlated with prenatal or postpartum att i t u d e s or with observed maternal behaviour at one month postpartum. It was concluded that evidence has been provided to support the notion that maternal-infant bonding should be studied l o n g i t u d i n a l l y i n order to trace the gradual development of that bond; i n addition, evidence has been provided that the mother-infant bond should be studied using assessments of both attitudes and a c t u a l , observable maternal behaviour. TABLE OF CONTENTS I n t r o d u c t i o n 1 Methods 41 R e s u l t s and D i s c u s s i o n 56 C o n c l u s i o n 115 R e f e r e n c e s . , 124 T a b l e s 135 A p p e n d i x 167 v i TABLES I . P r e n a t a l Q u e s t i o n n a i r e : Demographic V a r i a b l e s 135 I I . P r e n a t a l Q u e s t i o n n a i r e : C o r r e l a t i o n s Among R e p o r t e d P h y s i c a l and E m o t i o n a l F e e l i n g s 136 I I I . P r e n a t a l Q u e s t i o n n a i r e : R e p o r t e d P h y s i c a l P roblems 137 IV. P r e n a t a l Q u e s t i o n n a i r e : C o r r e l a t i o n s Among Items A s s e s s i n g F e e l i n g s Toward t h e Pregnancy 138 V. P r e n a t a l Q u e s t i o n n a i r e : C o r r e l a t i o n s Among Items A s s e s s i n g S u pport o f Husband 139 V I . P r e n a t a l Q u e s t i o n n a i r e : Items I n c l u d e d i n F a c t o r A n a l y s i s .140 V I I . P r e n a t a l Q u e s t i o n n a i r e : E i g e n v a l u e s and P e r c e n t V a r i a n c e A c c o u n t e d F o r i n Ten F a c t o r S o l u t i o n 142 V I I I . P r e n a t a l Q u e s t i o n n a i r e : F a c t o r s and R o t a t e d F a c t o r L o a d i n g s . . . 143 IX. I n f a n t Temperament P r e d i c t i o n and R e p o r t : C h i - S q u a r e T e s t s on P r o p o r t i o n o f S u b j e c t s R e s p o n d i n g i n Each C a t e g o r y 145 X. B e h a v i o u r R e c o r d : I n d i v i d u a l B e h a v i o u r Means, S t a n d a r d D e v i a t i o n s , F r e q u e n c i e s and I n t e r - O b s e r v e r Agreement 146 X I . C o r r e l a t i o n s Among t h e M a t e r n a l Composites 148 X I I . C o r r e l a t i o n s Among M a t e r n a l Composites and P r e n a t a l Q u e s t i o n n a i r e I t ems. . 150 X I I I . C o r r e l a t i o n s Among M a t e r n a l R a t i n g S c a l e Items 152 XIV. C o r r e l a t i o n s Between M a t e r n a l R a t i n g S c a l e s and M a t e r n a l Composites 155 XV. C o r r e l a t i o n s Between M a t e r n a l R a t i n g S c a l e s and I n f a n t B e h a v i o u r and I n f a n t Outcome 157 XV I . C o r r e l a t i o n s Between M a t e r n a l R a t i n g S c a l e s and Some P r e n a t a l Q u e s t i o n n a i r e I tems. 158 X V I I . P o s t p a r t u m Q u e s t i o n n a i r e : C o r r e l a t i o n s Among P h y s i c a l and E m o t i o n a l F e e l i n g s 161 X V I I I . P o s t p a r t u m Q u e s t i o n n a i r e : R e p o r t e d P h y s i c a l P roblems 162 XIX. P o s t p a r t u m Q u e s t i o n n a i r e : C o r r e l a t i o n s Among P a r e n t - I n f a n t A t t a c h m e n t Items 163 XX. P o s t p a r t u m Q u e s t i o n n a i r e : C o r r e l a t i o n s Between P a r e n t - I n f a n t A t t a c h m e n t Items and Ot h e r P o s t p a r t u m V a r i a b l e s 164 v i i TABLES (Cont'd) XXI . C o r r e l a t i o n s Between P o s t p a r t u m Q u e s t i o n n a i r e Items and M a t e r n a l R a t i n g S c a l e s 165 v i i i ACKNOWLEDGEMENTS I w i s h t o acknowledge t h e f o l l o w i n g p e o p l e who have h e l p e d t o make t h i s r e s e a r c h p o s s i b l e : T a n n i s MacBeth W i l l i a m s , f o r h e r c o n t i n u i n g s u p p o r t and encouragement; M i c h a e l C h a n d l e r and Rod Wong, f o r t h e i r h e l p and p a t i e n c e ; E v e r e t t W a t e r s , f o r h i s h e l p f u l a d v i c e a t t h e b e g i n n i n g o f t h i s p r o j e c t ; Sheena M. D a v i d s o n , f o r h e r g r e a t a s s i s t a n c e t h r o u g h o u t o u r c o l l a b o r a t i o n ; L e s l e y J o y , f o r e n d l e s s d a t a c o l l e c t i o n and r e l i a b i l i t y s e s s i o n s , and f o r s u p p o r t a l l a l o n g ; V i r g i n i a Green, L e w i s James and Susanna N e u f e l d , f o r t h e i r s t a t i s t i c a l a d v i c e and help; w i t h d a t a a n a l y s i s . A l s o , t h e Canada C o u n c i l , f o r s u p p o r t d u r i n g t h i s r e s e a r c h ; H e a l t h and W e l f a r e Canada, f o r s u p p o r t o f some o f t h e r e s e a r c h i n c l u d e d h e r e ; S t . P a u l ' s H o s p i t a l and t h e Vancouver C h i l d b i r t h A s s o c i a t i o n , f o r t h e i r h e l p f u l c o o p e r a -t i o n ; and a g r e a t debt i s owed t o t h e f a m i l i e s , who gave f r e e l y o f t h e i r t i m e and s h a r e d t h e i r l i v e s w i t h me. F i n a l l y , Amanda, Sweet Pea, t h e M u f f i n and C a l l i e A.P.B., w i t h o u t whom I would s t i l l be on S a l t s p r i n g I s l a n d . And o f c o u r s e , D e l o r e s , f o r h u r l i n g p l e a s u r e a t d e s p a i r . 1 The s t u d y o f m a t e r n a l b e h a v i o u r a f f o r d s an o p p o r t u n i t y t o i n v e s t i g a t e i n d e t a i l the f o r m a t i o n and maintenance o f a u n i q u e a f f e c t i o n a l b o n d — t h e r e l a t i o n s h i p o f t h e mother t o h e r i n f a n t . F o r n e a r l y a decade d e v e l o p m e n t a l p s y c h o l o g i s t s have been c a l l i n g f o r r e - f o c u s i n g c o n s i d e r a t i o n t o w a r d t h e r e c i p r o c a l , i n t e r a c t i v e n a t u r e o f t h e p a r e n t - i n f a n t r e l a t i o n s h i p (R.Q. B e l l , 1968; 1974; L e w i s & Rosenblum, 1 9 7 4 ) . T h i s c a l l has e n c o u r a g e d r e s e a r c h e r s t o abandon t h e t r a d i t i o n a l u n i d i r e c t i o n a l c a u s e - e f f e c t model i n w h i c h p a r e n t a l b e h a v i o u r i s s t u d i e d m a i n l y i n o r d e r t o a s s e s s i t s i m p a c t upon i n f a n t development, and has d i r e c t e d a t t e n t i o n towards t h e i n f a n t as an a c t i v e p a r t i c i p a n t i n t h e r e l a t i o n s h i p ( G o l d b e r g , 1977). I t i s i r o n i c t h a t one consequence o f t h i s r e c o g n i t i o n o f t h e i n f a n t ' s s o c i a l competence i n s h a p i n g the m o t h e r - i n f a n t r e l a t i o n s h i p has been a r e l a t i v e n e g l e c t o f t h e o t h e r f o r c e s w h i c h i n f l u e n c e t h e mother's b e h a v i o u r . I t i s i m p o r t a n t t o n o t e t h a t m a t e r n a l b e h a v i o u r i s r e l a t i o n a l i n i t s v e r y n a t u r e ; t h a t i s , " m a t e r n a l " n e c e s s a r i l y i m p l i e s t h e e x i s t e n c e o f a n o t h e r p e r s o n . B e h a v i o u r , a t t i t u d e s and emotions can be termed m a t e r n a l o n l y when t h e y a r e d i r e c t e d t o w a r d a n o t h e r p e r s o n . Thus i t i s n e c e s s a r y t o s t u d y m a t e r n a l b e h a v i o u r i n a r e l a t i o n a l c o n t e x t . C u r r e n t i n f a n t b e h a v i o u r i s o f c o u r s e an i n f l u e n c e , and i t i s t h a t i n f l u e n c e w h i c h has r e c e i v e d t h e major s h a r e o f a t t e n t i o n i n a t t e m p t s t o d i s e n t a n g l e t h e s t r a n d s o f t h e m o t h e r - i n f a n t r e l a t i o n s h i p . As a r e s u l t , o t h e r i n f l u e n c e s w h i c h a r e b o t h i n t r i n s i c and e x t r i n s i c t o t h e r e l a t i o n s h i p have n o t been g i v e n a dequate c o n s i d e r a t i o n . These o t h e r i n f l u e n c e s would i n c l u d e t h e mother's p a s t h i s t o r y o f i n t e r p e r s o n a l r e l a t i o n s h i p s ; h e r c u l t u r a l and s u b c u l t u r a l e x p e c t a t i o n s o f t h e m a t e r n a l r o l e and m a t e r n a l b e h a v i o u r ; p s y c h o l o g i c a l and p h y s i o l o g i c a l f a c t o r s r e s u l t i n g f r o m h e r p r e g n a n c y , l a b o u r and d e l i v e r y , and t h e a c t u a l h i s t o r y o f t h e m o t h e r - i n f a n t r e l a t i o n s h i p b e g i n n i n g a t t h e b i r t h o f t h e i n f a n t . 2 A r e l a t i v e l y r e c e n t a r e a o f r e s e a r c h d e s i g n a t e d as " m a t e r n a l - i n f a n t b o n d i n g " ( K l a u s & K e n n e l l , 1976) has i n v o l v e d a t t e m p t s t o d e a l w i t h t h e i m p a c t o f t h e m o t h e r - i n f a n t r e l a t i o n s h i p upon t h e mother, and d e t a i l s o f some a s p e c t s o f m a t e r n a l b e h a v i o u r and m o t h e r - i n f a n t i n t e r a c t i o n have been s t u d i e d . T h i s r e s e a r c h , w h i c h has r e c e i v e d a g r e a t d e a l o f a t t e n t i o n i n b o t h t h e p r o f e s s i o n a l l i t e r a t u r e and t h e p o p u l a r p r e s s has been f o c u s e d on t h e e a r l y n e o n a t a l p e r i o d , e s p e c i a l l y t h e f i r s t few hours a f t e r t h e i n f a n t ' s b i r t h . One v a r i a b l e f r o m t h i s p e r i o d w h i c h has r e c e i v e d much emphasis i s t h e o c c u r r e n c e o f p h y s i c a l s e p a r a t i o n o f mother and ne o n a t e s h o r t l y a f t e r t h e b i r t h , e i t h e r as a r e s u l t o f b i r t h c o m p l i c a t i o n s ( s u c h as p r e m a t u r i t y o r c a e s a r i a n s e c t i o n , f o r e x a m p l e ) , o r t h r o u g h r o u t i n e h o s p i t a l p o l i c y . Thus t h e f o c u s o f t h i s r e s e a r c h has been upon m a t e r n a l b e h a v i o u r p a t t e r n s d u r i n g t h e e a r l y p o s t - p a r t u m p e r i o d ( e . g . , K l a u s , J e r a u l d , K r e g e r , M c A l p i n e , S t e f f a & K e n n e l l , 1972; K l a u s , K e n n e l l , Plumb & Z u e h l k e , 1970; K l a u s & K e n n e l l , 1970; K l a u s , T r a u s e & K e n n e l l , 1975), and t h e i n f l u e n c e o f p o s t p a r t u m s e p a r a t i o n on t h e su b s e q u e n t c o g n i t i v e development o f t h e c h i l d ( R i n g l e r , J a r v e l l a , N a v o j o s k y & K l a u s , 1975). I n one s t u d y , t h e m o t h e r - i n f a n t p a i r was f o l l o w e d t h r o u g h t h e f i r s t f i v e y e a r s o f t h e c h i l d ' s l i f e ( R i n g l e r , T r a u s e & K l a u s , 1976). A few r e s e a r c h e r s have q u e s t i o n e d t h e c o n c l u s i o n s drawn by t h e s e i n v e s t i g a t o r s ( e . g . , Dunn, 1975; L o z o f f , 1977) and one has a s s e r t e d t h a t " t h e emphasis on t h e immediate p o s t - p a r t u m p e r i o d may o b s c u r e t h e i m p o r t a n c e o f p r e n a t a l i n f l u e n c e s and p o s t n a t a l a d a p t a t i o n s " ( L o z o f f i n K l a u s & K e n n e l l , 1976, p. 85). The r e s u l t s o f o t h e r s t u d i e s p r o v i d e s u p p o r t f o r t h e i d e a t h a t m a t e r n a l b e h a v i o u r i s s t r o n g l y a f f e c t e d by p r e n a t a l a t t i t u d e s ( H u b e r t , 1974), and by e a r l y e x p e r i e n c e s w i t h t h e i n f a n t (Robson & Moss, 1970). The r e s e a r c h d e s c r i b e d i n t h i s paper was d e s i g n e d as an i n i t i a l a t t e m p t 3 to deal with the complexity of the early mother-infant r e l a t i o n s h i p . The i n t r i n s i c complexity of t h i s problem i s r e f l e c t e d i n the wide range of issues which must be considered when i n v e s t i g a t i n g questions i n th i s area. The study of maternal behaviour and early mother-infant i n t e r a c t i o n has three l o g i c a l entry points from three separate f i e l d s of study. (1) Developmental Psychologists have studied the attachment r e l a t i o n s h i p between mother and in f a n t , and although the t r a d i t i o n a l focus of that research has been the e f f e c t s of the attachment r e l a t i o n s h i p upon the socioemotional development of the i n f a n t , recent work has acknowledged the part played by maternal behaviour i n e s t a b l i s h i n g and maintaining that r e l a t i o n s h i p (e.g., Ainsworth, 1973; Weinraub & Lewis, 1975). (2) Ethologists have contributed a large body of information concerning maternal behaviour of animals i n both n a t u r a l i s t i c and experimental s i t u a t i o n s which has helped to c l a r i f y some human maternal behaviour patterns. (3) Work by p e d i a t r i c i a n s interested i n both neonatal behaviour and the genesis of parenting disorders such as c h i l d abuse has led to close scrutiny of modern o b s t e t r i c and p e d i a t r i c p r a c t i c e s and t h e i r impact upon the emerging mother-infant r e l a t i o n s h i p . The contributions of each of these f i e l d s to the study of maternal behaviour and the concept of maternal bonding w i l l be outlined by reviewing the relevant l i t e r a t u r e i n each area. Then an i n t e g r a t i o n of these three areas w i l l be made, and the present research, which focuses upon methodological considerations for the study of the maternal-infant a f f e c t i v e bond, w i l l be introduced. I. Contributions of Developmental Psychology The network of re l a t i o n s h i p s between the infant and those i n h i s or her environment forms the matrix through which the neonate develops into a f u l l y functioning s o c i a l being (Richards, 1974; Weinraub, Brooks & Lewis, 1975). Recognition of the importance of these r e l a t i o n s h i p s f o r l a t e r development, 4 b o t h c o g n i t i v e (S.M. B e l l , 1970; D e c a r i e , 1965; E s c a l o n a , 1953) and s o c i o - e m o t i o n a l ( A i n s w o r t h , 1969; Y a r r o w & P e d e r s e n , 1972), has l e d t o i n c r e a s i n g l y d e t a i l e d r e s e a r c h i n t o t h e i r n a t u r e . The main body o f t h e work has grown o u t o f m a t e r n a l d e p r i v a t i o n s t u d i e s i n w h i c h t h e t r a u m a t i c s e p a r a t i o n o f mothers and c h i l d r e n d u r i n g w a r t i m e o r f a m i l y c r i s e s was i n v e s t i g a t e d . C o n c l u s i o n s were drawn about t h e n a t u r e o f t h e m o t h e r - c h i l d r e l a t i o n s h i p b a s e d on b e h a v i o u r o b s e r v e d d u r i n g and subsequent t o t h e s e d r a m a t i c e v e n t s ( R o b e r t s o n & Bowlby, 1952; S p i t z , 1945). W i t h t h e s u p p o r t o f p r i m a t e r e s e a r c h ( H a r l o w , 1961; H a r l o w & H a r l o w , 1962), r e s e a r c h e r s o f human b e h a v i o u r c o n c l u d e d t h a t p r o t r a c t e d s e p a r a t i o n f r o m t h e mother, and thus t h e r u p t u r i n g o f t h e m o t h e r - c h i l d bond, had e x t e n s i v e d e t r i m e n t a l e f f e c t s upon t h e p e r s o n a l i t y o f t h e young c h i l d . L e a d i n g d i r e c t l y f r o m work on m a t e r n a l d e p r i v a t i o n , John Bowlby p r o p o s e d a t h e o r y o f a t t a c h m e n t t h a t w o u l d a c c o u n t f o r t h e a f f e c t i o n a l bond between mother and c h i l d ( Bowlby, 1958). Based on e t h o l o g y and e v o l u t i o n a r y p r i n c i p l e s , i t had as i t s h a l l m a r k p r o x i m i t y - s e e k i n g and p r o x i m i t y - m a i n t a i n i n g b e h a v i o u r on t h e p a r t o f t h e i n f a n t w h i c h w o u l d c o n t r i b u t e t o s p e c i e s s u r v i v a l . There has been a g r e a t d e a l o f r e s e a r c h on at t a c h m e n t i n t h e twenty y e a r s s i n c e Bowlby f o r m u l a t e d h i s t h e o r y and i n v e s t i g a t o r s have a l i g n e d t h e m s e l v e s i n v a r i o u s t h e o r e t i c a l camps, b a s i n g t h e i r r e s e a r c h on c o g n i t i v e p r i n c i p l e s ( e . g . , L i t t e n b e r g , T u l k i n , & Kagan, 1971), d e v e l o p m e n t a l t h e o r i e s o f s o c i a l r e l a t i o n s h i p s ( e . g . , B e r n a l , 1974; Weinraub, Brooks & L e w i s , 1975), o r t a k i n g a "mainstream" a p p r o a c h , t h a t i s , f o l l o w i n g Bowlby ( e . g . , A i n s w o r t h , 1967; S c h a f f e r & Emerson, 1964). R e s e a r c h i n t h e a r e a o f a t t a c h m e n t / m o t h e r - i n f a n t i n t e r a c t i o n has been c h a r a c t e r i z e d by a l a c k o f consensus r e g a r d i n g measurement, and each r e s e a r c h team has f o r m u l a t e d s p e c i f i c s e t s o f b e h a v i o u r s t o use as measures of t h e a t t a c h m e n t bond. Whatever t h e t h e o r e t i c a l l e a n i n g s o f t h e l a r g e numbers o f 5 d e v e l o p m e n t a l p s y c h o l o g i s t s i n t e r e s t e d i n a t t a c h m e n t , a l l seem t o a g r e e t h a t t h e m o t h e r - i n f a n t r e l a t i o n s h i p i s c h a r a c t e r i z e d as a r e c i p r o c a l , i n t e r a c t i v e s y s t e m embedded i n t i m e ( A i n s w o r t h , 1969; 1973; L e w i s , 1972; Moss, 1967). What, e x a c t l y , does t h i s mean, and what a r e t h e i m p l i c a t i o n s f o r e m p i r i c a l r e s e a r c h ? Bowlby's e a r l y v i e w s on a t t a c h m e n t c o n c e n t r a t e d on t h e p r o x i m i t y - p r o m o t i n g b e h a v i o u r s o f the i n f a n t (Bowlby, 1958), w h i l e n e g l e c t i n g somewhat t h e i n t e r a c t i v e components. S c h a f f e r and Emerson (1964) a l s o c o n c e n t r a t e d on t h e i n f a n t i n t h e i r d e f i n i t i o n o f a t t a c h m e n t as " t h e t e n d e n c y o f t h e young t o seek t h e p r o x i m i t y o f c e r t a i n o t h e r members o f t h e s p e c i e s " (p.6). As e m p i r i c a l r e s e a r c h began t o y i e l d c l e a r - c u t e v i d e n c e o f t h e i n f l u e n c e o f m a t e r n a l b e h a v i o u r on t h e att a c h m e n t bond, t h e d e f i n i t i o n o f t h e co n c e p t began t o change, and b o t h t h e o r e t i c a l and o p e r a t i o n a l d e f i n i t i o n s were m o d i f i e d by some r e s e a r c h e r s t o i n c l u d e m a t e r n a l b e h a v i o u r . Thus, A i n s w o r t h (1973) has d e f i n e d a t t a c h m e n t as "an a f f e c t i o n a l t i e t h a t one p e r s o n forms t o a n o t h e r p e r s o n , b i n d i n g them t o g e t h e r i n spac e and e n d u r i n g o v e r t i m e " ( p . l ) . Y a r r o w and P e d e r s e n (1972) r e f e r t o a t t a c h m e n t as "a r e l a t i o n s h i p c h a r a c t e r i z e d by s t r o n g i n t e r d e p e n d e n c e and i n t e n s e a f f e c t " , t h e development o f w h i c h i s "a r e c i p r o c a l i n t e r a c t i v e p r o c e s s " (p. 302). Thus i t i s e x p l i c i t l y acknowledged t h a t t h e a t t a c h m e n t r e l a t i o n s h i p i n v o l v e s two p e o p l e who c o n t r i b u t e a f f e c t and b e h a v i o u r t o t h e o n g o i n g p r o c e s s and whose b e h a v i o u r and a f f e c t a r e i n t u r n i n f l u e n c e d by t h e i n t e r a c t i o n w i t h i n t h e r e l a t i o n s h i p . The r e l a t i o n s h i p , w h i c h endures o v e r t i m e , i s c o n t i n u a l l y a l t e r e d as a f u n c t i o n o f t h e b e h a v i o u r a l and a f f e c t i o n a l e v e n t s o c c u r r i n g w i t h i n t h e r e l a t i o n s h i p . P r e s e n t b e h a v i o u r a l p a t t e r n s ( i . e . , t h o s e o b s e r v e d i n e m p i r i c a l r e s e a r c h ) a r e a f f e c t e d by e a r l i e r i n t e r a c t i v e p a t t e r n s , and go on t o a f f e c t s u b sequent p a t t e r n s . 6 Time is very much an element of the mother-infant dyad. In nearly a l l of the attachment l i terature , however, "time" has been assumed to start at the bi r th of the infant when observable interaction begins. As i t turns out many researchers do not begin observations of mother-infant pairs u n t i l well Into the f i r s t quarter of the f i r s t year. Given that the interactive process is continually building on earl ier events, the neglect of the f i r s t two months and the even more widespread ignoring of the prenatal and early neonatal period appears to have rather serious implications for the v a l i d i t y of attachment research. A further c r i t i c ism which can be lodged against attachment theory as a f u l l account of the mother-infant relationship is that the mother is seen merely as the object of the infant 's behaviour. Maternal behaviour is not accorded an independent status; there is l i t t l e attempt to explain or account for the patterns and antecedents of maternal behaviour, or to deal with the exigencies of the mother's l i f e which affect her relationship and interaction with her infant. Although Bowlby has acknowledged the contribution of the mother as a blend of native endowment, history of interpersonal relations, and absorption of the values and practices of the culture (Bowlby, 1969), neither he nor his associates have dealt with these elements as i f they were meaningful components of the attachment bond. A brief review of attachment theory w i l l make clear what a limited part maternal behaviour is thought to play in the formation of the infant-mother attachment bond. Attachment theory The ethological approach to attachment as formulated by Bowlby (1958) reflected a growing interest of developmental psychology in behavioural systems for which the observable behaviour is an outward manifestation of inner organization, and for which the context of behaviour i s not only the 7 e x t e r n a l e n v i r o n m e n t b u t a l s o t h e i n t e r n a l e n v i r o n m e n t — t h e n e u r o p h y s i o l o g i c a l s t a t e o f t h e o r g a n i s m ( A i n s w o r t h , 1 9 6 9 ) . T h i s a p p r o a c h grew out o f advances i n the b i o l o g i c a l s c i e n c e s , e s p e c i a l l y e t h o l o g y and g e n e t i c s , and o f r e c e n t f o r m u l a t i o n s o f c o n t r o l systems t h e o r y and computer models. The common i n t e r e s t o f t h e s e d i v e r s e f i e l d s i s t h e i n n e r s t r u c t u r e o f t h e o r g a n i s m , w i t h a t t e n t i o n f o c u s e d on the e f f e c t o f e n v i r o n m e n t a l i n f l u e n c e s ( b o t h i n t e r n a l and e x t e r n a l ) on n a t u r a l l y endowed p o t e n t i a l . A c c o r d i n g t o t h e systems t h e o r y m odel, t r a n s f o r m a t i o n and growth o f t h e o r g a n i s m a r e due t o o r g a n i s m - e n v i r o n m e n t i n t e r a c t i o n . The e s s e n c e o f Bowlby's c o n t r i b u t i o n s i s a t h e o r y o f s o c i a l r e l a t i o n s h i p s w h i c h combines t h i s model w i t h p s y c h o a n a l y t i c t h e o r y , t h u s t a k i n g advantage o f t h e c u r r e n t s t a t e o f knowledge i n p s y c h o l o g y and i n r e l a t e d f i e l d s such as e t h o l o g y and b i o l o g y . The b a s i s o f Bowlby's p o s i t i o n i s t h a t human a t t a c h m e n t b e h a v i o u r has b i o l o g i c a l f o u n d a t i o n s w h i c h can be b e s t u n d e r s t o o d w i t h i n t h e c o n t e x t o f e v o l u t i o n a r y t h e o r y . A c c o r d i n g l y , t h e most a d a p t i v e b e h a v i o u r p a t t e r n s a r e t h o s e t h a t promote s p e c i e s s u r v i v a l . The r e l a t i v e l y l o n g p e r i o d o f i n f a n t i l e h e l p l e s s n e s s c h a r a c t e r i s t i c o f t h e human s p e c i e s i s a s e r i o u s t h r e a t t o t h a t s u r v i v a l ; an i n f a n t who cannot be q u i c k l y and e a s i l y r e t r i e v e d by i t s mother endangers n o t o n l y i t s e l f b u t a l s o i t s mother who may, as a consequence, n o t l i v e t o p r o d u c e r e p l a c e m e n t o f f s p r i n g . R e c o g n i z i n g t h e o b v i o u s p o i n t t h a t t h e human s p e c i e s has s u r v i v e d i n s p i t e of i t s v u l n e r a b i l i t y , Bowlby h y p o t h e s i z e d t h a t t h e young o f t h e s p e c i e s a r e endowed w i t h a b e h a v i o u r a l s y s t e m w h i c h s e r v e s t o promote t h e p a r e n t a l a t t e n t i o n and c a r e g i v i n g b e h a v i o u r needed t o p r o t e c t t h e i n f a n t t h r o u g h i t s e x t e n d e d i m m a t u r i t y . A t t a c h m e n t b e h a v i o u r on t h e p a r t o f t h e i n f a n t would i n c l u d e v o c a l i z a t i o n , c r y i n g , s m i l i n g , l o o k i n g , p h y s i c a l l y a p p r o a c h i n g t h e p a r e n t o r i n i t i a t i n g a 8 p i c k - u p . The p r e d i c t e d outcome o f t h i s b e h a v i o u r a l s y s t e m i s t h e c l o s e p r o x i m i t y o f mother and i n f a n t , w h i c h i s a t t a i n e d , a c c o r d i n g t o Bowlby, t h r o u g h s i g n a l s o f t h e i n f a n t w h i c h c a l l f o r m a t e r n a l r e s p o n s e , o r , w i t h t h e development o f motor s k i l l s , t h r o u g h i n f a n t - i n i t i a t e d a c t i v i t y . Bowlby f a i l s t o d e a l d i r e c t l y w i t h t h e o b v i o u s t h i r d c h o i c e — a c t i v i t y i n i t i a t e d i n d e p e n d e n t l y by t h e mother. I n f a c t , m a t e r n a l b e h a v i o u r i s r a r e l y c o n s i d e r e d t o have i n d e p e n d e n t o r i g i n s , d e s p i t e t h e many a c t i v i t i e s w i t h w h i c h t h e mother must become i n v o l v e d i n o r d e r t o m a i n t a i n h e r own and h e r i n f a n t ' s s u r v i v a l . The p r o v i s i o n o f f o o d and s h e l t e r a r e t h e mother's j o b wh e t h e r we a r e r e f e r r i n g t o t h e p e r i o d o f s p e c i e s e v o l u t i o n , o r t o t h e p r e s e n t t i m e , and t h a t j o b w i l l o f t e n i n t e r f e r e w i t h t h e mother's a v a i l a b i l i t y t o h e r i n f a n t . The mechanism r e s p o n s i b l e f o r t h e a c t i v a t i o n o f t h e p r o x i m i t y - p r o m o t i n g s y s t e m i s p o s i t e d by Bowlby as a complex s y s t e m and o f i t s e l f , t h e el e m e n t s o f w h i c h i n c l u d e t h e p h y s i c a l d i s t a n c e between mother and c h i l d , t h e i n t e r n a l s t a t e o f t h e i n f a n t , and el e m e n t s i n t h e e x t e r n a l e n v i r o n m e n t , s u c h as f e a r -o r c u r i o s i t y - e v o k i n g s t i m u l i . A g a i n , we see t h a t t h e mother's i n t e r n a l s t a t e i s n o t e x p l i c i t l y i n c l u d e d among t h e a c t i v a t i n g c o n d i t i o n s . One i m p o r t a n t r e a s o n why m a t e r n a l b e h a v i o u r i s l e f t o ut o f t h i s p i c t u r e may be t h e i n t r i n s i c c o m p l e x i t y o f i t s m o t i v a t i o n . T r a c i n g t h e a n t e c e d e n t s o f a s p e c i f i c m a t e r n a l b e h a v i o u r i n any g i v e n s i t u a t i o n , and a c c o u n t i n g f o r d i f f e r e n c e s i n t h a t s p e c i f i c b e h a v i o u r o v e r b o t h s i m i l a r and d i s s i m i l a r s i t u a t i o n s w o u l d r e q u i r e a taxonomy o f m a t e r n a l b e h a v i o u r t h a t was u n a v a i l a b l e t o Bowlby and t h a t r e s e a r c h e r s today s t i l l l a c k . The t o p i c o f m a t e r n a l b e h a v i o u r has grown i n t o a f i e l d o f s t u d y i t s e l f , and Bowlby i s n o t t o be u n d u l y f a u l t e d f o r c o n c e n t r a t i n g o n l y on i n f a n t b e h a v i o u r and assuming some s t a b i l i t y i n m a t e r n a l r e s p o n s e s y s t e m s . I t does appear now, however, 9 that some attention must be paid to both i n d i v i d u a l differences and to systematic population differences ( i . e . , c u l t u r a l , socioeconomic, etc.) i n maternal behaviour i f the construct of attachment, which ult i m a t e l y involves two people, i s to have continued meaning for researchers wishing to study the mother-infant system. An issue which has been the topic of recurrent discussion i n the attachment l i t e r a t u r e (e.g., Ainsworth, 1969; Ainsworth, B e l l & Stayton, 1974; Bowlby, 1969; Lamb, 1974; Rosenthal, 1973; Sroufe & Waters, 1978) i s the d i s t i n c t i o n between the i n t e r n a l organization of an a f f e c t i o n a l system and i t s outward, observable behaviour. Since s i m i l a r issues w i l l undoubtedly a r i s e as the study of maternal behaviour continues, t h i s topic i s worth some atte n t i o n here. An attachment has been studied as an unobservable which can be known or observed through the medium of attachment behaviour. The d i s t i n c t i o n between attachment and attachment behaviour i s sometimes obscured, and the energy with which the argument concerning i t has been pursued may be some measure of i t s presumed c e n t r a l i t y i n attachment theory. The main point of concern to those i n t e r e s t e d i n maternal behaviour i s that the attachment i t s e l f i s a t i e or r e l a t i o n s h i p ; i t i s a separate e n t i t y from the inner organization of attachment behaviour systems which controls s p e c i f i c observable behaviour v i s - a - v i s s p e c i f i c attachment figures ( c f . , Sroufe & Waters, 1978). Thus, while p a r t i c u l a r attachment behavours may be heightened or attenuated i n a s p e c i f i c s i t u a t i o n , the attachment as a re l a t i o n s h i p to a person remains s t a b l e . For example, a c h i l d may be e i t h e r strongly or weakly attached to i t s mother; the fac t that s/he may cry and c l i n g to the mother when a stranger approaches i s not a d i r e c t measurement of the strength of the attachment i t s e l f ; t h i s outward behaviour i s merely an i n d i c a t i o n that the system of attachment behaviours has been a c t i v a t e d . 10 A l t e r n a t i v e l y , using an example of maternal behaviour, a mother may pick up her i n f a n t and hold i t to her body i f the p a i r are i n some p h y s i c a l l y dangerous s i t u a t i o n . Her basic fe e l i n g s toward her c h i l d , that i s to say, her attachment, i s not changed by her behaviour, and cannot be measured by i t ; a l l that may be i n f e r r e d i s that her i n t e r n a l system of pr o t e c t i v e behaviour, was activated by the s i t u a t i o n . A f t e r observing t h i s behaviour, we cannot t e l l how attached she i s to her i n f a n t . Indeed, i t would not be unusual to observe a stranger behaving i d e n t i c a l l y toward the infant i n the same s i t u a t i o n , but we could not i n f e r a deep-seated, emotional involvement with the in f a n t from the stranger's behaviour; that i s , we could not assess the attachment of the stranger to the infant by observing her/his behaviour i n one p a r t i c u l a r s i t u a t i o n . I t has been asserted that attachment i s stable and enduring through time while attachment behaviours are va r i a b l e i n q u a l i t y , exhibited i n t e r m i t t e n t l y and determined by the inner state of the organism and the external state of the environment (Ainsworth, 1973). I t i s because t h i s d i s t i n c t i o n i s made by attachment t h e o r i s t s that attachment i s not considered to be an incremental construct, i . e . , that more infant attachment behaviour indicates a stronger i n f a n t attachment. In f a c t , there may be evidence to the contrary: i n some cases continual e x h i b i t i o n of heightened attachment behaviour on the part of an infant or young c h i l d has been regarded as an i n d i c a t i o n of a weak or insecure attachment (Ainsworth, 1969; 1973; Ainsworth, B e l l & Stayton, 1974). The idea that maternal attachment and maternal attachment behaviour could be negatively r e l a t e d , or at le a s t may not be p o s i t i v e l y r e l a t e d , has not been explored by researchers of maternal behaviour. To return to the r o l e of maternal behaviour i n the theory of attachment, we f i n d that Ainsworth (1969) has set the stage f o r acknowledging both 11 m a t e r n a l and i n f a n t c o n t r i b u t i o n s t o t h e e s t a b l i s h m e n t o f t h e i r r e l a t i o n s h i p by s t a t i n g : G e n e t i c programming c o n t i n u e s t o b i a s the i n f a n t t o behave i n ways a d a p t e d t o t h e o r i g i n a l e n v ironment o f e v o l u t i o n a r y a d a p t e d n e s s , and s i m i l a r l y , under a l l t h e l a y e r s o f i n d i v i d u a l l e a r n i n g and c u l t u r a l a c q u i s i t i o n , t h e r e i s s t i l l a b i a s f o r mothers t o behave r e c i p r o c a l l y — a b i a s w h i c h may have been more o r l e s s s h a r p e n e d or b l u n t e d by l e a r n i n g i n any i n d i v i d u a l mother. ( p . 1000) A l t h o u g h t h e b i o l o g i c a l p r e d i s p o s i t i o n on the p a r t o f t h e mother t o w a r d c a r e g i v i n g and p r o t e c t i o n has been made an i n t r i n s i c p a r t o f t h e a t t a c h m e n t s y s t e m , t h i s has n o t been e x p l i c i t l y acknowledged i n d i s c u s s i o n s o f a t t a c h m e n t . The r o l e o f t h e mother i s o f t e n seen as a c o r o l l a r y t o t h e i n f a n t ' s ; t h e p o i n t h e r e i s t h a t a t t a c h m e n t b e h a v i o u r on t h e p a r t o f b o t h mother and i n f a n t a r e e s s e n t i a l t o the e s t a b l i s h m e n t o f t h e a t t a c h m e n t r e l a t i o n s h i p . Bowlby c h a r a c t e r i z e d m a t e r n a l b e h a v i o u r as " r e c i p r o c a l " t o i n f a n t b e h a v i o u r ; t h u s m a t e r n a l " r e t r i e v i n g " b e h a v i o u r i s deemed r e c i p r o c a l t o i n f a n t a t t a c h m e n t b e h a v i o u r i n t h a t b o t h t o g e t h e r have t h e b i o l o g i c a l f u n c t i o n o f p r o t e c t i n g the i n f a n t f r o m danger. However, Bowlby l e a v e s t h e q u e s t i o n o f t h e mother's r o l e i n t h e s y s t e m l a r g e l y u n e x p l o r e d ; h i s main f o c u s i s on t h e e s t a b l i s h e d a t t a c h m e n t r e l a t i o n s h i p between a young c h i l d and i t s mother ( A i n s w o r t h , 1969). The f a c t t h a t m a t e r n a l b e h a v i o u r has n o t been t r a d i t i o n a l l y e x p l o r e d f o r i t s c o n t r i b u t i o n t o t h e a t t a c h m e n t r e l a t i o n s h i p n e ed n o t d i s s u a d e us f r o m l o o k i n g a t a t t a c h m e n t t h e o r y f r o m t h e m a t e r n a l p o i n t o f v i e w . From a b i o l o g i c a l and e v o l u t i o n a r y s t a n d p o i n t , i t makes sense t h a t a s y s t e m o f m a t e r n a l a t t a c h m e n t might o p e r a t e t o keep t h e mother i n p r o x i m i t y t o h e r i n f a n t , t o compel h e r t o c o n t i n u e n u r t u r i n g and n o u r i s h i n g t h e i n f a n t , t o keep h e r aware o f t h e i n f a n t ' s whereabouts when she i s n o t i n p r o x i m i t y and keep h e r a t t u n e d t o t h e i n f a n t ' s s i g n a l s . I n the absence o f a m a t e r n a l p r e d i s p o s i t i o n t o behave i n ways t h a t promote t h e s e outcomes, t h e 12 b e h a v i o u r a l b i a s e s on the p a r t o f t h e i n f a n t p o s i t e d by a t t a c h m e n t t h e o r i s t s w o u l d be l e s s t h a n f u n c t i o n a l . Not o n l y must t h e i n f a n t be a b l e t o c r y f o r i t s mother t o come i f i t i s c o l d , hungry o r f r i g h t e n e d , b u t t h e mother must be a b l e t o l i s t e n f o r t h e i n f a n t ' s c r y , d i s t i n g u i s h i t f r o m o t h e r n o i s e s and f r o m t h e c r i e s o f o t h e r i n f a n t s , know where t h e d i s t r e s s e d i n f a n t i s and go t o i t s a i d w i t h o u t d e l a y . The a c c o m p l i s h m e n t o f t h e s e t a s k s r e q u i r e s t h e c o o r d i n a t i o n o f complex a u d i t o r y , v i s u a l and k i n e s t h e t i c s y s t e m s , t h e a c t i v a t i o n o f t h e s e systems and t h e s u p p r e s s i n g o f i m p u l s e s t o r e s p o n d t o d i s t r a c t i n g s t i m u l i . As we s h a l l see i n t h e f o l l o w i n g s e c t i o n , t h i s c o o r d i n a t i o n o f m a t e r n a l b e h a v i o u r i s a c c o m p l i s h e d by a n i m a l mothers and human mothers a l i k e . B u t i n t h e human mother, t h e r e i s s o m e t h i n g more, s o m e t h i n g o v e r r e a c h i n g t h e mere o r g a n i z a t i o n o f b e h a v i o u r a l s y s t e m , s o m e t h i n g w h i c h Yarrow & P e d e r s e n (1972) have termed an " i n t e n s e a f f e c t " w h i c h c h a r a c t e r i z e s t h e mother's r e l a t i o n s h i p t o h e r i n f a n t and w h i c h s e r v e s t o b i n d h e r t o him and t o o r i e n t b o t h h e r b e h a v i o r a l and h e r a f f e c t i o n a l systems t o w a r d him. T h i s i n t e n s e a f f e c t i s n o t t r a n s i t o r y i n n a t u r e , i t i s n o t momentary, i t i s n o t m e r e l y a c t i v a t e d by an extreme s i t u a t i o n s u c h as the a p p r o a c h o f danger. R a t h e r , i t may be thought o f as a p r o m i s e n o t o n l y t o n u r t u r e and c a r e f o r t h e i n f a n t t o d a y , b u t t o c o n t i n u e n u r t u r i n g and c a r i n g f o r t h e d e v e l o p i n g i n f a n t f o r many y e a r s t o come, t h r o u g h s l e e p l e s s n i g h t s , t h r o u g h i l l n e s s , t h r o u g h t h e " t e r r i b l e t w o s " , and on i n t o c h i l d h o o d and beyond. I t i s a p r o m i s e t o behave w i t h t h e same u n c o n d i t i o n a l c a r i n g and l o v e t h r o u g h good t i m e s and bad, f o r b e t t e r o r f o r w o r s e , so t o speak. Because a p r o m i s e i s by d e f i n i t i o n f u t u r e - o r i e n t e d , we s h o u l d n o t r e q u i r e t h a t s p e c i f i c m a t e r n a l a t t a c h m e n t b e h a v i o u r s measured t o d a y be c o r r e l a t e d w i t h t h o s e measured tomorrow, o r w i t h a q u a l i t a t i v e measure o f m a t e r n a l a t t a c h m e n t i t s e l f , i f t h a t a t t a c h m e n t c o u l d be measured. What i s r e q u i r e d i n 13 o r d e r t o s t u d y m a t e r n a l a t t a c h m e n t i s a way o f m e a s u r i n g t h e s t r e n g t h o f t h e m a t e r n a l p r o m i s e , and a model w h i c h f i t s s p e c i f i c m a t e r n a l b e h a v i o u r s t o t h a t p r o m i s e . One s t e p t o w a r d d e v i s i n g t h a t model wou l d be an acknowledgement o f t h e c o m p l e x i t y o f t h e m a t e r n a l bond and o f t h e range of a t t i t u d e s and b e h a v i o u r w h i c h must be d e a l t w i t h i n o r d e r t o a p proach an adequate measure o f t h e bond i t s e l f . L e t us l e a v e t h i s d i s c u s s i o n now and e x p l o r e t h e o t h e r a r e a s o f s t u d y w h i c h c o n t r i b u t e i n f o r m a t i o n t o t h e r e s e a r c h e r s o f m a t e r n a l b e h a v i o u r , e t h o l o g y and p e d i a t r i c s . We w i l l r e t u r n t o t h i s d i s c u s s i o n o f t h e m a t e r n a l p r o m i s e w i t h a d d i t i o n a l i n f o r m a t i o n and i d e a s f r o m t h e s e two f i e l d s o f s t u d y . I I . C o n t r i b u t i o n s o f E t h o l o g y E t h o l o g i c a l r e s e a r c h has h e l p e d t o f o c u s a t t e n t i o n upon f o u r groups o f v a r i a b l e s w h i c h appear t o be r e l a t e d t o m a t e r n a l c a r e g i v i n g and p r o t e c t i v e b e h a v i o u r i n a n i m a l s : 1) i n f a n t v i s u a l , a u d i t o r y and b e h a v i o u r a l c u e s ; 2) m a t e r n a l b e h a v i o u r a l systems and c ues; 3) c o n d i t i o n s o f the b i r t h and r e a r i n g s i t u a t i o n s ; and 4) t h e r o l e o f hormones. These v a r i a b l e s a r e we11-interwoven, and even l a b o r a t o r y s t u d i e s have n o t a l w a y s been s u c c e s s f u l i n s e p a r a t i n g t h e i r e f f e c t s . The i m p o r t a n c e o f e t h o l o g i c a l r e s e a r c h i n b o t h f i e l d and l a b o r a t o r y has been t h e d e t a i l i n g o f a n i m a l m o t h e r i n g b e h a v i o u r w h i c h o c c u r s i n t h e absence of t h e k i n d o f e n d u r i n g a f f e c t i o n a l t i e s w h i c h can be c a l l e d upon t o e x p l a i n m a t e r n a l b e h a v i o u r i n humans. I n f a n t Cues A n i m a l s p e c i e s d i f f e r i n t h e m a t u r i t y o f t h e young a t b i r t h , and p a t t e r n s o f m a t e r n a l - i n f a n t r e l a t i o n s h i p s a r e a d a p t e d t o t h e l e v e l o f i n d e pendence o f t h e newborn: a l t r i c i a l s p e c i e s such as n e s t - b u i l d e r s and b u r r o w - d w e l l i n g a n i m a l s a r e f ound t o have a l o n g , i n t e n s e p e r i o d o f m a t e r n a l c a r e f o r t h e immature newborn, w i t h a s h o r t weaning p e r i o d and a b r u p t n a t u r a l 14 separation of mother and young; precocial species, such as herding and ground-living animals have a shorter i n i t i a l period of intense care followed by an extended weaning period and gradual separation of mother and infant which ends in the transition of the young to the status of member of the herd or group. In either case, whereas much of the burden of maintaining the physical contact necessary to promote infant survival f a l l s upon the mother, the infant is often equipped with a system to f a c i l i t a t e i n i t i a l and continuing contact. In ducks and geese, the young are imprinted to their mother within the f i r s t thirty-six hours of l i f e and are thus able to keep within the mother's nutritive and protective range (Hess 1958, 1972). In higher order animals such as the rhesus monkey, the infant is able to crawl from the birth canal to the mother's ventral surface immediately after birth, often with l i t t l e or no assistance from the mother (Mitchell, 1972) and cling to the mother's fur in order to maintain contact with her nipple (Harlow, 1961). The newborn kangaroo, which is barely more than a fetus and completely unable to sustain i t s e l f independently i s nevertheless able to crawl into i t s mother's pouch and attach i t s e l f to the nipple, where i t remains for an extended period to complete i t s development. Thus in many species, animal infants actively promote the mother-infant contact necessary for survival. There is some indication, however, that these independently-initiated behavioural patterns are important in e l i c i t i n g complementary maternal caregiving activity and that the mother-infant system is dependent upon the behaviour contributed by both partners. For example, the contact-clinging reflex of the infant rhesus has been found to stimulate cradling and i n i t i a t i o n of ventral contact (Harlow, Harlow, & Hansen, 1963; Seay, Alexander, and Harlow, 1964), and the absence of this contact-clinging by the infant results in the attenuation and eventual absence of maternal 15 c a r e g i v i n g b e h a v i o u r ( H a r l o w , H a r l o w , & Hansen, 1 9 6 3 ) . A n i m a l i n f a n t s a l s o e x h i b i t cues w h i c h s e r v e t o e l i c i t m a t e r n a l b e h a v i o u r . J ay ( 1 9 6 3 ) c i t e s v i s u a l cues s u c h as c o a t c o l o r , q u a l i t y o f movement and s i z e o f i n f a n t , as w e l l as t h e a u d i t o r y cues o f v o c a l i z a t i o n , t o a c c o u n t f o r m a t e r n a l r e s p o n s e s i n l a n g u r s . The mewing o f h e r k i t t e n s b r i n g s th e d o m e s t i c c a t t o h e r young i f she i s w i t h i n h e a r i n g r a n g e . A u d i t o r y and v i s u a l v a r i a b l e s s u c h as t h e s e a r e t h o u g h t t o be r e s p o n s i b l e f o r t h e i n t e n s i t y o f m a t e r n a l c a r e f o r young i n f a n t s , and t h e d e c r e a s e i n t h i s c a r e as t h e i n f a n t g e t s o l d e r and t h e c u e s , e s p e c i a l l y t h o s e o f c o l o r , s i z e and movement, change w i t h m a t u r i t y (DeVore, 1 9 6 3 ; J a y , 1 9 6 3 ) . I n l a b o r a t o r y s t u d i e s m a t e r n a l b e h a v i o u r has been shown t o be g r e a t e s t t o w a r d newborns and t o d e c r e a s e as o l d e r t e s t - i n f a n t s a r e p r e s e n t e d t o mice ( N o i r o t , 1 9 6 4 ) , h a m s t e r s ( N o i r o t & R i c h a r d s , 1 9 6 6 ; R i c h a r d s , 1 9 6 6 ) , and r a t s ( R o s e n b l a t t , 1 9 6 5 ) . V a r i b l e s s u c h as c o l o r , s i z e and movement may be f a c t o r s w h i c h e l i c i t m a t e r n a l b e h a v i o u r i n n u l l i p a r o u s f e m a l e s ( R o s e n b l a t t , 1 9 6 7 ; 1 9 6 9 ) and i n male and female a d u l t s (DeVore, 1 9 6 3 ; J a y , 1 9 6 3 ) . I n some s p e c i e s , a c o n s t e l l a t i o n o f i n f a n t cues must be p r e s e n t t o f o s t e r m a t e r n a l c a r e g i v i n g b e h a v i o u r . M a i e r ( 1 9 6 3 ) f o u n d t h a t a n e s t h e t i z a t i o n o f t h e hen's v e n t r a l s u r f a c e c a u s e d t h e f a i l u r e o f a p p r o p r i a t e m a t e r n a l r e s p o n s e s i n s p i t e o f t h e v i s u a l and a u d i t o r y cues p r o v i d e d by t h e p r e s e n c e o f t h e c h i c k s . M a t e r n a l b e h a v i o u r a l systems and cues F i e l d s t u d i e s have shown t h a t i n some c a s e s , m a t e r n a l cues a c t as e l i c i t o r s o f i n f a n t a t t a c h m e n t b e h a v i o u r s , j u s t as i n f a n t cues s e r v e t o e l i c i t m a t e r n a l c a r e g i v i n g b e h a v i o u r s . I n d u c k s , t h e mother a l t e r s h e r v o c a l i z a t i o n p a t t e r n s when she moves away from t h e n e s t so t h a t h e r d u c k l i n g s ar e s i g n a l l e d t o f o l l o w h e r (Hess, 1 9 5 8 ; 1 9 7 2 ) . I n h i g h e r - o r d e r mammals such as baboons and chimpanzees, v i s u a l , a u d i t o r y and b e h a v i o u r a l cues a r e 16 combined t o b r i n g i n f a n t s i n t o p r o x i m i t y t o t h e i r mothers when th e mother moves f r o m a f e e d i n g s p o t o r when danger t h r e a t e n s (De V o r e , 1 9 6 3 ) . C o n d i t i o n s o f b i r t h and r e a r i n g s i t u a t i o n s The r o l e s o f p a r t u i t i o n and the e x p e r i e n c e s s u r r o u n d i n g b i r t h i n the development and m a i n t e n a n c e o f m a t e r n a l b e h a v i o u r have been s t u d i e d i n two ways: by o b s e r v i n g a n i m a l s t h a t have undergone s u r g i c a l d e l i v e r y o f t h e i r young, o r by s e p a r a t i n g the mother f r o m h e r young a t d i f f e r e n t s t a g e s and f o r v a r y i n g p e r i o d s , and t h e n o b s e r v i n g m a t e r n a l b e h a v i o u r upon r e u n i o n . I n r a t s , d e l i v e r y by c a e s a r i a n s e c t i o n was n o t found t o a f f e c t the mother's r e s p o n s e t o h e r pups a f t e r h e r r e c o v e r y f r o m s u r g e r y ( R o s e n b l a t t , i n K l a u s & K e n n e l l , 1 9 7 6 ) ; however, r a t s d e l i v e r i n g n o r m a l l y who had t h e i r pups removed i m m e d i a t e l y a f t e r b i r t h d i d n o t r e s p o n d t o t e s t - p u p s p r e s e n t e d s e v e r a l weeks l a t e r , i n c o n t r a s t w i t h r a t s a l l o w e d t o keep t h e i r pups f o r as l i t t l e as t h i r t y m i n u t e s a f t e r b i r t h , who t h e n d i d respond t o t h e l a t e r p r e s e n t a t i o n o f t h e t e s t - p u p s ( B r i d g e s , 1975). Thus i n r a t s i t appears t h a t c o n t a c t w i t h t h e young i n t h e immediate p o s t p a r t u m p e r i o d i s i m p o r t a n t i n e l i c i t i n g and m a i n t a i n i n g m a t e r n a l b e h a v i o u r . The concept o f a c r i t i c a l p e r i o d f o r m a t e r n a l b e h a v i o u r has been used t o d e s c r i b e t h i s s i t u a t i o n , and t h e p a r a m e t e r s o f t h i s c r i t i c a l p e r i o d a r e h y p o t h e s i z e d t o d i f f e r a c r o s s s p e c i e s . I n b i o l o g i c a l r e s e a r c h a c r i t i c a l p e r i o d i s one i n w h i c h c e r t a i n s t r u c t u r e s , p h y s i o l o g i c a l o r b e h a v i o u r a l , must d e v e l o p i n o r d e r f o r t h e o r g a n i s m o r u n i t t o become f u l l y f u n c t i o n i n g . I f e v e n t s o r c o n d i t i o n s i n t e r f e r e w i t h t h e development o f t h e s e s t r u c t u r e s a t t h e c r i t i c a l p e r i o d , t h e i r u l t i m a t e f a i l u r e t o d e v e l o p has i m p a c t upon t h e subsequent s u c c e s s o f t h e o r g a n i s m . The c o n c e p t o f a c r i t i c a l p e r i o d i n t h e development o f t h e m o t h e r - i n f a n t r e l a t i o n s h i p has been a d o p t e d by some r e s e a r c h e r s who s t u d y human mothers and i n f a n t s , a l t h o u g h c o n c e p t has been s o f t e n e d somewhat t o a " s e n s i t i v e p e r i o d " . 17 T h i s w i l l be d i s c u s s e d i n more d e t a i l i n a l a t e r s e c t i o n . E t h o l o g i c a l work has shown some a d d i t i o n a l f a c t o r s w h i c h may i n t e r a c t w i t h a c r i t i c a l p e r i o d t o c r e a t e b o t h i n t e r - and i n t r a - s p e c i e s d i f f e r e n c e s i n m a t e r n a l b e h a v i o u r . S a c k e t t and R u p p e n t h a l (1974) have shown t h a t l a b o r a t o r y - r e a r e d monkeys d e l i v e r e d by c a e s a r i a n s e c t i o n and s e p a r a t e d f r o m t h e i r i n f a n t s f o r two h o u r s r e f u s e d t o a c c e p t t h e i r young by the t h i r d day p o s t p a r t u m ; w h e r e a s , f e r a l - r e a r e d monkeys who underwent c a e s a r i a n s e c t i o n and s e p a r a t i o n a c c e p t e d t h e i r i n f a n t s by t h e second day. The d i f f e r e n c e between l a b o r a t o r y and f e r a l monkeys a r e e x p l a i n e d as a f u n c t i o n o f r e a r i n g c o n d i t i o n s o f t h e mother h e r s e l f , and t h e work o f H a r l o w and H arlow (1966) showing t h a t m o t h e r l e s s monkeys f a i l t o e x h i b i t m a t e r n a l b e h a v i o u r t o t h e i r own o f f s p r i n g s u p p o r t s t h i s e x p l a n a t i o n . However, th e a c t u a l mechanisms r e s p o n s i b l e f o r the f a i l u r e have n o t been c l e a r l y d e l i n e a t e d . The mere s e p a r a t i o n o f mother and young a f t e r n o r m a l d e l i v e r y has been shown t o a f f e c t l a t e r m a t e r n a l b e h a v i o u r and the degree of e f f e c t depends upon th e t i m i n g and l e n g t h of s e p a r a t i o n . I n r a t s , s e p a r a t i o n o f a few days b e g i n n i n g i m m e d i a t e l y a f t e r b i r t h r e s u l t s i n a t t e n u a t i o n o f n u r s i n g , r e t r i e v i n g and n e s t b u i l d i n g b e h a v i o u r s ( R o s e n b l a t t & Lehrman, 1963; R o s e n b l a t t , 1969). I n g o a t s , s e p a r a t i o n o f one t o t h r e e h o u r s i m m e d i a t e l y a f t e r b i r t h was f o l l o w e d by m a t e r n a l r e j e c t i o n upon r e u n i o n , whereas t h e same amount of s e p a r a t i o n b u t w i t h f i v e m i n u t e s of c o n t a c t a f t e r b i r t h was f o l l o w e d by a c c e p t a n c e of t h e young upon r e u n i o n ( K l o p f e r , 1971). C o l l i a s (1956), a l s o w o r k i n g w i t h g o a t s , showed t h a t s e p a r a t i o n of goat and k i d f o r l e s s t h a n one h o u r b e g i n n i n g s h o r t l y a f t e r b i r t h was f o l l o w e d by a c c e p t a n c e o f t h e young by the mother, whereas s e p a r a t i o n of more th a n one hour was f o l l o w e d by r e j e c t i o n . I n monkeys, S a c k e t t and h i s c o l l e a g u e s have f o u n d s e v e r a l v a r i a b l e s w h i c h appear t o a f f e c t a f e m a l e ' s a t t r a c t i o n toward i n f a n t s ( S a c k e t t & R u p p e n t h a l , 1974). N o r m a l l y , n u l l i p a r o u s f e m a l e s a r e a t t r a c t e d t o 18 t e s t - n e o n a t e s . Monkey mothers s e p a r a t e d from t h e i r i n f a n t s f o r one t o t w e n t y - f o u r h o u r s a f t e r b i r t h were f o u n d t o p r e f e r c o n t a c t w i t h n e o n a t e s o v e r c o n t a c t w i t h a d u l t s ; t h o s e s e p a r a t e d l o n g e r f a i l t o show a p r e f e r e n c e f o r newborns. Normal mothers who r e a r t h e i r own i n f a n t s and a r e s e p a r a t e d f r o m them p r e f e r t h e i r own i n f a n t s t o o t h e r i n f a n t s o r t o a d u l t s ; t h o s e who have r e a r e d s e v e r a l i n f a n t s s e r i a l l y show no p r e f e r e n c e f o r t h e i r b i o l o g i c a l o f f s p r i n g o v e r o t h e r i n f a n t s t h e same age. M o t h e r l e s s mothers r e a r e d i n l a b o r a t o r i e s , i n c o n t r a s t t o f e r a l - r e a r e d m o t h e r s , show no a t t r a c t i o n t o n e o n a t e s , and i n d e e d a r e g e n e r a l l y a b e r r a n t i n t h e i r b e h a v i o u r toward n e o n a t e s even a f t e r a t t a i n i n g the m u l t i p a r o u s s t a t u s w h i c h w o u l d cause a n o r m a l l y - r e a r e d mother t o be h i g h l y a t t r a c t e d t o newborns. One v e r y i n t e r e s t i n g f i n d i n g f r o m t h i s s e r i e s o f e x p e r i m e n t s by S a c k e t t & R u p p e n t h a l i s t h a t f e m a l e s who r e a r t h e i r i n f a n t s i n c o n f i n e d c o n d i t i o n s w h i c h do n o t a l l o w t h e mother t o i n t e r a c t w i t h a n i m a l s o t h e r t h a n h e r own i n f a n t show much l o w e r l e v e l s o f a t t r a c t i o n s toward i n f a n t s t h a n do mothers who have had a c c e s s t o o t h e r a n i m a l s and o p p o r t u n i t y t o i n t e r a c t w i t h them d u r i n g the r e a r i n g p e r i o d . One cannot h e l p b u t t h i n k of t h e human mother, i s o l a t e d w i t h h e r i n f a n t i n h e r house o r a p a r t m e n t , who l o n g s f o r a d u l t company t o h e l p h e r get t h r o u g h t h e day. Thus we f i n d t h a t m a t e r n a l p a r i t y , t h e r e a r i n g c o n d i t i o n s of t h e mother h e r s e l f , l o s s of c o n t a c t w i t h t h e i n f a n t and m a t e r n a l s o c i a l e n v i r o n m e n t have a l l been shown t o a f f e c t a monkey mother's m a t e r n a l b e h a v i o u r . A d o p t i o n s t u d i e s , i n w h i c h a f e m a l e i s i n t r o d u c e d t o young n o t h e r own, have been u n d e r t a k e n i n an a t t e m p t t o e x p l o r e v a r i a b l e s r e l a t i n g t o a k i n d of t h r e s h o l d o f m a t e r n a l b e h a v i o u r . I n l a b o r a t o r y r a t s , a female w h i c h has been l a c t a t i n g f o r one day a f t e r t h e d e l i v e r y o f h e r own young i s more l i k e l y t o s u c c e s s f u l l y adopt a l i e n pups ( t h a t i s , t o behave i n a manner t h a t promotes 19 th e s u r v i v a l o f t h e adopted young) t h a n i s a female w h i c h i s a l s o l a c t a t i n g b u t i s t e n days p o s t p a r t u m ( G r o t a , 1968). The e l a p s e d t i m e f r o m p a r t u r i t i o n , t h e n , a p pears t o a f f e c t t h e s u c c e s s o f t h e a d o p t i o n . I n d o m e s t i c c a t s , t h e s i z e o f t h e l i t t e r and time o f i n t r o d u c t i o n t o t h e a d o p t i v e mother (whose own k i t t e n s have been removed a t b i r t h ) i n f l u e n c e s a d o p t i v e b e h a v i o u r : a s i n g l e k i t t e n was s u c c e s s f u l l y a d o p t e d up u n t i l f i f t e e n days a f t e r t he b i r t h and immediate r e m o v a l o f t h e mother's own k i t t e n s ; a l i t t e r o f t h r e e was s u c c e s s f u l l y a d o p t e d i f i n t r o d u c e d b e f o r e t h e f i f t e e n t h day, b u t a t t a c k e d and a v o i d e d i f i n t r o d u c e d a f t e r t h e f i f t e e n t h day ( S c h n e i r l a , R o s e n b l a t t & Tobach, 1963). I n g o a t s , a l i e n young a r e n o r m a l l y b u t t e d away, b u t a goat can be made t o adopt a k i d i f mother and k i d a r e i s o l a t e d f r o m t h e h e r d and th e mother i s p r e v e n t e d f r o m b u t t i n g ( H e r s h e r , Richmond & Moore, 1963). There i s e v i d e n c e t h a t t h e b e h a v i o u r o f t h e young i s a l s o a v a r i a b l e i n t h e s u c c e s s o f t h e a d o p t i o n : c a t s w i l l n o t adopt a k i t t e n w h i c h shows e c c e n t r i c b e h a v i o u r ( S c h n e i r l a , R o s e n b l a t t & Tobach, 1963), even under o p t i m a l c o n d i t i o n s ; r h e s u s monkeys have been o b s e r v e d t o abandon a t t e m p t s t o adopt an i n f a n t who r e f u s e d c o n t a c t o r a k i t t e n who was u n a b l e t o c l i n g t o t h e a d o p t i n g mother (Harlow, H a r l o w & Hansen, 1963). The r o l e o f hormones The mechanisms u n d e r l y i n g m a t e r n a l b e h a v i o u r have been t r a d i t i o n a l l y a s s i g n e d t o hormonal c o n d i t i o n , and hormonal changes b e f o r e , d u r i n g and a f t e r p a r t u r i t i o n have been shown t o a f f e c t a f e m a l e ' s e x h i b i t i o n o f c a r e g i v i n g b e h a v i o u r t o w a r d newborns. Female ha m s t e r s and r a t s show i n c r e a s i n g c a r e g i v i n g b e h a v i o u r when p r e s e n t e d w i t h t e s t - n e w b o r n s a t t h r e e s t a g e s : non-pregnant females show l e s s c a r e g i v i n g b e h a v i o u r t h a n p r e g n a n t f e m a l e s , who show l e s s t h a n l a c t a t i n g f e m a l e s ; t h i s t r e n d i s r e v e r s e d i f t h e p r e g n a n c y i s t e r m i n a t e d ( R i c h a r d s , 1966; R o s e n b l a t t , 1969). V i r g i n r a t s and mic e 20 i n j e c t e d w i t h b l o o d p l a s m a f r o m newly d e l i v e r e d f e m a l e s e x h i b i t m a t e r n a l b e h a v i o u r t o w a r d t e s t - i n f a n t s ( R i c h a r d s , 1966; T e r k e l & R o s e n b l a t t , 1968). The f a c t t h a t p r i m a t e s who have j u s t g i v e n b i r t h p r e f e r t o v i e w newborns r a t h e r t h a n a d u l t s has been a t t r i b u t e d t o hormonal f a c t o r s by H a r l o w and h i s a s s o c i a t e s ; t h i s p r e f e r e n c e has been shown t o d e c r e a s e i f the new mother i s s e p a r a t e d f r o m h e r young ( C r o s s and H a r l o w , 1963). Thus f a r , however, p r i m a t o l o g i s t s have n o t d i s t i n g u i s h e d t h e e f f e c t s o f hormones f r o m t h o s e o f s e p a r a t i o n , so t h e c o n c l u s i o n t h a t hormones a r e i n v o l v e d i s o n l y r e a s o n a b l e s p e c u l a t i o n . C r o s s - t r a n s f u s i o n r e s e a r c h , i n w h i c h t h e b l o o d o f v i r g i n , p r e g n a n t and newly d e l i v e r e d f e m a l e r a t s i s mix e d , shows t h a t s u b s t a n c e s i n the b l o o d d u r i n g a l i m i t e d t i m e around p a r t u i t i o n i n d u c e s m a t e r n a l b e h a v i o u r t o w a r d t e s t - n e o n a t e s ( T e r k e l & R o s e n b l a t t , 1972). I t appears t h a t a r i s e i n e s t r a d i o l , a h o r m o n a l s u b s t a n c e s e c r e t e d j u s t b e f o r e p a r t u r i t i o n , accompanies p r e p a r t u m n e s t - b u i l d i n g and r e t r i e v i n g b e h a v i o u r and may be r e s p o n s i b l e f o r t h e o n s e t o f m a t e r n a l b e h a v i o u r i n r a t s ( R o s e n b l a t t & S e i g e l , 1975). I t s h o u l d be n o t e d t h a t a r i s e i n e s t r a d i o l i n human females s h o r t l y b e f o r e p a r t u r i t i o n has been found by T u r n b u l l and h i s c o l l e a g u e s ( T u r n b u l l , P a t t e n , F l i n t , K e i r s e , Jeremy & A n d e r s o n , 1974). The i n t e r a c t i o n o f hormonal f a c t o r s and t h e p r e s e n c e o f the young ap p e a r s t o a f f e c t p o s t p a r t u m m a t e r n a l b e h a v i o u r and i t has been arg u e d t h a t t h e mechanisms r e s p o n s i b l e f o r human m a t e r n a l b e h a v i o u r s h i f t f r o m i n t e r n a l ( i . e . , hormonal) t o e x t e r n a l ones ( K l a u s & K e n n e l l , 1976). whether o r n o t t h i s t r a n s i t o n c r e a t e s i n t h e human mother a s e n s i t i z a t i o n t o i n f a n t b e h a v i o u r a l c u e s , as K l a u s and K e n n e l l appear t o be a r g u i n g , i s s t i l l t o be d e t e r m i n e d . L e t us t u r n t o t h e l i t e r a t u r e c o n t r i b u t e d by m e d i c a l r e s e a r c h e r s i n t h e f i e l d o f p e d i a t r i c s w h i c h a d d r e s s e s some of t h e same i s s u e s as the 21 e t h o l o g i c a l l i t e r a t u r e , namely, s p e c i e s - s p e c i f i c m a t e r n a l b e h a v i o u r , i n f a n t and m a t e r n a l c u e s , t h e r o l e o f p a r t u r i t i o n and b i r t h e x p e r i e n c e s , and ho r m o n a l i n f l u e n c e s . I I I . C o n t r i b u t i o n s o f P e d i a t r i c s Human m a t e r n a l b e h a v i o u r i s a complex s y s t e m o f a t t i t u d e s , a f f e c t and a c t i o n s w h i c h a r i s e s f r o m an e q u a l l y complex s e t o f a n t e c e d e n t s , as does any human b e h a v i o u r s ystem. The mother's h i s t o r y o f i n t e r p r e r s o n a l r e l a t i o n s w i t h h e r own p a r e n t s , h e r husband, h e r c h i l d r e n and o t h e r s g i v e r i s e t o a c h a r a c t e r i s t i c s t y l e o f i n t e r a c t i o n as w e l l as t o a t t i t u d e s and e x p e c t a t i o n s about t h e q u a l i t y and c o n t e n t o f p e r s o n a l r e l a t i o n s h i p s ( K l a u s & K e n n e l l , 1970). I n a d d i t i o n , t h e p r a c t i c e s and v a l u e s o f h e r s o c i a l and c u l t u r a l m i l i e u c o n t r i b u t e a g r e a t d e a l t o t h e s p e c i f i c a t t i t u d e s and e x p e c t a t i o n s she has t o w a r d h e r new i n f a n t . I n t h e p a s t twenty y e a r s e s p e c i a l l y , t h e " c u l t o f C h i l d P s y c h o l o g y " (Newson & Newson, 1974) o f f e r s an u n e n d i n g s t r e a m o f i n f o r m a t i o n and a d v i c e about c h i l d r e n and c h i l d r e a r i n g w h i c h may be c o n s i s t e n t w i t h o r i n c o n f l i c t w i t h t h e v a l u e s t h e mother a l r e a d y h o l d s . The mother's b e h a v i o u r t o w a r d h e r newborn c h i l d i s a l s o a f f e c t e d by h e r a t t i t u d e s t o w a r d and e x p e c t a t i o n s o f pregnancy and c h i l d b i r t h , as w e l l as whether t h e pregnanc y was d e s i r e d ( H u b e r t , 1974). Her e x p e r i e n c e s w i t h p r e v i o u s p r e g n a n c i e s , b i r t h s and c h i l d r e a r i n g problems w i l l u n d o u b t e d l y c o l o r h e r a t t i t u d e s t o w a r d a new i n f a n t , and the e x i g e n c i e s of t h e needs and a c t i v i t i e s o f o l d e r c h i l d r e n w i l l have t h e i r e f f e c t upon h e r i n t e r a c t i o n w i t h h e r newest c h i l d ( L e w i s , 1976). I n a d d i t i o n , e x p e r i e n c e s d u r i n g h e r p r e s e n t p r e g n a n c y , e s p e c i a l l y t h r e a t o f m i s c a r r i a g e o r o t h e r m e d i c a l problems t h a t might r e s u l t i n l o s s o f t h e baby, have been shown t o a f f e c t t h e mother's b e h a v i o u r toward t h e i n f a n t once i t i s b o r n ( K l a u s & K e n n e l l , 1970). P r e m a t u r i t y i t s e l f has been t r e a t e d as an e m o t i o n a l c r i s i s w h e r e i n t h e a n t i c i p a t o r y g r i e f 2 2 e x p e r i e n c e d by t h e mother may i n t e r f e r e w i t h t h e e s t a b l i s h m e n t o f h e r r e l a t i o n s h i p t o h e r i n f a n t ( K a p l a n & Mason, 1 9 6 0 ) . C o n v e r s e l y , t h r e a t o f l o s s o f t h e i n f a n t m i ght h e i g h t e n t h e mother's a t t a c h m e n t t o him once he i s b o r n . Two f a c t o r s w h i c h may be c r u c i a l i n t h e development o f t h e m o t h e r - i n f a n t r e l a t i o n s h i p e s p e c i a l l y i n f i r s t p r e g n a n c i e s a r e t h e i n t e r a c t i o n o f t h e mother's knowledge and e x p e c t a t i o n s o f n e o n a t a l b e h a v i o u r w i t h t h e i n f a n t ' s a c t u a l b e h a v i o u r ( H u b e r t , 1 9 7 4 ) , and t h e e v e n t s o f t h e e a r l y p o s t - p a r t u m d a y s , i . e . , t h e way i n w h i c h h o s p i t a l p r a c t i c e s c o n s t r a i n t h e m o t h e r - i n f a n t r e l a t i o n s h i p ( K l a u s & K e n n e l l , 1 9 7 0 ) . Most o f t h e r e s e a r c h on t h e m a t e r n a l s i d e o f t h e m o t h e r - i n f a n t a t t a c h m e n t r e l a t i o n s h i p has been done by n e o n a t o l o g i s t s and p s y c h o l o g i s t s c o n c e r n e d w i t h t h e e f f e c t s o f s e p a r a t i n g newborn i n f a n t s f r o m t h e i r m o t h e r s , p r i m a r i l y i n t h e c a s e o f t h e p r e m a t u r e i n f a n t . T h i s a t t e n t i o n upon t h e e f f e c t s o f s e p a r a t i o n was s t i m u l a t e d by t h e r e s u l t s o f c o r r e l a t i o n a l s t u d i e s i n w h i c h samples o f p r e m a t u r e i n f a n t s , who were c a r e d f o r i n t h e i n t e n s i v e - c a r e n u r s e r y and thus s e p a r a t e d f r o m t h e i r mothers f o r l o n g p e r i o d s , were f o u n d l a t e r t o have d i s p r o p o r t i o n a t e l y h i g h r a t e s o f c h i l d abuse o r b a t t e r i n g (Elmer & Gregg, 1 9 6 7 ; K l e i n & S t e r n , 1 9 7 1 ; O l i v e r , Cox, T a y l o r & B a l d w i n , 1 9 7 4 ; S k i n n e r & C a s t l e , 1 9 6 9 ) and f a i l u r e t o t h r i v e i n t h e absence o f o r g a n i c d i s e a s e (Ambuel & H a r r i s , 1 9 6 3 ; E v a n s , R e i n h a r t & Succop, 1 9 7 2 ; Shaheen, A l e x a n d e r , Truskowsky & B a r b e r o , 1 9 6 8 ) . The d i s c o v e r y o f t h e s e d r a m a t i c c o r r e l a t e s o f e a r l y m a t e r n a l - i n f a n t s e p a r a t i o n l e d r e s e a r c h e r s who were i n t e r e s t e d i n " m o t h e r i n g d i s o r d e r s " ( K l a u s & K e n n e l l , 1 9 7 6 ; Rose, Boggs, A l d e r s t e i n , 1 9 6 0 ) t o a t t e m p t t o u n d e r s t a n d t h e mechanisms o f what was t h e n termed m a t e r n a l a t t a c h m e n t (Robson & Moss, 1 9 7 0 ) , and what has come t o be c a l l e d m a t e r n a l - i n f a n t b o n d i n g ( K l a u s & K e n n e l l , 1 9 7 6 ) . Thus, t h e ma j o r f o c u s o f p e d i a t r i c s r e s e a r c h has been t h e 23 e x p e r i e n c e s d u r i n g t h e immediate p o s t p a r t u m p e r i o d , and t h e l a t e r c o r r e l a t e s o f e a r l y s e p a r a t i o n i n h o s p i t a l . V e r y l i t t l e a t t e n t i o n has d e v o t e d t o the mother's a t t i t u d e s and e x p e c t a t i o n s ; r a r e l y have r e s e a r c h p r o j e c t s spanned t h e p r e n a t a l t h r o u g h t h e e a r l y i n f a n c y p e r i o d t o examine t h e i n t e r r e l a t i o n s h i p s among p r e n a t a l , p e r i n a t a l and p o s t n a t a l v a r i a b l e s . L e t us examine t h e i s s u e o f e a r l y s e p a r a t i o n v e r s u s e a r l y c o n t a c t as p r e s e n t e d i n s t u d i e s o f r o o m i n g - i n , and s t u d i e s o f t h e r e l a t i o n s h i p between p o s t p a r t u m s e p a r a t i o n o r c o n t a c t and l a t e r m a t e r n a l f u n c t i o n i n g . R ooming-in I n t h e l a t e 1800's when women began r o u t i n e l y t o g i v e b i r t h i n h o s p i t a l , r o o m i n g - i n ( a l l o w i n g t h e i n f a n t t o s t a y i n the mother's room) was s t a n d a r d p r o c e d u r e and t h e mother's p a r t i c i p a t i o n i n t h e c a r e o f even t h e p r e m a t u r e i n f a n t was encouraged. When i n f a n t m o r b i d i t y and m o r t a l i t y r a t e s began t o r i s e due t o e p i d e m i c v i r a l i n f e c t i o n s and i n a d e q u a t e equipment, n e o n a t e s were i s o l a t e d i n s e p a r a t e wards and t h e h a n d l i n g o f i n f a n t s was r e d u c e d t o a minimum. E v e n t u a l l y t h e mother was c o m p l e t e l y b a r r e d f r o m the h o s p i t a l n u r s e r y , and t h e s e p a r a t i o n o f mothers and i n f a n t s became t h e s t a n d a r d p r o c e d u r e . K l a u s & K e n n e l l (1970) n o t e t h a t i n most c u l t u r e s e x c e p t f o r We s t e r n s o c i e t i e s , t h e mother and newborn i n f a n t a r e s e c l u d e d t o g e t h e r f o r s e v e r a l days f o l l o w i n g b i r t h . I n sh a r p c o n t r a s t , a l l mothers and newborns i n We s t e r n h o s p i t a l s a r e s e p a r a t e d f r o m one a n o t h e r t o a g r e a t e r o r l e s s e r d e g r e e . F u l l - t e r m i n f a n t s a r e r o u t i n e l y t a k e n from t h e i r mothers a f t e r b i r t h and p l a c e d i n a n u r s e r y f o r t h e d u r a t i o n o f t h e h o s p i t a l s t a y ; t h e y a r e p e r i o d i c a l l y b r o u g h t t o t h e i r mothers f o r s h o r t f e e d i n g s e s s i o n s and t h e n r e t u r n e d t o t h e n u r s e r y . I n h o s p i t a l s w h i c h have r e t a i n e d o r r e - i n s t i t u t e d t h e p r a c t i c e o f r o o m i n g - i n , r e s e a r c h e r s have had t h e o p p o r t u n i t y t o compare r o o m i n g - i n 24 mothers w i t h mothers who e x p e r i e n c e d t h e more r o u t i n e s e p a r a t i o n f r o m t h e i r i n f a n t s . G r e e n b e r g , Rosenberg & L i n d (1973) compared one hundred p r i m i p a r o u s mothers a s s i g n e d randomly t o r o o m i n g - i n o r c o n v e n t i o n a l h o s p i t a l a rrangements i n S t o c k h o l m . The r o o m i n g - i n mothers had t h e o p p o r t u n i t y t o i n t e r a c t w i t h t h e i r i n f a n t s f o r e i g h t h o urs a day whereas i n t h e c o n v e n t i o n a l group t h e b a b i e s were b r o u g h t t o t h e i r mothers f o r t w e n t y - m i n u t e f e e d i n g s e s s i o n s s i x t o e i g h t t i m e s a day. The r e s u l t s o f q u e s t i o n n a i r e s a d m i n i s t e r e d t o t h e mothers r e v e a l e d t h a t r o o m i n g - i n mothers j u d g e d t h e m s e l v e s t o be more s e l f - c o n f i d e n t and competent i n t h e c a r e o f t h e i r i n f a n t s and more a b l e t o u n d e r s t a n d t h e meaning of t h e i r i n f a n t s ' c r i e s t h a n d i d mothers i n t h e c o n v e n t i o n a l group. Rooming-in mothers a l s o r e p o r t e d f e e l i n g l e s s uneasy h e a r i n g t h e i r own i n f a n t s c r y . The r o o m i n g - i n mothers were d e s c r i b e d t o have " d e v e l o p e d m a t e r n a l f e e l i n g s f a s t e r t h a n the c o n v e n t i o n a l m o t h e r s " by t h e a u t h o r s (p. 3 8 5 ) , b u t they d i d n o t o u t l i n e t h e c r i t e r i a used t o make t h i s judgment. There were no d i f f e r e n c e s between the groups i n t h e i r s e l f - r e p o r t s o f how much t h e y t h o u g h t t h e i n f a n t w o u l d r e s t r i c t t h e i r n o r m a l a c t i v i t i e s , how g r e a t a r e s p o n s i b i l i t y t h e y t h o u g h t t h e i n f a n t w o u l d be, how many f u t u r e c h i l d r e n t h e y p l a n n e d t o h a v e , o r how a n x i o u s they f e l t about the h o s p i t a l c a r e o f t h e i n f a n t . No d i f f e r e n c e s were f o u n d i n how t i r e d the mothers f e l t a f t e r d e l i v e r y , how much s l e e p i n g m e d i c a t i o n they r e c e i v e d , t h e p r e s e n c e o f t h e f a t h e r i n t h e l a b o u r room o r the i n c i d e n c e o f b r e a s t - f e e d i n g p r o b l e m s . The r a t h e r u n i q u e arrangements i n t h i s s t u d y may have a f f e c t e d t h e r e s u l t s , however. Because t h e r o o m i n g - i n mothers were i n w a r d - t y p e accommodations, s h a r i n g a room w i t h t h r e e o t h e r mothers and t h e i r i n f a n t s , t h o s e mothers b e n e f i t t e d f r o m t h e m u t u a l s u p p o r t of t h e o t h e r mothers and g a i n e d knowledge o f i n d i v i d u a l d i f f e r e n c e s i n n e o n a t a l b e h a v i o u r , w h i c h may have a f f e c t e d t h e i r a t t i t u d e s and r a t e o f a d j u s t m e n t . I t i s d i f f i c u l t t o s e p a r a t e o u t t h e 25 e f f e c t s o f r o o m i n g - i n f r o m t h e e f f e c t s o f t h i s " t h e r a p e u t i c community." No e v a l u a t i o n o f a c t u a l m a t e r n a l b e h a v i o u r was made i n t h i s s t u d y , and no f o l l o w - u p o f t h e s u b j e c t s has been r e p o r t e d . D e s p i t e t h e s e i n a d e q u a c i e s , however, t h e r e s u l t s o f t h i s s t u d y c o n f i r m t h e f i n d i n g s o f e a r l i e r s t u d i e s c o m p a r i n g r o o m i n g - i n w i t h c o n v e n t i o n a l a r r a n g e m e n t s . J a c k s o n and h e r c o l l e a g u e s f o u n d t h a t r o o m i n g - i n mothers a c q u i r e d g r e a t e r competence and c o n f i d e n c e i n h a n d l i n g t h e i r i n f a n t s and had b e t t e r u n d e r s t a n d i n g o f t h e i n f a n t ' s b e h a v i o u r ( J a c k s o n , O l m s t e a d , F o o r d , Thomas & H y d e r , 1948). M o t h e r s who have l i t t l e c o n t a c t w i t h t h e i r newborns may f e e l t e n s e and u n f a m i l i a r w i t h t h e i r i n f a n t s w h i l e s t i l l i n h o s p i t a l and a f t e r r e t u r n i n g home; m a t e r n a l d i s t r e s s and a n x i e t y c o n c e r n i n g u n e x p e c t e d i n f a n t b e h a v i o u r o r b e h a v i o u r a l p a t t e r n s may a f f e c t t h e development of a c l o s e r e l a t i o n s h i p between mother and c h i l d . I n d e e d , m a t e r n a l a n x i e t y has been shown t o be r e l a t e d t o d i f f i c u l t i e s i n b r e a s t - f e e d i n g ( O l m s t e a d , S v i g b e r g s o n & Kleeman, 1949) and t o l a t e r b e h a v i o u r a l d i s o r d e r s i n t h e c h i l d (Shea, K l a t s k i n & J a c k s o n , 1952). I n f a n t c r y i n g upon r e t u r n i n g home f r o m h o s p i t a l has been j u d g e d t o be a m a j o r p r o b l e m i n t h e a d j u s t m e n t o f t h e mother t o motherhood and h e r new baby ( L i n d , i n G r e e n b e r g , R o s e n b e r g , & L i n d , 1973); t h e f a c t t h a t r o o m i n g - i n mothers i n t h e G r e e n b e r g s t u d y f e l t l e s s uneasy h e a r i n g t h e i r i n f a n t s c r y , f e l t t h a t t h e y c o u l d u n d e r s t a n d t h e meaning o f t h e c r y and f e l t t h a t t h e y knew what t o e x p e c t i n t h e way o f newborn b e h a v i o u r p o i n t s t o an e a s i e r a d j u s t m e n t and a more r e l a x e d , l e s s a n x i e t y - l a d e n r e l a t i o n s h i p between mother and i n f a n t . Some r e s e a r c h e r s have p r e d i c t e d a l o w e r i n c i d e n c e o f p o s t p a r t u m e m o t i o n a l problems f o r r o o m i n g - i n mothers (Gordon, K a p o s t i n s & Gordon, 1965); however t h i s p r e d i c t i o n has n o t been e m p i r i c a l l y t e s t e d . R e c e n t l y , D a v i d s o n (1978) has shown t h a t m a t e r n a l s e l f - r e p o r t o f a n x i e t y and d e p r e s s i o n a t one month p o s t p a r t u m was r e d u c e d by t h e i n t e r v e n t i o n of a n u r s e who v i s i t e d t h e mother 26 a t home f o u r t e e n days a f t e r t h e b i r t h t o " i n t r o d u c e " t h e mother t o h e r new i n f a n t by d e m o n s t r a t i n g and e x p l a i n i n g i n f a n t b e h a v i o u r and b e h a v i o u r a l p a t t e r n s . S e p a r a t i o n v e r s u s c o n t a c t I n c o n t r a s t w i t h f u l l - t e r m , h e a l t h y i n f a n t s who a r e u s u a l l y t a k e n f r o m t h e d e l i v e r y s u i t e t o t h e n u r s e r y and b r o u g h t o u t t o t h e i r mothers f o r f e e d i n g , p r e m a t u r e l y b o r n i n f a n t s o r i n f a n t s who e x p e r i e n c e b i r t h d i f f i c u l t i e s o r a r e b o r n w i t h problems a r e t a k e n f r o m t h e d e l i v e r y room t o the i n t e n s i v e c a r e n u r s e r y where t h e y a r e k e p t i n i n c u b a t o r s o r i s o l e t t e s u n t i l t h e y r e a c h an a p p r o p r i a t e w e i g h t and c o n d i t i o n . O n l y t h e n a r e t h e y p l a c e d i n t h e r e g u l a r n u r s e r y and r e u n i t e d w i t h t h e i r mothers f o r f e e d i n g . I n t h e c a s e o f v e r y p r e m a t u r e o r s i c k i n f a n t s , t he mother i s u s u a l l y d i s c h a r g e d f r o m h o s p i t a l a f t e r a few days b u t t h e i n f a n t may be k e p t i n h o s p i t a l f o r a l o n g t i m e , r e s u l t i n g i n s e p a r a t i o n s w h i c h may l a s t up t o t w e l v e weeks. I n t h e s e c a s e s , mothers may o r may n o t v i s i t t h e i r i n f a n t s d u r i n g t h i s p r o t r a c t e d p e r i o d o f s e p a r a t i o n . The r e s u l t s o f t h e e t h o l o g i c a l r e s e a r c h w h i c h has j u s t been r e v i e w e d has encouraged some h o s p i t a l s t o acknowledge t h e p o s s i b l e n e g a t i v e e f f e c t s o f m o t h e r - i n f a n t s e p a r a t i o n and t o make arrangements f o r an i n c r e a s e i n c o n t a c t between mothers and t h e i r p r e m a t u r e i n f a n t s . Such changes i n h o s p i t a l p o l i c i e s have a f f o r d e d an o p p o r t u n i t y f o r r e s e a r c h e r s t o s t u d y d i f f e r e n c e s i n m a t e r n a l b e h a v i o u r t h a t may r e s u l t f r o m t h e degr e e o f s e p a r a t i o n e x p e r i e n c e d i n t h e v a r i o u s a r r a n g e m e n t s . R e s u l t s o f t h i s r e s e a r c h have been u s e d t o s u p p o r t t h e o r e t i c a l s p e c u l a t i o n s about t h e n a t u r e and a n t e c e d e n t s o f t h e m a t e r n a l a t t a c h m e n t bond. R e s e a r c h e r s a t t h e S t a n f o r d U n i v e r s i t y M e d i c a l S c h o o l m o d i f i e d h o s p i t a l p o l i c y r e g a r d i n g p r e m a t u r e i n f a n t s i n o r d e r t o s t u d y the e f f e c t s o f t h e 27 routine separation of the mother and infant (Barnett, Leiderman, Grobstein, & Klaus, 1970). Mothers were allowed to enter the premature nursery and have t a c t i l e contact with the infant through the portholes of the baby's i s o l e t t e . Later the mother was permitted to feed the baby. Mothers were interviewed during the time t h e i r infants were i n the premature u n i t and a f t e r discharge. On the basis of animal research (e.g., Harlow, Harlow, & Hansen, 1963; Maier, 1963), i t was hypothesized that mothers deprived of t a c t i l e and caretaking contact with t h e i r infants would be less responsive than mothers who were allowed to handle t h e i r i n f a n t s , and that further, a mother who i s unattached to her i n f a n t because of her separation from him s h o r t l y a f t e r b i r t h may, i n turn, deprive the i n f a n t of adequate stimulation when she assumes r e s p o n s i b i l i t y f or h i s care. The preliminary report of t h i s study noted that mothers who were allowed to i n t e r a c t with t h e i r infants were d i f f e r e n t i n three ways from mothers who suffered i n t e r a c t i o n a l deprivation: contact mothers exhibited greater commitment to the i n f a n t , greater self-confidence i n the a b i l i t y to be a mother, and a higher l e v e l of stimulation and s k i l l i n caretaking behaviour. In a r e l a t e d study, ( L e i f e r , Leiderman, Barnett, & Williams, 1972), mothers of premature infants were randomly assigned to a contact group or a non-contact group, and both groups were compared with a group of f u l l - t e r m mothers. As i n the previous study, contact mothers had access to the premature nursery and could touch the infants through the portholes of the i s o l e t t e . Non-contact mothers were permitted to view t h e i r infants through a glass wall but could not touch them, t a l k to them, or hear them. F u l l - t e r m mothers had normal arrangements, i . e . , t h e i r infants stayed i n the nursery except f o r feeding, but they had f u l l sensory contact when the infants were brought to them. Thus, although mothers i n a l l three groups were separated 28 f r o m t h e i r i n f a n t s a t p a r t u r i t i o n and c o n t i n u e d t o e x p e r i e n c e p a r t i a l s e p a r a t i o n t h r o u g h o u t t h e h o s p i t a l s t a y , t h e mothers d i f f e r e d i n t h e modes o f c o n t a c t a v a i l a b l e t o them, t h e l e n g t h of t i m e t h a t f u l l o r p a r t i a l s e p a r a t i o n p e r s i s t e d , t h e age and m a t u r i t y o f t h e i n f a n t and t h e p h y s i o l o g i c a l and h o r monal s t a t u s o f t h e mother when f u l l c o n t a c t was r e s t o r e d ( a t d i s c h a r g e ) . D i s c h a r g e was a t t h r e e days f o r f u l l - t e r m i n f a n t s and a t t h e a t t a i n m e n t of a w e i g h t o f 2500 grams f o r p r e m a t u r e s . B e h a v i o u r a l o b s e r v a t i o n s were made p r i o r t o , one week, and f o u r weeks a f t e r h o s p i t a l d i s c h a r g e , and t i m e - s a m p l e d d a t a were g a t h e r e d w h i l e t h e mother engaged i n n o r m a l c a r e t a k i n g a c t i v i t i e s and i n t e r a c t i o n , The o n l y c o n s i s t e n t f i n d i n g was t h a t f u l l - t e r m mothers were o b s e r v e d t o e x h i b i t more v e n t r a l c o n t a c t and more s m i l i n g t o t h e i r i n f a n t s t h a n mothers i n e i t h e r t h e s e p a r a t e d o r c o n t a c t g r o u p s . The l a c k o f d i f f e r e n c e f o u n d between s e p a r a t e d and c o n t a c t groups was a t t r i b u t e d by t h e a u t h o r s t o t h e m i n i m a l d i f f e r e n c e s i n c o n t a c t o p p o r t u n i t y e x p e r i e n c e d by t h e s e m o t h e r s ; i . e . , even t h e c o n t a c t mothers c o u l d n o t h o l d t h e i r i n f a n t s o r have f u l l b o d i l y c o n t a c t w i t h them. I t was a l s o n o t e d t h a t t h e amount o f a c c u m u l a t e d e x p o s u r e between c o n t a c t mothers and t h e i r i n f a n t s o v e r t h e s e p a r a t i o n p e r i o d was r e l a t i v e l y low s i n c e t h e f r e q u e n c y o f t h e s e m o t h e r s ' v i s i t s t o h o s p i t a l once t h e y t h e m s e l v e s were d i s c h a r g e d was l o w . On rough e s t i m a t e , t h e c o n t a c t mothers chose o r were a b l e t o v i s i t t h e i r i n f a n t s o n l y about once e v e r y s i x d a y s . T h i s i n i t s e l f may be some i n d i c a t i o n t h a t t h e s t r e n g t h o f t h e i r a t t a c h m e n t t o t h e i r i n f a n t s had a t t e n u a t e d d e s p i t e e x t r a c o n t a c t , a l t h o u g h t h i s v i e w i s tempered somewhat by t h e f a c t t h a t no d i f f e r e n c e s were found when th e two p r e m a t u r e groups ( c o n t a c t and n o - c o n t a c t ) were combined and compared w i t h the f u l l - t e r m groups a f t e r one month o f f u l l c o n t a c t . The a u t h o r s n o t e , however, t h a t o t h e r m a t e r n a l b e h a v i o u r p o i n t s s t r o n g l y t o d i f f e r e n c e s t h a t were s i m p l y n o t p i c k e d up i n t h e o b s e r v a t i o n s . 29 Five of the twenty-two mothers in the separated group had their marriages end i n divorce, and two of these mothers chose to relinguish custody of their infants. Although the number of cases is small, as the authors point out, this i s a remarkable departure from what is considered to be normal maternal and marital behaviour, and suggests that the premature bi r th of an infant and/or the fact of mother-infant separation may very seriously disrupt normal family patterns, as well as affecting the mother-infant relationship i t s e l f . In a study spec i f i ca l ly concerned with developmental patterns of maternal attachment, Robson & Moss (1970) followed 54 primiparious women and their infants through the f i r s t several months of the infants ' l i v e s . In the report of this study the authors define maternal attachment as "the extent to which a mother feels that her infant occupies an essential position in her l i f e " (p. 977). The data reported are from an interview with the mother when the infant was approximately 3 1/2 months of age, in which (among other things) three questions about the "onset, course and determinants" of the mother's feelings toward her infant were asked. The questions were: When did the mother f i r s t experience positive feelings and love toward her baby? When did the baby f i r s t become a person to the mother? When did the baby f i r s t seem to recognize the mother? Unfortunately these data are mainly restrospective (cf. Yarrow, Campbell & Burton, 1970), that i s , they describe subjects' memories of experiences during labour, delivery, the hospital stay and i n i t i a l establishment of home care. Robson and Moss (1970) extrapolated a pattern of maternal attachment from their subjects' responses which begins with feelings of estrangement during the hospital stay (the authors state that the 24% of this sample who had rooming-in were no different from the remainder of the sample); "impersonal feelings of affect ion" toward the infant were f e l t during the f i r s t four to six weeks, and feelings that the 30 in f a n t was a unique person who was seen as responding d i f f e r e n t i a l l y to h i s own mother were experienced by the end of two months. This was found to correspond to subjects' reports of responsive smiling, eye contact and v i s u a l following on the part of t h e i r i n f a n t s . Robson and Moss concluded that "the release of human maternal fee l i n g s seems to depend heavily upon the infa n t ' s capacity to e x h i b i t behaviours that characterize adult forms of s o c i a l communication" (p. 984). These data and conclusions concerning the development of maternal attachment are of value, but the main f a u l t s of t h i s work remain: the data were gathered r e t r o s p e c t i v e l y , and no actual observations of maternal behaviour were included. A s e r i e s of studies at Case Western Reserve Medical Center (Kennell, Jerauld, Wolfe, Chester, Kreger, McAlpine, S t e f f a & Klaus, 1974; Klaus & Kennell, 1970; Klaus, Kennell, Plumb & Zuehlke, 1970; Klaus, Jerauld, Kreger, McAlpine, S t e f f a & Kennell, 1972) were designed to test the notion that there i s a s e n s i t i v e period immediately a f t e r b i r t h during which the mother's a b i l i t y to become attached to her infant i s optimal. This research i s based upon e t h o l o g i s t s ' demonstration of c r i t i c a l periods for attachment i n mammals (discussed i n the previous s e c t i o n ) . Fourteen primiparous mothers comprised an experimental group ("extended-contact"), who were given t h e i r infants f o r one hour within the f i r s t three hours a f t e r b i r t h , and for f i v e extra hours per day f o r each of the three days of the h o s p i t a l stay. The fourteen primiparous mothers i n the co n t r o l group experienced routine separation a f t e r b i r t h and twenty-minute feeding sessions every four hours for the three-day h o s p i t a l stay. Dependent measures for t h i s research consisted of: 1) responses to two questions asked during an interview at one month postpartum which were concerned with maternal response to infant crying and maternal reaction to being away from the infant ( i . e . , leaving the i n f a n t with another 31 person while the mother went out); 2) observed maternal behavour during a p h y s i c a l examination of the infant at one month; and 3) observed maternal caretaking behaviour during a feeding (Klaus, Jerauld, Kreger, McAlpine, S t e f f a & Kennell, 1972). The authors found differences between the contact and co n t r o l group i n the interview data (control mothers tended to l e t t h e i r i n fants cry and reported f e e l i n g "good" while out without the infant more than d i d contact mothers who tended to pick the infant up i f he c r i e d , and who tended not to want to go out without t h e i r i n f a n t ) ; i n the observations during the p h y s i c a l examination (contact mothers tended to stand near the in f a n t and attempt to comfort him i f he c r i e d more often than did co n t r o l mothers); and i n the observed feeding (out of twenty-five behaviours coded, two—en face p o s i t i o n and fondling the b a b y — d i s c r i m i n a t e d between the two groups). When the infants were one year of age, the two groups of mothers answered d i f f e r e n t l y to an interview question concerning how they f e l t when they returned to work or school (only s i x of the contact mothers and seven of the control mothers had returned to t h e i r previous a c t i v i t i e s ) . Again more contact mothers soothed t h e i r infants during a p h y s i c a l examination when the i n f a n t was one year o l d . No differences were found i n mother-infant i n t e r a c t i o n , interviews, or a free-play s i t u a t i o n (Kennell, Jerauld, Wolfe, Chesler, Kreger, McAlpine; S t e f f a & Klaus, 1974). On the basis of these findings Klaus and Kennell have hypothesized that the period immediately a f t e r b i r t h i s a s e n s i t i v e period i n the human mother "which i s the optimal time for an a f f e c t i o n a l bond to develop between the mother and her i n f a n t " (Kennell, Trause & Klaus 1975, p. 94). However, the evidence f o r t h i s notion appears to be somewhat inadequate, both i n terms of sampling and measurement. The sample was small (n=28), nearly u n i - r a c i a l (26 32 black, 2 white women), and consisted of very young (mean age = 18.4 years), mostly unmarried mothers, a l l of whom bottle-fed their infants . Although data regarding social status are not reported (except to say that i t was comparable for both groups), young, unmarried black women in an urban area in the U.S. are l i k e l y to be of low education and low income. Any general conclusions drawn from such a restricted sample ought to be called into question. An equally serious c r i t i c ism of these studies can be made concerning the face v a l i d i t y of the outcome measures; they appear insuff ic ient both in quality and quantity. No observation or interviews were done i n hospital during the postpartum period; coded observations from a filmed feeding yielded either very few differences between the smaples (at one month) or no differences (at one year); other natural is t ic observation of mother-infant interaction were either omitted (at one month) or showed no differences (at one year). The conclusions of these authors are based upon answers to three interview questions (two at one month and one at one year) and the behaviour of young, single, black women in the presence of older, high-status, white physicians who were conducting a physical examination of their infants. The results obtained must surely reflect the ecology of the situation in which the data were gathered ( c f . Bronfenbrenner, 1977); whether they also reflect actual differences due to postpartum experiences is not at a l l clear. The separation/contact research is not only weak in methodology and sampling, but is incomplete theoretically. It is not surprising that contact between mother and infant after bir th increases maternal famil iar i ty with infant behaviour; nothing more could be expected. The question which remains unanswered i s : how does this increased familiari ty interact with previous knowledge and experience or the lack of i t , and exactly what differences in 33 m a t e r n a l - i n f a n t i n t e r a c t i o n r e s u l t . One element w h i c h w o u l d l e n d a g r e a t d e a l o f w e i g h t t o t h e f i n d i n g s c o n c e r n i n g t h e e f f e c t s o f s e p a r a t i o n b u t w h i c h has n o t been a s s e s s e d by any o f t h e s e r e s e a r c h e r s i s t h a t o f m a t e r n a l e x p e c t a t i o n s o f i n f a n t b e h a v i o u r . I t makes sense t h a t mothers who have t h e most u n r e a l i s t i c e x p e c t a t i o n s o f i n f a n t b e h a v i o u r , e i t h e r o v e r - o r u n d e r - e s t i m a t e s o f t h e i r c a p a b i l i t i e s and c a p a c i t i e s , would be t h e most a f f e c t e d by s e p a r a t i o n i n h o s p i t a l and the r e s u l t a n t l a c k o f o p p o r t u n i t y t o become f a m i l i a r w i t h what a newborn i s r e a l l y l i k e and what can be r e a l i s t i c a l l y e x p e c t e d i n t h e way o f b e h a v i o u r . An u n q u e s t i o n e d a s s u m p t i o n o f most r e s e a r c h e r s i n t h e f i e l d o f m a t e r n a l b e h a v i o u r i s t h a t e x p e r i e n c e w i t h i n f a n t s i s i s o m o r p h i c w i t h p a r i t y — t h a t i s , p r i m i p a r a s a r e assumed t o be n a i v e w i t h r e g a r d t o i n f a n t b e h a v i o u r , and m u l t i p a r a s a r e assumed t o be u n i v e r s a l l y k n o w l e d g e a b l e about i t . Common sense a l o n e w o u l d c a l l t h i s a s s u m p t i o n i n t o q u e s t i o n , b u t i t has n e v e r been e m p i r i c a l l y t e s t e d . To be s u r e , many women, e s p e c i a l l y W e s t e r n women b r o u g h t up i n s m a l l f a m i l i e s and l i v i n g a l o n e w i t h t h e i r husbands b e f o r e t h e b i r t h o f t h e i r c h i l d , may a r r i v e home fr o m h o s p i t a l w i t h l i t t l e i d e a o f how t o c a r e f o r t h e i r i n f a n t s . B u t n o t a l l new mothers l a c k e x p e r i e n c e w i t h i n f a n t s ; t h e y may have h e l p e d t o c a r e f o r s i b l i n g s o r f o r t h e i n f a n t s o f n e i g h b o u r s o r r e l a t i v e s , o r th e y may have l e a r n e d how t o c a r e f o r i n f a n t s i n a c h i l d - c a r e r e l a t e d j o b . Women b r i n g v a r y i n g degrees o f e x p e r i e n c e t o t h e i r r o l e as mother, b u t the amount o f e x p e r i e n c e and i t s i m p a c t upon t h e i r a c t u a l m o t h e r i n g b e h a v i o u r w i t h t h e i r own i n f a n t has n e v e r been a s s e s s e d . A n o t h e r f a c t o r n o t e x p l o r e d by r e s e a r c h e r s i s t h e i n t e g r a t i o n o f t h e newborn i n t o t h e f a m i l y . L i t t l e n o r m a t i v e d a t a c o n c e r n i n g t h i s i n t e g r a t i o n e x i s t s ; e x i s t i n g work i s l a r g e l y c o n c e r n e d w i t h t h e mother's r e s p o n s e t o h e r newborn i m m e d i a t e l y a f t e r d e l i v e r y . Newton and Newton (1962) f o u n d t h a t the 34 most frequent i n i t i a l maternal response to the newborn was "smiles a l i t t l e " (as opposed to "greatly pleased", "indifferent", or "disgusted"). However, no relationship was drawn between this i n i t i a l reaction and either later maternal behaviour or infant outcome. Rising (1974) discusses the f i r s t hour after birth in terms of a "fourth stage of labour: family integration." Spontaneous parental response to the infant after the birth is seen by Rising as an indicator of later adjustment. A systematic method for recording these responses, both verbal (such as calling the baby by name, or voicing disappointment over the baby's sex) and non-verbal (kissing or reaching for the baby, turning away from baby, husband, or attendants) was offered, but neither normative nor follow-up data were presented. In another study, (Gray, 1977) i n i t i a l maternal response to the newborn was used as an indicator of risk for later child abuse, but again no data relating i n i t i a l response to later maternal behaviour were offered. It has been suggested by Barnett and his colleagues (Barnett, Leiderman, Grobstein & Klaus, 1970) that the late entrance of the premature infant into the family, where mother and infant were not regarded as a unit, could affect the normal development of the mother-infant relationship; this suggestion, however, was not followed up by either Barnett and his associates or by other researchers. The point being made here is that the real issue of family integration, that i s , the long-term integration of the infant into the family, has not been treated anywhere in the literature. No where has i t been acknowledged that true family integration, which includes not only the acceptance of the infant by the parents, but the acceptance of parental roles and responsibilities, begins when the baby is planned or when the woman learns that she is pregnant, and continues throughout pregnancy, parturition, the 35 p o s t p a r t u m s t a y i n h o s p i t a l and the t r a n s i t i o n t o home c a r e . There has been no work on t h e n o r m a t i v e c o u r s e o f t h i s l o n g - t e r m i n t e g r a t i o n . There i s a need t o e x p l o r e t h e i m p l i c a t i o n s t h a t e a r l y e x p e r i e n c e s and a t t i t u d e s have f o r t h e c o n s t a n t l y a d j u s t i n g p r o c e s s o f f a m i l y i n t e g r a t i o n . I V . C r i t i q u e and I n t r o d u c t i o n t o t h e P r e s e n t R e s e a r c h Three a r e a s o f r e s e a r c h w h i c h c o n t r i b u t e i n f o r m a t i o n t o t h e f i e l d o f m a t e r n a l b e h a v i o u r have been r e v i e w e d . D e v e l o p m e n t a l p s y c h o l o g i s t s have p r o v i d e d t h e o r i e s o f human a t t a c h m e n t r e l a t i o n s h i p s w h i c h , i t has been a r g u e d , must be augmented by a f o c u s on t h e u n i q u e l y a d u l t a s p e c t s o f a mother's a b i l i t y t o p r o j e c t i n t o t h e f u t u r e and see h e r r e l a t i o n s h i p t o h e r i n f a n t as one t h a t grows and changes. E t h o l o g i s t s have shown how b o t h m a t e r n a l and i n f a n t cues and b e h a v i o u r a l systems i n t e r a c t w i t h b i r t h and r e a r i n g c o n d i t i o n s and w i t h h o r m o n a l f a c t o r s t o p r o d u c e s p e c i e s >=— s p e c i f i c m a t e r n a l - i n f a n t p a t t e r n s i n a n i m a l s . M e d i c a l r e s e a r c h e r s have e x p l o r e d t h e e f f e c t s o f m o t h e r - i n f a n t c o n t a c t upon t h e ways i n w h i c h human mothers r e l a t e t o t h e i r i n f a n t s . There a r e t h r e e ways i n w h i c h c u r r e n t r e s e a r c h on m a t e r n a l b e h v i o u r i s s e r i o u s l y f l a w e d ; t h e s e d e f i c i e n c i e s a r e r e f l e c t e d i n t h e u n c l e a r r e s u l t s o f t h e m a j o r r e s e a r c h p r o j e c t s t o d a t e , i n t h e u n c e r t a i n t y w i t h w h i c h t h e s e r e s u l t s have been i n t e r p r e t e d , and i n t h e g e n e r a l f a i l u r e o f t h e i n v e s t i g a t o r s i n t h e f i e l d t o i n t e g r a t e and b u i l d upon o n g o i n g r e s e a r c h . These f l a w s a r e : 1) t h e absence o f a sound t h e o r e t i c a l model of m a t e r n a l b e h a v i o u r ; 2) t h e d e a r t h o f t e s t e d m e t h o d o l o g i c a l t o o l s w i t h w h i c h t o s t u d y t h e p r o b l e m ; and 3) t h e l a c k o f a comprehensive b u t s p e c i f i c d e f i n i t i o n o f m a t e r n a l a t t a c h m e n t o r m a t e r n a l b o n d i n g . P e r h a p s b e c a u s e t h o s e w o r k i n g on t h e i s s u e o f b o n d i n g have been f o r the most p a r t m e d i c a l r e s e a r c h e r s and t h e 36 problem has therefore come to be seen in l ight of hospital management techniques, there has been l i t t l e attempt to ground the research in a theoretical perspective that would account for maternal behviour in the context of the influences upon i t , the consequences of maternal behaviour in terms of family development and the broad network of the mother's interpersonal relationships, and the reciprocally interactive nature of the mother-infant relationship i t s e l f . Due perhaps to the links hypothesized between "bonding" and child abuse (Klaus & Kennell, 1976), and due to the focus of alarmed attention upon the growing rate of child abuse reports, there appears to have been a bandwagon effect in which researchers have seized upon the tools nearest to hand and applied them to the problem with great haste and fervour. The result has been the use of research methodology that has been examined neither for i t s spec i f i c i ty to the problem of maternal behaviour, nor more importantly, for the direct influence that methodology has upon the kinds of results obtained. The combined effect of weak theory with weak methodology brings the f i e l d to the following example of impasse. Leifer and her colleagues, in discussing the ambiguous results of their research, state that differences between the contact-, separated- and f u l l term- mothers are expected to disappear with time as the women return to non-pregnant status and "experience the pleasures associated with infant care" (Leifer , Leiderman, Barnett & Williams, 1972, p. 127). To say that this conclusion is counter-intuitive is to badly understate the si tuation. For the new mother, isolated from emotional support, bewildered by the constant and confl ic t ing advice from relat ives , friends, health care professionals and books, and exhausted from both the physical shock of parturition and the unending demands of a newborn infant , the "pleasures associated with infant care" are few and far between. Much more important, however, than these researchers' 37 ignorance of the r e a l i t i e s of modern motherhood, is the fact that this conclusion could be drawn only in the absence of an adequate theoretical model. I f , for example, one views the mother-infant relationship within an interactional model in which the effects of behaviour and experience are cumulative, and indeed, the proponents of bonding appear to be t e l l i n g us that the lack of opportunity for early mother-infant contact has serious implications for the later development of both mother and infant, then differences between groups of mothers should increase, not decrease, with time. There are four possible reasons that the Stanford group f a i l e d to find differences between their groups: f i r s t , there may actually be no differences between these three groups; second, the behaviours they chose to observe may simply have been the wrong ones, and indeed, no theoretical basis is given for their choice; thi rd , the choice of molecular over molar behaviours may have been wrong, and the evidence of the marital and family problems seems to indicate that this might be the case; and fourth, the observations reported may have been done in the wrong context, or at the wrong time, or may not have extended far enough in time into the mother-infant relat ionship. In this and other studies, the possible effects of early experience may have been obscured because the tools used were inadequate or inappropriate, and therefore the selection of variables or of data-collection points may have been misguided. R.Q. B e l l (1968, 1971) and Moss (1965) have made this point with regard to the study of infant behaviour, and the insight i s of course no less applicable to the study of maternal behaviour. The lack of a specif ic defini t ion of bonding .or maternal attachment has added to the confusion and compounded the theoretical and methodological problems. Klaus and Kennell, i n their book Maternal-Infant Bonding, (1976) neither clearly differentiate the term "bond" from the term "attachment", nor 38 do t h e y i n d i c a t e t h a t t h e y a r e u s i n g b o t h terms t o r e f e r t o one and t h e same phenomenon. They d e f i n e a t t a c h m e n t as a "unique r e l a t i o n s h i p between two p e o p l e t h a t i s s p e c i f i c and endures t h r o u g h t i m e " (p. 2), a f t e r A i n s w o r t h and Bowlby, and spend a s h o r t p a r a g r a p h o u t l i n i n g the i s s u e o f a t t a c h m e n t v e r s u s a t t a c h m e n t b e h a v i o u r s , b u t they do n o t d e a l w i t h i t as e i t h e r a t h e o r e t i c a l o r o p e r a t i o n a l p r o b l e m . The d e f i n i t i o n o f m a t e r n a l a t t a c h m e n t g i v e n by Robson and Moss (1970) - " t h e e x t e n t t o w h i c h a mother f e e l s t h a t h e r i n f a n t o c c u p i e s a c e n t r a l p o s i t i o n i s h e r l i f e " (p. 979) a l s o f a i l s t o s p e c i f y e l e m e n t s w h i c h c o u l d f o r m t h e b a s i s o f an o p e r a t i o n a l d e f i n i t i o n . L e i f e r and h e r c o l l e a g u e s speak o f " m a t e r n a l a t t a c h m e n t " and d e f i n e i t as " t h e degree t o w h i c h a mother i s a t t e n t i v e t o and m a i n t a i n s p h y s i c a l c o n t a c t w i t h h e r i n f a n t " ( L e i f e r , L e i d e r m a n , B a r n e t t , & W i l l i a m s , 1972, p. 117). The c e n t r a l p r o b l e m w i t h t h i s d e f i n i t i o n i s t h a t i t i s o v e r - i n c l u s i v e — i t f a i l s t o s p e c i f y b e h a v i o u r s o r b e h a v i o u r p a t t e r n s e x c l u s i v e t o a mother w i t h h e r own i n f a n t . An i n f a n t - c a r e w o r k e r o r a b a b y - s i t t e r i s e x p e c t e d t o be and i n d e e d w o u l d be o b s e r v e d t o be a t t e n t i v e t o and i n p h y s i c a l c o n t a c t w i t h any i n f a n t i n h i s o r h e r c h a r g e . An a d d i t i o n a l p r o b l e m i s t h a t t h e t e r m " a t t a c h m e n t " evokes t h e e t h o l o g i c a l c o n c e p t o f s p e c i e s - s u r v i v a l mechanisms, and has been used f o r s e v e r a l decades t o denote i n f a n t b e h a v i o u r and b e h a v i o u r a l systems by Bowlby (1969), A i n s w o r t h (1969; 1973), and o t h e r s who have d e f i n e d t h e f i e l d w h i c h i s c a l l e d " a t t a c h m e n t " . I t m i g h t be b e s t t o c o n s i g n t h e t e r m " a t t a c h m e n t " t o t h e use o f i n f a n t a t t a c h m e n t r e s e a r c h e r s , and use a n o t h e r term t o r e f e r t o the e m o t i o n a l t i e o f a mother t o h e r i n f a n t . I f t h e t e r m "bond" i s used f o r t h i s p u r p o s e , i t s h o u l d be d e f i n e d i n a way i n w h i c h t h e component of r e l a t i o n s h i p - b u i l d i n g and m a i n t e n a n c e t h a t i s u n i q u e l y a d u l t i s e m p h a s i z e d , t h e component r e f e r r e d t o i n an e a r l i e r s e c t i o n i n the d i s c u s s i o n o f t h e " m a t e r n a l p r o m i s e " . L e t us 39 refer to this component as commitment. If conceived of in terms of commitment, we can see that this component is at once both cognitive, in terms of making an intentional choice to become involved with another, and emotional in terms of the strong p u l l toward another that some developmental psychologists have recently had the courage to c a l l love (Ainsworth, 1973). It is commitment which distinguishes the adult relationship, whether to another adult or to an infant or child, from the relationship of the child to his parent, which i s , at least to begin with, driven by need. It is commitment that makes a relationship "endure through time" (Klaus and Kennell 1976, p. 2) and bridge physical separation over great distances. Commitment can be seen as a general construct in human relationships (cf. Rubin, 1973) and i t is this generality that makes i t useful in attempting to describe the maternal side of the mother-infant relationship. It is important to recognize that this relationship is one of many in the mother's l i f e , and i t should be possible to describe i t using the same parameters which describe her other relationships. The commitment that motivates a mother to put the needs of her infant over her own is no different from that which motivates anyone to put the needs of another over their own—it is not unique to the mother-infant situation. Human relationships are built upon a foundation of commitment, and disintegrate with the breakdown of that commitment; the behaviour generated by the commitment w i l l change with time and circumstance, but as long as the commitment is s t i l l there, the bond remains. Let us use the term "bond" now to refer to the commitment a mother makes to her infant, one that may have begun in hopes and expectations many years before the birth of the infant, or one that may have been constructed only after the discovery of an unexpected pregnancy and subsequent decision to bear the child, or one that has never been made, and whose lack is reflected in neglectful, or perhaps abusive parental behaviour. 40 The p u r p o s e o f t h i s r e s e a r c h was t o e x t e n d and improve upon e x i s t i n g r e s e a r c h by making a p r e l i m i n a r y e x p l o r a t i o n o f b o t h t h e w i d e range o f i n f l u e n c e s upon t h e m a t e r n a l bond and t h e e q u a l l y wide range o f m a n i f e s t a t i o n s o f t h a t bond, a t t i t u d i n a l as w e l l as b e h a v i o u r a l . T h i s r e s e a r c h was ba s e d upon a c u m u l a t i v e model of m a t e r n a l b e h a v i o u r i n w h i c h b e h a v i o u r a t any g i v e n p o i n t i s i n f l u e n c e d by p a s t e v e n t s and i n t u r n i n f l u e n c e s e v e n t s y e t t o come. The r e s e a r c h d e s i g n was n e c e s s a r i l y l o n g i t u d i n a l and s p e c i f i c a l l y d e a l t w i t h the two-month p e r i o d f r o m t h e l a s t month o f pregn a n c y t h r o u g h t h e f i r s t month o f the i n f a n t s ' l i f e . The main e f f o r t was t h e t e s t i n g o f measures t o be used i n a s s e s s i n g t h e i n f l u e n c e s upon t h e m a n i f e s t a t i o n s o f t h e m a t e r n a l bond, t o v a l i d a t e them, r e l a t e them t o one a n o t h e r and t o d i s c o v e r how t o e x t e n d them t o c o v e r a w i d e r t i m e span and t o d e a l w i t h a g r e a t e r c o m p l e x i t y o f d e t a i l . Thus the f o l l o w i n g c h a p t e r on methods w i l l c o n t a i n t h e u s u a l d e s c r i p t i o n o f s u b j e c t p r o c e d u r e s , and a l s o a s e c t i o n on t h e development o f t h e i n s t r u m e n t s and measures u s e d . The c h a p t e r on R e s u l t s w i l l d e a l w i t h e s t i m a t e s o f r e l i a b i l i t y and v a l i d i t y o f t h e measures as w e l l as a n a l y s i s o f t h e d a t a c o l l e c t e d u s i n g them. I n t h i s r e s e a r c h , t w e n t y - s e v e n p r i m i p a r o u s women were i n t e r v i e w e d d u r i n g t h e i r t h i r d t r i m e s t e r o f pregnancy and q u e s t i o n a i r e s r e g a r d i n g p r e n a t a l a t t i t u d e s were a d m i n i s t e r e d a t t h a t t i m e . I n f o r m a t i o n about l a b o u r , d e l i v e r y , and t h e p o s t p a r t u m h o s p i t a l s t a y was s u b s e q u e n t l y t a k e n f r o m h o s p i t a l r e c o r d s . A t one month p o s t p a r t u m , q u e s t i o n n a i r e s were a g a i n a d m i n i s t e r e d , and a n a t u r a l i s t i c o b s e r v a t i o n o f m a t e r n a l - i n f a n t i n t e r a c t i o n was made i n t h e home. 41 METHODS Methods I : S u b j e c t s and P r o c e d u r e s S u b j e c t s . S u b j e c t s f o r t h i s s t u d y were two groups o f p r i m i p a r o u s women and t h e i r i n f a n t s . The two groups d i f f e r e d i n method o f r e c r u i t m e n t , r e s e a r c h e r c o n t a c t and e x t e n t o f i n v o l v e m e n t . Core group. The c o r e group c o n s i s t e d o f t w e n t y - s e v e n women who gave b i r t h a t S t . P a u l s ' H o s p i t a l i n Vancouver between A p r i l and September 1977. They were r e c r u i t e d d u r i n g p r e n a t a l t o u r s o f t h e h o s p i t a l o b s t e t r i c f a c i l i t i e s w h i c h a r e c o n d u c t e d w e e k l y by t h e head n u r s e o f t h e m a t e r n i t y u n i t . The t o u r i n c l u d e s v i s i t s t o t h e l a b o u r / d e l i v e r y s u i t e , t h e i n t e n s i v e c a r e n u r s e r y and the m a t e r n i t y u n i t / r e g u l a r n u r s e r y . H o s p i t a l p r o c e d u r e s a r e e x p l a i n e d and q u e s t i o n s answered. A t t h e end of each t o u r , t h e head n u r s e i n t r o d u c e d t h e r e s e a r c h e r t o t h o s e on the t o u r . The r e s e a r c h e r v e r b a l l y e x p l a i n e d t h e r e s e a r c h p r o j e c t , p r o v i d e d a w r i t t e n e x p l a n a t i o n (Appendix L ) , and asked t h o s e women who were h a v i n g t h e i r f i r s t baby t o l e a v e t h e i r names and t e l e p h o n e numbers so t h e y c o u l d be c o n t a c t e d i n d i v i d u a l l y . Twenty-one t o u r s were a t t e n d e d by the r e s e a r c h e r ; 104 women were p r e s e n t and o f t h o s e 75 s i g n e d up t o be c o n t a c t e d ( 7 2 % ) . A mean o f f i v e women a t t e n d e d each t o u r ( r a n g e : 1-9) and a mean o f t h r e e s i g n e d up a t each t o u r ( r a n g e : 1-6); t h e mean r a t e o f s i g n - u p on any g i v e n t o u r was 74% (range 17-100%). W i t h i n one week o f each t o u r , t h e r e s e a r c h e r c o n t a c t e d each p o t e n t i a l s u b j e c t by t e l e p h o n e , answered q u e s t i o n s about t h e p r o j e c t , a g a i n e x p l a i n e d t h e e x t e n t o f i n v o l v e m e n t , and a s c e r t a i n e d whether the woman would be w i l l i n g t o p a r t i c i p a t e . Core group s u b j e c t s were t o l d t h a t t h e y would be i n v o l v e d i n p r e n a t a l and p o s t p a r t u m v i s i t s , and t h a t i n f o r m a t i o n would be t a k e n from t h e i r h o s p i t a l c h a r t s . Of the 68 women who c o u l d be re a c h e d by t e l e p h o n e , 55 a g r e e d t o p a r t i c i p a t e ( 8 0 % ) . Of t h o s e 55 s u b j e c t s , 27 c o m p l e t e d t h e s t u d y . Of t h e 28 women who 42 a g r e e d t o p a r t i c i p a t e b u t d i d n o t c o m p l e t e the s t u d y , s i x gave b i r t h b e f o r e a p r e n a t a l v i s i t c o u l d be a r r a n g e d , t h r e e dropped out due t o m e d i c a l p r o b l e m s , seven were seen f o r t h e p r e n a t a l v i s i t b u t were u n a b l e t o a r r a n g e f o r a p o s t -partum v i s i t , f o u r had n o t g i v e n b i r t h by t h e end o f t h e s t u d y , and e i g h t were n o t i n c l u d e d due t o m i s c e l l a n e o u s r e a s o n s (moving o u t o f t h e a r e a , g i v i n g b i r t h a t a n o t h e r h o s p i t a l , n o t s p e a k i n g enough E n g l i s h t o c o m p l e t e t h e q u e s t i o n n a i r e s , e t c . ) . The 27 women who made up t h e c o r e group were a l l m a r r i e d and spoke E n g l i s h w i t h o u t d i f f i c u l t y . T h e i r mean age was 26.9 y e a r s ( r a n g e : 20-37 y e a r s ) ; t h e mean age f o r husbands was 29.6 (range 23-42 y e a r s ) . These c o u p l e s had l i v e d i n common r e s i d e n c e ( e i t h e r l e g a l l y m a r r i e d o r c o h a b i t i n g ) a mean o f t h r e e y e a r s , n i n e months ( r a n g e : 9 months t o 8 y e a r s ) b e f o r e h a v i n g t h e i r f i r s t baby. (No woman was i n c l u d e d who had p r e v i o u s l y c a r r i e d a pregna n c y t o term.) Mean number o f y e a r s o f e d u c a t i o n f o r w i v e s was 13.6 (range 10-20 y e a r s ) ; f o r husbands, 13.9 (10-18 y e a r s ) . The mean o c c u p a t i o n a c c o r d i n g t o the H o l l i n g s h e a d code ( H o l l i n g s h e a d , 1956) was 4.4 f o r w i v e s and 4.7 f o r husbands ( r a n g e : 2-6 and 1-7 r e s p e c t i v e l y ) . Examples o f o c c u p a t i o n s r a t e d as 4 a r e c o m p u t e r - o p e r a t o r , t y p i s t , bank t e l l e r , e t c . Three o f t h e w i v e s l i s t e d t h e i r o c c u p a t i o n as h o u s e w i f e . Q u e s t i o n n a i r e group. The second group o f s u b j e c t s c o n s i s t e d o f 107 women who a t t e n d e d p r e n a t a l c l a s s e s g i v e n by the Vancouver C h i l d b i r t h A s s o c i a t i o n . P r e n a t a l q u e s t i o n n a i r e s (Appendix A) were g i v e n out by t h e p r e n a t a l c l a s s t e a c h e r t o t h o s e women who were e x p e c t i n g t h e i r f i r s t baby. A l e t t e r from t h e r e s e a r c h e r (Appendix T) e x p l a i n i n g t h e s t u d y and i n v i t i n g p a r t i c i p a t i o n was a t t a c h e d t o each q u e s t i o n n a i r e . The c o m p l e t e q u e s t i o n n a i r e s were r e t u r n e d by t h e s u b j e c t s t o t h e p r e n a t a l c l a s s t e a c h e r , who r e t u r n e d them t o t h e r e s e a r c h e r by m a i l . The mean age o f t h e women i n t h i s group was 27.2 ( r a n g e : 19 t o 3 8 ) ; f o r t h e i r husbands o r p a r t n e r s , 30.2 ( r a n g e : 23 t o 43 4 1 ) . The mean l e n g t h o f common r e s i d e n c e f o r t h o s e who gave t h e i n f o r m a t i o n (83%) was t h r e e y e a r s , seven months ( r a n g e : 11 months t o 8.5 y e a r s ) . Mean number o f y e a r s o f e d u c a t i o n f o r t h e women was 13.7 ( r a n g e : 10 t o 2 0 ) , and f o r t h e i r p a r t n e r s was 14.5 ( r a n g e : 10 t o 2 0 ) . Average o c c u p a t i o n u s i n g t h e H o l l i n g s h e a d s c a l e was 4.3 f o r t h e women ( r a n g e : 2 t o 7) and 4.8 f o r t h e i r p a r t n e r s ( r a n g e : 1 t o 7 ) . No s i g n i f i c a n t d i f f e r e n c e s were found between t h e c o r e group and t h e q u e s t i o n n a i r e group i n age, e d u c a t i o n , o c c u p a t i o n o r l e n g t h o f common r e s i d e n c e (see T a b l e 1 ) . S u b j e c t p r o c e d u r e s - Core group. P r e n a t a l v i s i t . S u b j e c t s i n t h e c o r e group, h a v i n g been i n i t i a l l y c o n t a c t e d by t e l e p h o n e , were s c h e d u l e d f o r p r e n a t a l i n t e r v i e w s i n t h e i r homes. I n t e r v i e w s were o p t i m a l l y s c h e d u l e d one month b e f o r e t h e s u b j e c t ' s e s t i m a t e d due d a t e , but f o r some s u b j e c t s t h i s was n o t p o s s i b l e , as t h e i r due d a t e s were a l r e a d y l e s s t h a n one month away a t t h e t i m e of f i r s t c o n t a c t . The w i d e range o f t i m e between p r e n a t a l i n t e r v i e w and a c t u a l b i r t h d a t e (mean = 22 d a y s ; r a n g e : 2 t o 52 days) r e f l e c t s t h i s f a c t , as w e l l as t h e f a c t t h a t e s t i m a t e d due d a t e s were q u i t e i n a c c u r a t e : o f t h e 27 s u b j e c t s , o n l y one gave b i r t h on h e r due d a t e . There was a mean o f 12 d a y s ' v a r i a t i o n between due d a t e and b i r t h d a t e ; 18 s u b j e c t s d e l i v e r e d a f t e r t h e i r due d a t e s (mean = 13 da y s ; r a n g e : 2 t o 28 days) and 8 s u b j e c t s d e l i v e r e d b e f o r e t h e i r due d a t e s (mean = 11 d a y s ; r a n g e : 1 t o 30 d a y s ) . One week b e f o r e t h e s c h e d u l e d a p p o i n t m e n t f o r t h e p r e n a t a l i n t e r v i e w , t h e r e s e a r c h e r s e n t a package o f p r e n a t a l m a t e r i a l s t o t h e s u b j e c t s , c o n s i s t i n g o f a l e t t e r from t h e r e s e a r c h e r (Appendix N ) , t h e P r e n a t a l Q u e s t i o n n a i r e (Appendix A ) , t h e I n f a n t Temperament P r e d i c t i o n ( A ppendix B ) , and a s e t o f c o n s e n t forms t o be s i g n e d by t h e woman and h e r husband o r p a r t n e r (Appendix M). The q u e s t i o n n a i r e s were f i l l e d o u t by t h e s u b j e c t s b e f o r e t h e i n t e r v i e w , 44 and were used as the basis of discussion with the subject during the prenatal v i s i t . In some cases, when the package did not reach the subject before the interview, the completed forms were returned to the researcher by mail. The prenatal v i s i t served to e s t a b l i s h rapport with the subject and to c l a r i f y items on the Prenatal Questionnaire i f necessary. Ho s p i t a l. The researcher v i s i t e d the h o s p i t a l twice weekly i n order to keep i n contact with mothers once they entered the h o s p i t a l , and to gather information concerning labour, d e l i v e r y and the postpartum period from the h o s p i t a l charts (Chart Variables, Appendix J). The researcher usually had a b r i e f v i s i t with the mother, but no information was gathered from her during her h o s p i t a l stay. In some cases, there was no v i s i t during the h o s p i t a l stay, i f the mother was unavailable during the researcher's v i s i t to the maternity unit ( i . e . , the subject was bathing, doing exercises, etc. or had been discharged before the researcher's r e g u l a r l y scheduled t r i p to the h o s p i t a l ) . Postpartum v i s i t . One week p r i o r to the infant's one month birthday the mother was again contacted by telephone and an appointment was made for the researcher to v i s i t the home and observe mother and infant during a time when the infant would be awake for at le a s t one hour and a feeding would occur. Postpartum materials sent to the mother by mail before t h i s v i s i t consisted of a l e t t e r o u t l i n i n g the purpose of the v i s i t (Appendix 0), a Postpartum Questionnaire (Appendix Q) and an Infant Temperament Report (Appendix C). Again, i f the materials did not reach the subject i n time, they were returned to the researcher by mail. The postpartum v i s i t took place an average of 32 days a f t e r the b i r t h of the infa n t ; however, there was again a wide range (26 to 44 days), since v i s i t s were scheduled at the subject's convenience and personal s i t u a t i o n ( i . e . , they were scheduled around v i s i t s from r e l a t i v e s , holidays, appointments with the doctor, e t c . ) . 45 The r e s e a r c h e r c a l l e d t h e mother on t h e morning o f t h e v i s i t t o c o n f i r m t h e a p p o i n t m e n t . When t h e r e s e a r c h e r a r r i v e d a t t h e home, she t a l k e d t o t h e mother t o put h e r a t ease b e f o r e b e g i n n i n g t h e o b s e r v a t i o n . I f t h e i n f a n t was s t i l l a s l e e p when t h e r e s e a r c h e r a r r i v e d , t h e q u e s t i o n n a i r e s were d i s c u s s e d u n t i l t h e baby awakened. I f t h e i n f a n t was awake, t h e r e s e a r c h e r began a one-hour o b s e r v a t i o n a f t e r b r i e f l y c h a t t i n g w i t h t h e mother, and d i s c u s s e d t h e q u e s t i o n n a i r e s a f t e r t h e o b s e r v a t i o n p e r i o d ended. The mother was t o l d t h a t t h e f o c u s o f a t t e n t i o n d u r i n g the one-hour o b s e r v a t i o n would be on t h e i n f a n t and t h a t t h e mother s h o u l d c o n t i n u e w i t h h e r n o r m a l r o u t i n e as much as p o s s i b l e and r e f r a i n f rom i n t e r a c t i n g w i t h t h e r e s e a r c h e r u n t i l t h e end o f t h e o b s e r v a t i o n p e r i o d . N o r m a l l y , a c t i v i t i e s c a r r i e d on d u r i n g the o b s e r v a t i o n p e r i o d c o n s i s t e d o f a f e e d i n g , d i a p e r - c h a n g i n g and some n o n - c a r e g i v i n g i n t e r a c t i o n . I n some c a s e s t h e i n f a n t was a l s o b a t h e d d u r i n g t h e o b s e r v a t i o n p e r i o d . (See A p p e n d i c e s F and G f o r o b s e r v a t i o n t o o l s . ) I f t h e i n f a n t f e l l a s l e e p b e f o r e t h e end o f t h e o b s e r v a t i o n , t h e r e s e a r c h e r resumed t h e i n t e r v i e w w i t h t h e mother and w a i t e d u n t i l t he i n f a n t awakened. I f t h e mother j u d g e d t h a t t h e i n f a n t would n o t re-awaken w i t h i n a r e a s o n a b l e amount o f t i m e , arrangements were made f o r t h e r e s e a r c h e r t o r e t u r n t o f i n i s h t h e o b s e r v a t i o n . T h i s was n e c e s s a r y f o r 4 o f t h e 27 s u b j e c t s . A f t e r t h e p o s t p a r t u m v i s i t t he r e s e a r c h e r f i l l e d out t h e M a t e r n a l R a t i n g S c a l e s ( A p p e n d i c e s H and I ) f o r t h e mother, and made n o t e s about t h e v i s i t . S u b j e c t p r o c e d u r e s - Q u e s t i o n n a i r e group. There was no c o n t a c t between t h e r e s e a r c h e r and t h e s u b j e c t s i n t h e q u e s t i o n n a i r e g roup. P r e n a t a l Q u e s t i o n n a i r e s (Appendix A) were f i l l e d o ut anonymously by t h e s u b j e c t s and were r e t u r n e d t o t h e r e s e a r c h e r by t h e p r e n a t a l c l a s s t e a c h e r as e x p l a i n e d above. 46 Methods I I : Development o f I n s t r u m e n t s Seven q u e s t i o n n a i r e o r o b s e r v a t i o n i n s t r u m e n t s were used i n t h i s r e s e a r c h p r o j e c t , o f w h i c h s i x were d e v e l o p e d s p e c i f i c a l l y f o r t h i s l o n g i t u d i n a l s t u d y . They were d e s i g n e d t o a s s e s s : (1) p r e n a t a l e x p e r i e n c e s , a t t i t u d e s , e x p e c t a t i o n s and p r e p a r a t i o n f o r b i r t h , i n f a n t c a r e and v a r i o u s a s p e c t s o f t h e s o o n - t o - b e -assumed p a r e n t a l r o l e ( P r e n a t a l Q u e s t i o n n a i r e , A p p e n d i x A ) ; (2) p a r e n t a l e x p e c t a t i o n s f o r , and r e p o r t o f , i n f a n t temperament ( I n f a n t Temperament P r e d i c t i o n , A p p e n d i x B; I n f a n t Temperament R e p o r t , A p p e n d i x C ) ; (3) t i m e s p e n t i n h o s p i t a l w i t h t h e newborn i n f a n t ( H o s p i t a l D i a r y , A p p e n d i c e s D and E ) ; (4) m o t h e r - i n f a n t i n t e r a c t i v e b e h a v i o u r o b s e r v e d i n t h e n a t u r a l i s t i c s e t t i n g o f t h e home ( B e h a v i o u r R e c o r d , A p p e n d i c e s F and G); (5) p o s t p a r t u m e x p e r i e n c e s w i t h t h e new i n f a n t , and a s p e c t s o f i n f a n t c a r e and a d j u s t m e n t t o t h e p a r e n t a l r o l e ( P o s t p a r t u m Q u e s t i o n n a i r e , A p p e n d i x Q). I n a d d i t i o n , a r a t i n g s c a l e o f m a t e r n a l c a r e v a r i a b l e s d e v e l o p e d by A i n s w o r t h (1977) was used by t h e p o s t p a r t u m o b s e r v e r ( M a t e r n a l R a t i n g S c a l e s , A p p e n d i c e s H and I ) and i n f o r m a t i o n r e g a r d i n g t h e c o u r s e o f l a b o u r and d e l i v e r y , p e r i n a t a l m e d i c a t i o n , i n f a n t outcome and p o s t p a r t u m m e d i c a t i o n was t a k e n from t h e s u b j e c t ' s h o s p i t a l c h a r t ( C h a r t V a r i a b l e s , A p p e n d i x J ) . The development and use o f each i n s t r u m e n t w i l l be d i s c u s s e d s e p a r a t e l y and i n some d e t a i l , s i n c e a major p u r p o s e o f t h i s r e s e a r c h was t h e development o f i n s t r u m e n t s f o r a s s e s s i n g t h e development o f mother-i n f a n t b o n d i n g . A. P r e n a t a l Q u e s t i o n n a i r e (Appendix A) The i t e m s o f t h e P r e n a t a l Q u e s t i o n n a i r e were d e s i g n e d t o g a t h e r demographic i n f o r m a t i o n and t o a s s e s s e i g h t a r e a s of c o n c e r n thought t o be r e l a t e d t o sub sequent m a t e r n a l b e h a v i o u r and a d j u s t m e n t t o t h e p a r e n t a l r o l e . O r i g i n a l l y t h e q u e s t i o n n a i r e was p l a n n e d t o be open-ended, a l l o w i n g s u b j e c t s t o f i l l i n 47 t h e i r own r e s p o n s e s t o each i t e m . I n o r d e r t o f a c i l i t a t e d a t a a n a l y s i s , however, t h e f o r m a t was changed t o f i v e - p o i n t , L i k e r t - t y p e s c a l i n g on t h e i t e m s f o r w h i c h i t was a p p r o p r i a t e . Most of t h e o t h e r i t e m s were d e s i g n e d w i t h a l i m i t e d number of p o s s i b l e a n s w e r s , o f w h i c h t h e s u b j e c t was t o choose o n l y one, b u t a few o f t h e i t e m s were n e c e s s a r i l y open-ended. The q u e s t i o n n a i r e was p i l o t - t e s t e d on f o u r s u b j e c t s who were t h e n a s k e d t o d i s c u s s t h e q u e s t i o n n a i r e and t h e i r r e s p o n s e s w i t h t h e i n v e s t i g a t o r . On t h e b a s i s o f t h i s i n f o r m a t i o n t h e q u e s t i o n n a i r e was r e v i s e d t o i t s p r e s e n t form. The e i g h t s u b - s c a l e s and t h e i t e m s r e l a t e d t o each a r e i n c l u d e d i n A p p e n d i x K. The s u b - s c a l e s a r e : (a) mother's f e e l i n g s toward p r e g n a n c y , w h i c h i n c l u d e s b o t h e m o t i o n a l and p h y s i c a l a s p e c t s (7 i t e m s ) ; (b) mother's p e r c e p t i o n s o f t h e s u p p o r t o f h u s b a n d / p a r t n e r , i n c l u d i n g whether h u s b a n d / p a r t n e r a t t e n d e d p r e n a t a l c l a s s e s , h i s f e e l i n g s toward t h e pregnancy and t h e mother's a n t i c i p a t i o n o f h i s i n v o l v e m e n t i n c h i l d c a r e (10 i t e m s ) ; (c) mother's e x p e r i e n c e i n p r e n a t a l c l a s s e s , i n c l u d i n g t o p i c s c o v e r e d and s a t i s f a c t i o n w i t h t h e c l a s s e s (7 i t e m s ) ; (d) mother's p r e p a r a t i o n f o r l a b o u r and d e l i v e r y , i n c l u d i n g p l a n s f o r h a v i n g a p a r t n e r d u r i n g l a b o u r and d e l i v e r y and t h e use o f p e r i n a t a l m e d i c a t i o n (8 i t e m s ) ; (e) mother's c o n f i d e n c e i n c a r e g i v i n g a b i l i t y (4 i t e m s ) ; ( f ) mother's e x p e c t a t i o n o f t h e r o l e o f t h e i n f a n t i n h e r l i f e , i n c l u d i n g h e r p l a n s t o r e t u r n t o work, he r p l a n s f o r h a v i n g h e l p a t home a f t e r t h e b i r t h (11 i t e m s ) ; (g) mother's arrangements f o r c h i l d c a r e , i n c l u d i n g arrangement o f a room, c l o t h i n g , e t c . , f o r t h e baby, p l a n s f o r f e e d i n g , and knowledge about i n f a n t c a r e f r o m books (4 i t e m s ) ; and (h) mother's i n v o l v e m e n t w i t h and p r e d i c t i o n of a t t a c h m e n t t o t h e i n f a n t , i n c l u d i n g h e r w i s h e s t o keep t h e baby i n h e r h o s p i t a l room a f t e r t h e b i r t h , and h e r e s t i m a t i o n o f when she and h e r i n f a n t would d e v e l o p s t r o n g f e e l i n g s f o r one a n o t h e r (6 i t e m s ) . A f a c t o r a n a l y s i s of t h e r e s u l t s o f t h e P r e n a t a l Q u e s t i o n n a i r e was 48 p l a n n e d t o e m p i r i c a l l y v e r i f y t h e e x i s t e n c e o f s u b - s c a l e s and t h e r e l a t i o n s h i p o f e ach i t e m s t o t h e s u b - s c a l e s . B. I n f a n t Temperament P r e d i c t i o n (ITP) and R e p o r t (ITR) ( A p p e n d i c e s B and C) Because no temperament s c a l e s i n t e n d e d f o r use w i t h one-month o l d i n f a n t s were a v a i l a b l e , one was d e v e l o p e d f o r t h i s s t u d y . R o t h b a r t and h e r c o l l e a g u e s have r e c e n t l y d e v e l o p e d a temperament s c a l e f o r 3 t o 12 month o l d i n f a n t s ( R o t h b a r t , F u r b y , K e l l y and H a m i l t o n , 1977), b u t i t was n o t a v a i l a b l e even f o r a d a p t a t i o n t o t h e one-month l e v e l a t the b e g i n n i n g o f t h i s r e s e a r c h p r o j e c t . The temperament s c a l e d e v e l o p e d by Ca r e y ( 1 9 7 6 ) , w h i c h i s base d on th e work by Thomas, Chess and B i r c h (1968) and i s a l s o g e a r e d t o o l d e r i n f a n t s , was used t o g u i d e t h e s e l e c t i o n o f i t e m s s u i t a b l e f o r a younger sample. The r a t i o n a l e b e h i n d t h e temperament s c a l e s was n o t t o o b t a i n an i n d e p e n d -ent measure o f t h e i n f a n t ' s temperament, b u t t o have a measure o f t h e i n f a n t ' s temperament as i t was p e r c e i v e d by t h e p a r e n t . Thus, what was b e i n g measured was w h e t h e r t h e mother t h o u g h t h e r baby was ea s y t o manage o r was d i f f i c u l t t o h a n d l e . I t was a l s o t h ought t h a t t h e p a r e n t ' s a n t i c i p a t i o n o f t h e i n f a n t ' s temperament o r d i s p o s i t i o n b e f o r e t h e i n f a n t was b o r n , and t h e match o r mismatch of t h i s e x p e c t a t i o n t o t h e i n f a n t ' s " a c t u a l " temperament (as p e r c e i v e d by t h e p a r e n t ) , would be an i m p o r t a n t v a r i a b l e i n t h e mother's a d j u s t m e n t t o h e r new baby and t o t h e c o u r s e o f t h e i r r e l a t i o n s h i p . The I n f a n t Temperament P r e d i c t i o n and t h e I n f a n t Temperament R e p o r t each c o n s i s t o f 15 i t e m s w h i c h d e s c r i b e a s i t u a t i o n , such as "When I put my baby t o bed, s/he...", "When I show my baby a new t o y , s/he...", e t c . The s i t u a t i o n s a r e c a r e g i v i n g ones ( f e e d i n g , s l e e p i n g , b a t h i n g ) , i n t e r a c t i v e ones, s u c h as r e s p o n s e t o t o y s o r t o p e o p l e , and g e n e r a l temperament q u e s t i o n s r e g a r d i n g p h y s i c a l a c t i v i t y and mood. Each i t e m i s f o l l o w e d by t h r e e p o s s i b l e r e s p o n s e s . The r e s p o n s e s r e f l e c t a t h r e e - p o i n t s c a l e o f i n f a n t f u n c t i o n i n g , 49 s i m i l a r t o t h a t employed by Carey — easy baby, medium baby, d i f f i c u l t baby. F o r t h e ITP, mothers were asked t o c o n s i d e r t h e i r own and t h e i r husband's temperament, and t o p r e d i c t t h e i r i n f a n t ' s b e h a v i o u r i n t h e 15 s i t u a t i o n s ; f o r t h e ITR, t h e y were a s k e d t o r e p o r t t h e i r i n f a n t ' s r e s p o n s e i n t h e 15 s i t u a t i o n s . Each i t e m was g i v e n a s c o r e o f 1 (easy b a b y ) , 2 (medium b a b y ) , o r 3 ( d i f f i c u l t b a b y ) , and t h r e e o v e r a l l s c o r e s were computed f o r each s u b j e c t — ITP sum s c o r e , ITR sum s c o r e , and ITP-ITR d i f f e r e n c e s c o r e . C. H o s p i t a l D i a r y ( A p p e n d i c e s D and E) The H o s p i t a l D i a r y was used t o a s s e s s t h e amount o f m o t h e r - i n f a n t c o n t a c t i n h o s p i t a l . I t was d e v e l o p e d as an a t t e m p t t o v e r i f y t h e h y p o t h e s i s p u t f o r t h by m e d i c a l r e s e a r c h e r s t h a t t h e amount o f m o t h e r - i n f a n t c o n t a c t i m m e d i a t e l y a f t e r b i r t h ( K e n n e l l , J e r a u l d , W o l f e , C h e s t e r , K r e g e r , M c A l p i n e , S t e f f a & K l a u s , 1974; K l a u s , J e r a u l d , K r e g e r , M c A l p i n e , S t e f f a , & K e n n e l ; K l a u s & K e n n e l l , 1976; R i n g l e r , K e n n e l l , J a r v e l l a , N a v o j o s k y & K l a u s , 1975), and d u r i n g t h e h o s p i t a l s t a y ( L e i f e r , L e i d e r m a n , B a r n e t t & W i l l i a m s , 1972) i s an i m p o r t a n t v a r i a b l e w h i c h a f f e c t s t h e c o u r s e of m a t e r n a l - i n f a n t b o n d i n g . The d i a r y was d e s i g n e d w i t h two s e c t i o n s : t h e f i r s t c o n c e r n s c o n t a c t w i t h t h e i n f a n t r i g h t a f t e r b i r t h and t h r o u g h o u t t h e f i r s t 12 h o u r s and i s a s e r i e s o f q u e s t i o n s c o n c e r n i n g t h a t p e r i o d ; t h e second c o n c e r n s d a i l y c o n t a c t , i . e . , t h e amount o f t i m e t h e i n f a n t s t a y e d i n t h e mother's room d u r i n g each day o f t h e h o s p i t a l s t a y . I n a d d i t i o n , some assessment o f t h e d a i l y a c t i v i t i e s o f mother and i n f a n t was a t t e m p t e d ( s u c h as f e e d i n g , c h a n g i n g d i a p e r , h o l d i n g , a r r i v a l o f f a t h e r , n u r s e , e t c . ) . The d a i l y d i a r y c o n s i s t e d o f a g r i d o f h o u r s - b y -a c t i v i t i e s , and s u b j e c t s were asked t o f i l l i n t h e s q u a r e s f o r t h e a p p r o p r i a t e t i m e s and e v e n t s . 50 D. B e h a v i o u r R e c o r d ( A p p e n d i c e s F and G) The B e h a v i o u r R e c o r d i s an o b s e r v a t i o n a l t o o l d e v e l o p e d f o r r e c o r d i n g m o t h e r - i n f a n t i n t e r a c t i v e b e h a v i o u r i n a n a t u r a l i s t i c s e t t i n g . O r i g i n a l l y i t was an open-ended, c o n t i n u o u s r e c o r d i n g s y s t e m w i t h p r e - c o d e d c a t e g o r i e s b a s e d upon t h e work o f C l a r k e - S t e w a r t ( 1 9 7 3 ) . I n t h i s s y s t e m , a r u n n i n g r e c o r d o f m a t e r n a l and i n f a n t b e h a v i o u r i s w r i t t e n by an o b s e r v e r i n t o a s t e n o g r a p h e r ' s notebook w i t h t h e pages d i v i d e d l e n g t h w i s e , one s i d e f o r mother's b e h a v i o u r s , one s i d e f o r i n f a n t ' s b e h a v i o u r s . S i m u l t a n e o u s b e h a v i o u r i s r e c o r d e d on t h e same l i n e and n o n - s i m u l t a n e o u s b e h a v i o u r i s r e c o r d e d on a l t e r n a t i n g l i n e s . Time i n t e r v a l s a r e marked w i t h a h o r i z o n t a l l i n e a c r o s s t h e page. T h i s s y s t e m was a t t e m p t e d and abandoned f o r f o u r r e a s o n s . The most s e r i o u s p r o b l e m was t h a t t h e system r e l i e s upon t h e o b s e r v e r ' s memory o f t h e p r e - c o d e d c a t e g o r i e s , and i t was found t h a t i t was p o s s i b l e t o t e m p o r a r i l y f o r g e t one o r more c a t e g o r i e s i n a g i v e n o b s e r v a t i o n , t h e r e b y a c c i d e n t a l l y b u t s y s t e m a t i c a l l y r e d u c i n g t h e number of c a t e g o r i e s r e c o r d e d and making i t i m p o s s i b l e t o compare o b s e r v a t i o n s a c r o s s s u b j e c t s . I t was f e l t t h a t t h e C l a r k e - S t e w a r t method would be w o r k a b l e i f t h e o b s e r v e r were d o i n g many o b s e r v a t i o n s o v e r a s h o r t p e r i o d of t i m e , s i n c e r e p e t i t i o n o f t h e t a s k would h e l p r e t e n t i o n o f t h e c a t e g o r i e s i n t h e o b s e r v e r ' s memory. As t h i s was n o t t h e c a s e i n t h i s r e s e a r c h p r o j e c t , t h e s y s t e m was found t o be u n s u i t a b l e . Second, t h e w r i t i n g out o f each b e h a v i o u r o b s e r v e d , even i n a coded form, was found t o be v e r y t i m e - c o n s u m i n g , and t h u s a f a i r l y l a r g e p r o p o r t i o n o f t h e b e h a v i o u r e x h i b i t e d by t h e mother and i n f a n t was m i s s e d w h i l e t h e o b s e r v e r , was engaged i n w r i t i n g down th e p r e v i o u s b e h a v i o u r s . T h i r d , i n t e r - o b s e r v e r agreement c o u l d n o t be o b t a i n e d even a f t e r p r o l o n g e d t r a i n i n g , p o s s i b l y as a r e s u l t o f t h e two problems m e n t i o n e d above. F o u r t h , t h e t a s k of a c c u r a t e l y t r a n s c r i b i n g t h e raw d a t a once i t had been c o l l e c t e d was e x t r e m e l y t i m e - c o n s u m i n g , and r e l i a b i l i t y was d i f f i c u l t t o a c h i e v e . 51 The r e c o r d i n g s y s t e m d e v e l o p e d f o r t h i s p r o j e c t was a t i m e - s a m p l i n g s y s t e m based upon p r e v i o u s work of t h e p r e s e n t a u t h o r ( L e e - P a i n t e r & L e w i s , 1975; L e w i s & L e e - P a i n t e r , 1974). I n t h e p r e s e n t s y s t e m , t h e s e l e c t e d b e h a v i o u r a l c a t e g o r i e s were p r i n t e d on s p e c i a l o b s e r v a t i o n s h e e t s , and m a t e r n a l and i n f a n t b e h a v i o u r s were m e r e l y checked o f f by t h e o b s e r v e r as t h e y o c c u r r e d . T h i s was found t o save t i m e and p r e s e r v e a c c u r a c y , as a t r a i n e d o b s e r v e r needed v e r y l i t t l e t i m e t o l o c a t e and check o f f the b e h a v i o u r as i t happened and c o u l d be r e a d y t o r e c o r d t h e n e x t b e h a v i o u r when i t o c c u r r e d . The t i m e - b a s e chosen f o r r e c o r d i n g was f i f t e e n - s e c o n d i n t e r v a l s . T h i s i n t e r v a l was chosen t o be l a r g e enough f o r t h e o b s e r v e r t o o b s e r v e and r e c o r d a number of b e h a v i o u r s , but s m a l l enough so t h a t o n l y a l i m i t e d number o f b e h a v i o u r s w o u l d o c c u r w i t h i n one t i m e - f r a m e . Thus b o t h t h e r a t e and v a r i a t i o n of b e h a v i o u r f o r any i n d i v i d u a l m o t h e r - i n f a n t p a i r c o u l d be a c c u r a t e l y r e c o r d e d . The o b s e r v a t i o n s h e e t s (Appendix F) were p r i n t e d t o have 8 t i m e - f r a m e s o r t h e e q u i v a l e n t o f two m i n u t e s o f o b s e r v a t i o n a l t i m e p e r page. A s m a l l t i m e r c a l i b r a t e d t o f i f t e e n - s e c o n d i n t e r v a l s was used t o t i m e t h e i n t e r v a l s . The t o t a l o b s e r v a t i o n t i m e f o r each m o t h e r - i n f a n t p a i r was one h o u r , i . e . , t h e o b s e r v a t i o n p e r i o d c o n t i n u e d u n t i l t h e o b s e r v e r had c o l l e c t e d d a t a on 30 two-m i n u t e pages. U s i n g t h i s sytem a g i v e n b e h a v i o u r can be r e c o r d e d as h a v i n g o c c u r r e d o r h a v i n g n o t o c c u r r e d d u r i n g any g i v e n f i f t e e n - s e c o n d p e r i o d . B e h a v i o u r i s r e c o r d e d o n l y once d u r i n g a p e r i o d , no m a t t e r how many t i m e s i t a c t u a l l y o c c u r r e d d u r i n g t h a t t i m e - f r a m e . C o n t i n g e n t m a t e r n a l b e h a v i o u r i s r e c o r d e d i n a s p e c i a l s e c t i o n of each t i m e - f r a m e . The main element l o s t i n t h i s r e c o r d -i n g system i s t h e i n d i c a t i o n o f c o n t i n u o u s b e h a v i o u r . I t i s n o t p o s s i b l e t o e x t r a c t from t h e raw d a t a whether a b e h a v i o u r r e c o r d e d i n two c o n s e c u t i v e t i m e - f r a m e s was g o i n g on c o n t i n u o u s l y f o r 30 s e c o n d s , o r wehther i t o c c u r r e d once d u r i n g each o f two c o n s e c u t i v e f i f t e e n - s e c o n d r e c o r d i n g p e r i o d s w i t h a 52 pause between t h e two o c c u r r e n c e s . B e h a v i o u r a l c a t e g o r i e s were c h o s e n i n a way t h a t , i t was hoped, wo u l d e l i m i n a t e t h e p r o b l e m o f r e c o r d i n g e i t h e r m o l a r o r m o l e c u l a r b e h a v i o u r , b u t n o t b o t h , as had been t h e c a s e i n p r e v i o u s r e s e a r c h . G l o b a l c a t e g o r i e s were chosen t o r e f l e c t s e v e r a l p o s s i b l e d i m e n s i o n s o f m a t e r n a l b o n d i n g o r a d j u s t m e n t , and i n d i v i d u a l b e h a v i o u r s were grouped under t h e s e g l o b a l b e h a v i o u r a l c a t e g o r i e s . As t h e f o c u s o f t h e r e s e a r c h was the mother, more m a t e r n a l b e h a v i o u r s t h a n i n f a n t b e h a v i o u r s were o b s e r v e d and r e c o r d e d . The f i v e g l o b a l c a t e g o r i e s o f m a t e r n a l b e h a v i o u r i n c l u d e d 28 i n d i v i d u a l b e h a v i o u r s , and t h e two c a t e g o r i e s of i n f a n t b e h a v i o u r i n c l u d e d 7 i n d i v i d u a l b e h a v i o u r s . I n f a n t b e h a v i o u r s were chosen as an a b b r e v i a t e d c a t e g l o g u e o f t h e one-month b e h a v i o u r a l r e p e r t o i r e ; t h e y g i v e an o v e r a l l measure o f i n f a n t a c t i v i t y , and a l s o s e r v e as a n c h o r s f o r m a t e r n a l r e s p o n s i v e b e h a v i o u r . I n f a n t b e h a v i o u r s chosen were f o c u s a t t e n t i o n , v o c a l i z a t i o n , g r u n t , g r o s s motor movement, c r y - f u s s , s m i l e and m i s c e l l a n e o u s (yawn, b u r p , e t c . ) . M a t e r n a l b e h a v i o u r s were chosen t o r e f l e c t q u a l i t a t i v e d i f f e r e n c e s among the g l o b a l c a t e g o r i e s , t o d i f f e r e n t i a t e t i m e s p e n t i n c a r e g i v i n g t a s k s from t h a t i n n o n - c a r e g i v i n g i n t e r a c t i v e b e h a v i o u r , and t o e v a l u a t e v a r i o u s b e h a v i o u r s used i n p r e v i o u s r e s e a r c h . A l i s t o f b e h a v i o u r s and d e f i n i t i o n s i s i n c l u d e d i n A p p e n d i x G. The g l o b a l c a t e g o r i e s and t h e i r subsumed b e h a v i o u r s were: I . P h y s i c a l c o n t a c t : c l o s e p h y s i c a l c o n t a c t ( i n arms o r on s h o u l d e r ) l o o s e c o n t a c t i n f a n t h e l d i n mother's l a p i n f a n t h e l d s e c u r e l y away fr o m mother's body I I . S o c i a l engagement: V i s u a l engagement: mother h o l d s h e r f a c e s o t h a t ^ h e r eyes and h e r i n f a n t ' s eyes a r e i n t h e same p l a n e ("en f a c e " ) eye t o eye c o n t a c t 53 Vocal engagement: Tactile engagement: Play engagement: III. Provide stimulation: IV. Affection: V. Caregiving: VI. Contingent response: mother vocalizes to infant mother requests responsive smile or vocalization mother touches infant with fingers mother pats or strokes infant with palm of hand mother smiles at infant mother plays with infant with or without object mother makes a "play face" or exaggerated face at infant visual stimulation auditory stimulation tactile stimulation vestibular stimulation mother kisses infant mother uses infant's name mother uses a nickname mother feeding infant (breast or bottle) mother begins feeding mother interrupts feed mother changes infant's clothing, diaper or gives bath mother adjusts infant's position, clothing, etc. a l l maternal behaviour which is recorded as being contingently responsive to an infant's behaviour E. Postpartum Questionnaire (Appendix Q) The Postpartum Questionnaire was designed to gather information about seven areas of concern in the postpartum period; as in the Prenatal Questionnaire, most of the items were in the form of five-point Likert type scales. The areas assessed were: (a) postpartum physical condition of mother and infant; (b) mother's experiences in hospital during labour, delivery and postpartum stay; (c) mother's-perception of support of husband during labour and delivery and infant care; (d) mother's self-confidence in caregiving; (e) mother's caregiving routines; (f) mother's report of her relationship with 54 h e r i n f a n t ; and (g) mother's p e r c e p t i o n o f t h e r o l e of t h e i n f a n t i n h e r l i f e . S e v e r a l o f t h e s e s u b - s c a l e s a r e r e l a t e d t o s u b - s c a l e s on t h e P r e n a t a l Q u e s t i o n n a i r e and were i n c l u d e d b o t h f o r t h e i n f o r m a t i o n t h e y would y i e l d about t h e p o s t p a r t u m e x p e r i e n c e and t o d e t e r m i n e whether t h e r e i s c o n t i n u i t y between t h e p r e n a t a l and p o s t p a r t u m p e r i o d s w i t h r e g a r d t o t o p i c s s u c h as p e r c e p t i o n o f husband's s u p p o r t , c o n f i d e n c e i n c a r e g i v i n g , p e r c e p t i o n o f t h e m o t h e r - i n f a n t r e l a t i o n s h i p and the r o l e p l a y e d by t h e i n f a n t i n t h e mother's l i f e . F. M a t e r n a l R a t i n g S c a l e s ( A p p e n d i c e s H and I ) A s e t o f 18 s u b j e c t i v e r a t i n g s c a l e s w h i c h were d e v e l o p e d by A i n s w o r t h (1977) f o r use d u r i n g the f i r s t q u a r t e r o f t h e i n f a n t ' s f i r s t y e a r were i n c l u d e d i n o r d e r t o have a m o l a r assessment o f m a t e r n a l a t t i t u d e , e m o t i o n a l i n v o l v e m e n t and m a t e r n a l p e r c e p t i o n o f i n f a n t c a p a b i l i t i e s . They a r e i n t h e form o f n i n e - p o i n t L i k e r t - t y p e s c a l e s , and a r e f i l l e d out by t h e o b s e r v e r a f t e r t h e one-month p o s t p a r t u m v i s i t , w i t h t h e a s s i s t a n c e o f a manual p r o v i d e d by A i n s w o r t h (Appendix I ) w h i c h d e s c r i b e s i n d e t a i l f i v e a n c h o r p o i n t s f o r each s c a l e . The 18 r a t i n g s c a l e s f a l l i n t o s e v e n g e n e r a l a r e a s : A. G e n e r a l a t t i t u d e o f t h e mother toward h e r i n f a n t and toward h e r own r o l e as mother: (a) mother's p e r c e p t i o n o f i n f a n t , (2) mother's d e l i g h t e x p r e s s e d toward i n f a n t , (3) mother's a c c e p t a n c e o f i n f a n t and t h e demands o f i n f a n t c a r e , (4) mother's a b i l i t y t o p r o v i d e i n f o r m a t i o n about t h e i n f a n t ; B. F e e d i n g : (1) mother's s y n c h r o n i z a t i o n o f f e e d i n g t i m e s w i t h i n f a n t ' s own r h ythms, (2) w h e t h e r mother o r i n f a n t d e t e r m i n e s t h e amount o f f o o d g i v e n and t h e end o f a f e e d i n g s e s s i o n , (3) mother's s y n c h r o n i z a t i o n o f r a t e o f f e e d i n g t o i n f a n t ' s own p a c e ; C. A v a i l a b i l i t y and I n t e r a c t i o n : (1) mother's p h y s i c a l and p s y c h o l o g i c a l a v a i l a b i l i t y t o i n f a n t , (2) amount o f i n t e r a c t i o n o f f e r e d t o i n f a n t by mother, (3) a p p r o p r i a t e n e s s o f mother's i n t e r a c t i o n s w i t h 55 i n f a n t ; D. P h y s i c a l c o n t a c t : (1) amount o f p h y s i c a l c o n t a c t between mother and i n f a n t , (2) q u a l i t y o f mother's p h y s i c a l c o n t a c t w i t h i n f a n t ; E. M o t h e r ' s e f f e c t i v e n e s s o f and l a t e n c y t o r e s p o n d t o i n f a n t ' s c r y i n g ; F. S o c i a l c o n t a c t : (1) amount o f v i s u a l c o n t a c t w i t h mother and e n v i r o n m e n t , (2) amount o f a u d i t o r y and v o c a l c o n t a c t w i t h mother and e n v i r o n m e n t , (3) f r e q u e n c y of p l a y i n t e r a c t i o n p r o v i d e d by mother; G. F a c i l i t a t i o n o f s e n s o r i m o t o r development: (1) s t i m u l u s p o t e n t i a l o f t h e p h y s i c a l e n v i r o n m e n t , (2) mother's encouragement o f s e n s o r i m o t o r a c h i e v e m e n t . I n a d d i t i o n t o p r o v i d i n g a measure o f m a t e r n a l f u n c t i o n i n g , t h e s e s c a l e s were i n c l u d e d t o l e n d v a l i d i t y t o t h e o b s e r v a t i o n a l measurement o f s i m i l a r b e h a v i o u r and b e h a v i o u r a l p a t t e r n s ( e . g . amount o f p l a y , amount o f v i s u a l o r v o c a l c o n t a c t , o r amount o f s t i m u l a t i o n p r o v i d e d ) . G. C h a r t V a r i a b l e s (Appendix J ) I n f o r m a t i o n was t a k e n from t h e s u b j e c t s ' h o s p i t a l c h a r t s i n o r d e r t o d e t e r m i n e w h e t h e r t h e r e i s a r e l a t i o n s h i p between m a t e r n a l b e h a v i o u r a t one-month p o s t p a r t u m and s u c h v a r i a b l e s as l e n g t h o f l a b o u r , t y p e o f d e l i v e r y , p e r i n a t a l m e d i c a t i o n and i n f a n t outcome. The v a r i a b l e s used were: l e n g t h o f l a b o u r , s t i m u l a t i o n o f l a b o u r , t y p e o f d e l i v e r y ( v a g i n a l o r c a e s a r i a n s e c t i o n ) , m e c h a n i c a l i n t e r v e n t i o n such as use of f o r c e p s o r a r t i f i c i a l r u p t u r e o f t h e membranes, m e d i c a l i n t e r v e n t i o n s u c h as use o f a n a l g e s i a o r a n e s t h e s i a , i n f a n t ' s g e s t a t i o n a l age, i n f a n t ' s b i r t h w e i g h t , Agpar s c o r e s a t one and f i v e m i n u t e s , i n f a n t outcome (whether t h e i n f a n t went t o t h e r e g u l a r o r i n t e n s i v e c a r e n u r s e r y f o l l o w i n g d e l i v e r y ) , and p o s t - d e l i v e r y m e d i c a t i o n f o r mother o r i n f a n t . 56 RESULTS AND DISCUSSION The r e s u l t s o b t a i n e d f o r each o f t h e v a r i o u s i n s t r u m e n t s u s e d , and t h e r e l a t i o n s h i p s among th e v a r i a b l e s a s s e s s e d w i t h t h o s e i n s t r u m e n t s were b o t h o f i n t e r e s t . As t h e main p u r p o s e o f t h e r e s e a r c h was t h e e v a l u a t i o n o f methods r a t h e r t h a n h y p o t h e s i s t e s t i n g , each i n s t r u m e n t w i l l be t r e a t e d i n t u r n . F o r each i n s t r u m e n t t h e r e s u l t s w i l l be d e s c r i b e d and used as a g u i d e f o r making an assessment o f t h a t i n s t r u m e n t ; t h i s w i l l be f o l l o w e d by a d i s c u s s i o n o f t h e s t r e n g t h s and weaknesses o f t h a t i n s t r u m e n t and recommendations f o r changes f o r f u t u r e u s e . U n l e s s o t h e r w i s e n o t e d , t h e r e s u l t s a r e f o r t h e Core group o f s u b j e c t s (n = 27) on w h i c h a l l i n s t r u m e n t s were t e s t e d . A. P r e n a t a l Q u e s t i o n n a i r e (Appendix A) (Note: S p e c i f i c i t e m s on t h e P r e n a t a l Q u e s t i o n n a i r e w i l l be r e f e r r e d t o by a s h o r t h a n d s y s t e m i n d i c a t i n g t h e a p p e n d i x l e t t e r and i t e m number. F o r example, q u e s t i o n 10 i n t h e P r e n a t a l Q u e s t i o n n a i r e w i l l be r e f e r r e d t o as A:10. A l l s c a l e s used were f i v e - p o i n t , L i k e r t - t y p e s c a l e s . When two p o i n t s a r e m e n t i o n e d , t h e f i r s t i s r a t e d 1, and t h e second i s r a t e d 5; when t h r e e p o i n t s a r e m e n t i o n e d , t h e f i r s t i s r a t e d 1, t h e second ( m i d p o i n t ) i s r a t e d 3, and t h e t h i r d i s r a t e d 5.) The P r e n a t a l Q u e s t i o n n a i r e was c o n s t r u c t e d on t h e b a s i s of e i g h t a r e a s o f i n t e r e s t w h i c h were assumed t o be r e l a t e d t o b o t h p e r i n a t a l and p o s t p a r t u m v a r i a b l e s , and t o be t h e m s e l v e s i n t e r r e l a t e d . 1. F e e l i n g s toward pregnancy were e v a l u a t e d u s i n g t h r e e groups of i t e m s . (a) The e m o t i o n a l and p h y s i c a l accompaniments o f p r e g n a n c y ( A : l ) were a s s e s s e d by h a v i n g s u b j e c t s r a t e t h e i r o v e r a l l f e e l i n g s on 7 f i v e - p o i n t s c a l e s w h i c h had t h e f o l l o w i n g p a i r s o f anchor p o i n t s : " v e r y e n e r g e t i c " - " v e r y t i r e d " ; " v e r y r e l a x e d " - " v e r y a n x i o u s " ; " v e r y c o m f o r t a b l e " - " q u i t e u n c o m f o r t a b l e " ; 57 " c o n t e n t " - " i m p a t i e n t " ; " e l a t e d " - " d e p r e s s e d " ; " v e r y h a p p y " - " v e r y unhappy"; and " c u r i o u s " - " b o r e d " . The m i d p o i n t s f o r a l l s c a l e s were l a b e l l e d "normal f o r me". F o r t h e f i r s t f i v e s c a l e s , s u b j e c t s a c t u a l l y used a l l f i v e p o i n t s t o d e s c r i b e t h e m s e l v e s ; f o r t h e l a s t two s c a l e s , s u b j e c t s used o n l y t h e f i r s t t h r e e and t h e f i r s t f o u r p o i n t s , r e s p e c t i v e l y . S u b j e c t s r a t e d t h e m s e l v e s as n o r m a l l y r e l a x e d (X=2.7), c o m f o r t a b l e (X=2.8), c o n t e n t (X=2.5) and e l a t e d (X=2.7); f a i r l y t i r e d (X=3.4); q u i t e happy (X=l.-9) and f a i r l y c u r i o u s (X=2.2). C o r r e l a t i o n s among r e s p o n s e s t o t h e s e i t e m s a r e shown i n T a b l e 2. R e p o r t o f f e e l i n g c o n t e n t was p o s i t i v e l y r e l a t e d t o r e p o r t of f e e l i n g r e l a x e d , happy and c o m f o r t a b l e (r=.52, p_<.01; r=.43, p_<.05; r=.49, p_<.01 r e s p e c t i v e l y ) and r e p o r t o f f e e l i n g e l a t e d was p o s i t i v e l y r e l a t e d t o f e e l i n g e n e r g e t i c , happy and c o n t e n t (r=.43, p_<.05; r=.51, p_<.01; r=.42, p<.05 r e s p e c t i v e l y ) . There a r e a t l e a s t f o u r p o s s i b l e e x p l a n a t i o n s f o r t h e t e n d e n c y t o s e l f - r e p o r t as "normal f o r me" on t h e s e s c a l e s . (1) T h i s r e s p o n s e may a c c u r a t e -l y r e f l e c t t h e s u b j e c t ' s f e e l i n g s . (2) T h i s r e s p o n s e may r e f l e c t a w i s h t o be seen as " n o r m a l " and w i t h o u t s p e c i a l problems ( i . e . , " n o r m a l " i s t h e s o c i a l l y d e s i r a b l e r e s p o n s e ) . (3) T h i s r e s p o n s e may r e f l e c t a w i s h t o be n o r m a l , and t h e hope t h a t a n o r m a l pregnancy w i l l r e s u l t i n a n o r m a l baby. Or, (4) t h i s r e s p o n s e may be an a r t i f a c t o f s c a l e c o n s t r u c t i o n , r e f l e c t i n g a n a t u r a l tendency o f s u b j e c t s t o r a t e t h e m s e l v e s i n the m i d d l e o f a s c a l e . N o t e s made by t h e i n v e s t i g a t o r f o l l o w i n g t h e p r e n a t a l i n t e r v i e w i n d i c a t e d t h a t many women e x p r e s s e d boredom w i t h t h e i r p r e g n a n t c o n d i t i o n , and i m p a t i e n c e t o g i v e b i r t h . Y e t t h e y d i d n o t r a t e t h e m s e l v e s as even m o d e r a t e l y i m p a t i e n t o r b o r e d on t h e s e s c a l e s . The Q u e s t i o n n a i r e group (n=110 a d d i t i o n a l s u b j e c t s ) showed t h e same t e n d e n c y t o r e p o r t "normal f o r me" on t h e s e s c a l e s . whereas Core s u b j e c t s used o n l y t h r e e and f o u r s c a l e p o i n t s t o d e s c r i b e t h e m s e l v e s on two of t h e t h r e e s c a l e s ("very h a p p y " - " v e r y unhappy"; " c u r i o u s " - " b o r e d " ) , 58 Q u e s t i o n n a i r e s u b j e c t s used a l l f i v e p o i n t s on a l l s c a l e s , a l t h o u g h o n l y two o f t h e s e s u b j e c t s r a t e d t h e m s e l v e s as v e r y unhappy ( i . e . , used t h e l a s t p o i n t on t h e s c a l e ) , n i n e r a t e d t h e m s e l v e s as unhappy ( i . e . , used t h e second t o l a s t p o i n t ) , and o n l y f i v e r a t e d t h e m s e l v e s as b o r e d (used t h e l a s t p o i n t on t h a t s c a l e ) . The d a t a a v a i l a b l e do n o t g i v e adequate i n f o r m a t i o n t o d e c i d e what may be c a u s i n g t h e tendency t o r e p o r t "normal f o r me" on t h e s e s c a l e s . ( I t i s perhaps w o r t h n o t i n g t h a t i n h i s r e v i s e d temperament s c a l e C arey a v o i d e d t h e p r o b l e m o f m i d p o i n t s by u s i n g 6 - p o i n t s c a l e s ( C a r e y , 1978).) (b) P h y s i c a l problems d u r i n g pregnancy were r e c o r d e d u s i n g a c h e c k l i s t (A:2) and a t o t a l s c o r e and a s c a l e d s c o r e based upon t h e s e r i o u s n e s s o f t h e p r o b l e m ( s ) were d e r i v e d . The problems r e p o r t e d and number o f s u b j e c t s r e p o r t i n g each p r o b l e m a r e shown i n T a b l e 3. The number o f problems r e p o r t e d by any one s u b j e c t r a n g e d f r o m 0 t o 6, w i t h t h e mean g r e a t e r t h a n 2 (X=2.4). S e r i o u s n e s s o f problems were s c a l e d as f o l l o w s a f t e r c o n s u l t i n g w i t h a h e a l t h c a r e w o r k e r ( D a v i d s o n , 1977b) : s c o r e = 1 f o r m i l d p roblems o n l y ( i n s o m n i a , f a t i g u e , f l u i d r e t e n t i o n ) ; s c o r e = 2 f o r m i l d and/or one moderate p r o b l e m (morning s i c k n e s s , a n x i e t y , v a r i c o s e v e i n s , back o r l e g p r o b l e m s ) ; s c o r e = 3 f o r m i l d and/or two moderate p r o b l e m s ; s c o r e = 4 f o r m i l d and/or t h r e e o r f o u r moderate p r o b l e m s ; s c o r e = 5 f o r one o r more s e r i o u s p roblems ( h i g h b l o o d p r e s s u r e , b l e e d i n g , . d i a b e t e s , t o x e m i a , k i d n e y p r o b l e m s ) . The o b t a i n e d s c a l e d s c o r e s ranged f r o m 1 t o 5, w i t h t h e mean a t 2.4. (c) The t h i r d s e t o f p r e n a t a l q u e s t i o n n a i r e i t e m s c o n c e r n e d w i t h f e e l i n g s toward pregnancy i n v o l v e d assessment o f changes i n f e e l i n g s toward pregnancy (A:18-20, 2 6 ) . Three f i v e - p o i n t r a t i n g s c a l e s ("very h a p p y " - " v e r y unhappy" w i t h "mixed f e e l i n g s " as m i d p o i n t l a b e l ) were used t o d e s c r i b e f e e l i n g s a t f i r s t (upon l e a r n i n g o f p r e g n a n c y ) , l a t e r (when t h e s u b j e c t became used t o the i d e a ) and now l a s t t r i m e s t e r ) . S u b j e c t s a l s o d e s c r i b e d w h e t h e r t h e pregnancy was p l a n n e d ( " d e f i n i t e l y p l a n n e d " - " c o m p l e t e l y u n e x p e c t e d " ) , and 59 whether t h e pregnancy had caused a change i n t h e s u b j e c t ' s l i f e s t y l e ("a g r e a t d e a l " - " n o t a t a l l " ) . S i g n i f i c a n t c o r r e l a t i o n s among t h e s e i t e m s a r e shown i n T a b l e 4. S u b j e c t s r a t e d t h e m s e l v e s as m o d e r a t e l y happy upon l e a r n i n g o f t h e i r p r egnancy (X=1.96), and v e r y happy b o t h when t h e y became used t o t h e i d e a (X=1.3), and d u r i n g t h e l a s t t r i m e s t e r (X=1.2). S u b j e c t s o n l y used t h e f i r s t t h r e e p o i n t s o f t h e s e t h r e e s c a l e s t o d e s c r i b e t h e i r f e e l i n g s toward pregnancy. The modal r e p o r t was t h a t t h e pregnancy was d e f i n i t e l y p l a n n e d , a l t h o u g h 4 of th e 27 s u b j e c t s r e p o r t e d t h a t i t was " c o m p l e t e l y u n e x p e c t e d " , and 3 o t h e r s r e p o r t e d t h a t i t was somewhat u n e x p e c t e d . S u b j e c t s r e p o r t e d moderate changes i n t h e i r l i f e s t y l e as a r e s u l t o f t h e pregnan c y (X=2.7). The tend e n c y toward "happy" r a t i n g s was c o n f i r m e d by t h e Q u e s t i o n n a i r e group, as was t h e d i s t r i b u t i o n o f p l a n n i n g , a l t h o u g h more u n e x p e c t e d p r e g n a n c i e s were r e p o r t e d : 23 o ut o f 110 r e p o r t e d t h a t t h e pregnancy was " c o m p l e t e l y u n e x p e c t e d " . G r e a t e r changes i n l i f e s t y l e were a l s o r e p o r t e d by t h e Q u e s t i o n n a i r e g roup: 32% used t h e l a s t two p o i n t s on t h e s c a l e ( i n d i c a t i n g t h e g r e a t e s t amount o f change) t o d e s c r i b e t h e change i n t h e i r l i v e s , compared t o o n l y 18% o f t h e Core group. I t i s c u r i o u s t h a t , whereas o v e r o n e - q u a r t e r o f t h e Core s u b j e c t s r e p o r t e d t h a t t h e d i s c o v e r y o f t h e pregnancy was u n e x p e c t e d , n o t one r a t e d h e r s e l f as v e r y unhappy o r m o d e r a t e l y unhappy upon l e a r n i n g o f t h i s . A l t h o u g h t h e s o c i a l l y d e s i r a b l e " v e r y happy" was e x p e c t e d as t h e r e p o r t o f p r e s e n t f e e l i n g s , t h e i t e m s r e g a r d i n g f e e l i n g s a t f i r s t and l a t e r were d e l i b e r a t e l y i n c l u d e d i n o r d e r t o l e a r n about s u b j e c t s ' i n i t i a l r e a c t i o n s . Three p o s s i b l e e x p l a n a -t i o n s f o r t h i s s i t u a t i o n come t o mind. The sample might have been b i a s e d , i . e . , o n l y women happy w i t h t h e i r p r e g n a n c y v o l u n t e e r e d t o t a k e p a r t i n t h i s s t u d y . Or, perhaps women who d i s c o v e r an unwanted f i r s t p r egnancy may choose t o have an a b o r t i o n , t h e r e b y r e d u c i n g t h e number o f unhappy p r i m i p a r o u s women 60 who might have been p o t e n t i a l subjects. A t h i r d possible explanation i s dissonance reduction, i . e . , by the end of t h e i r pregnancy, even women who were unhappy at f i r s t have reconstructed t h e i r i n i t i a l f e e l i n g s to be more compatible with the unalterable fact that they are soon going to have a baby. There i s some support for t h i s explanation i n the prenatal interview data: one subject who said i n the interview that she had been di s t r e s s e d to f i n d h e r s e l f pregnant only a month a f t e r her marriage rated h e r s e l f on the questionnaire as only having "mixed f e e l i n g s " when she f i r s t learned of her pregnancy. The fact that f i v e percent of the Questionnaire group reported themselves to have been "very unhappy" at f i r s t but none described themselves as "very unhappy" l a t e r , or i n the t h i r d trimester, may be seen as lending support for the explanation that sample bias may be a f f e c t i n g the data. That i s , the fa c t that a greater number of Questionnaire group subjects did report f e e l i n g "very unhappy" at f i r s t may i n d i c a t e that the two samples were drawn from d i f f e r e n t populations. However, the lack of group differences i n responses to nearly every other item i n the Prenatal Questionnaire argues for another explanation. S o c i a l d e s i r a b i l i t y may have contaminated the data from the Core group. That i s , Questionnaire subjects may have f e l t free to report t h e i r true f e e l i n g s because t h e i r p a r t i c i p a t i o n was completely anonymous; however, Core subjects f i l l e d out t h e i r questionnaires knowing that a researcher who would be coming to v i s i t them would be l i k e l y to look at t h e i r responses and perhaps inquire about them. Thus they might have been more l i k e l y to give s o c i a l l y desirable responses to questions concerning t h e i r f e e l i n g s about t h e i r pregnancy. 2. The second of the eight areas of i n t e r e s t explored by the Prenatal Questionnaire was the support of the husband as perceived and reported by the subjects. I t was the subject's perception of support a v a i l a b l e , rather than 61 t h e a c t u a l s u p p o r t o f f e r e d o r r e p o r t e d by t h e husband, w h i c h was under s t u d y . Four s e t s o f i t e m s were used t o a s s e s s t h i s p e r c e i v e d s u p p o r t : t h e husband's a t t e n d a n c e i n p r e n a t a l c l a s s e s , h i s p l a n s t o be p r e s e n t a t t h e b i r t h , h i s f e e l i n g s toward p r e g n a n c y , and h i s i n t e n t i o n t o become i n v o l v e d w i t h i n f a n t c a r e . (a) P r e n a t a l c l a s s a t t e n d a n c e (A:9-10). A t l e a s t one p r e n a t a l c l a s s was a t t e n d e d by a l l b u t one husband (whose w i f e , a p r o f e s s o r o f p h y s i o l o g y , a l s o d i d n o t a t t e n d any c l a s s e s ) , and a l t h o u g h husbands g e n e r a l l y a t t e n d e d fewer c l a s s e s t h a n w i v e s , h a l f o f them a t t e n d e d a l l c l a s s e s g i v e n i n t h e c o u r s e i n w h i c h t h e c o u p l e had e n r o l l e d . (b) Husband's f e e l i n g s toward t h e p r e g n a n c y (A:23-25) were measured i n t h e same way as f o r w i v e s , i . e . , t h r e e f i v e - p o i n t s c a l e s f o r a t f i r s t , l a t e r , and now ( t h i r d t r i m e s t e r ) , a n c h o r e d as " v e r y happy"-"mixed f e e l i n g s " - " v e r y unhappy". Wives p e r c e i v e d t h e i r husbands' f e e l i n g s as more p o s i t i v e t h a n t h e i r own a t f i r s t (X=1.8) and as s i m i l a r t o t h e i r own l a t e r (X=1.3) and now (X=1.3). A g a i n o n l y t h e f i r s t t h r e e p o i n t s o f t h e s e s c a l e s were used. C o r r e l a t i o n s among i t e m s m e a s u r i n g w i v e s ' and husbands' f e e l i n g s were a l l g r e a t e r t h a n .53 (p<.01), and h a v i n g p l a n n e d t h e pregnancy was r e l a t e d t o w i v e s ' p e r c e p t i o n s o f p o s i t i v e f e e l i n g s f o r t h e i r husbands as w e l l as f o r t h e m s e l v e s ( a l l r_'s g r e a t e r t h a n .44, p<.05; see T a b l e 4 ) . (c) A l m o s t a l l husbands were p l a n n i n g t o a t t e n d l a b o u r (n=26) and d e l i v e r y (n=24) (A:34-36). On a f i v e - p o i n t s c a l e ( " q u i t e e n t h u s i a s t i c " - " w i l l i n g " - " n o t v e r y e n t h u s i a s t i c " ) 14 w i v e s r e p o r t e d t h e i r husbands t o be q u i t e e n t h u s i a s t i c about a t t e n d i n g t h e b i r t h , s i x were r e p o r t e d as e n t h u s i a s t i c , f i v e as w i l l i n g and one as u n e n t h u s i a s t i c . Husbands' i n v o l v e m e n t w i t h t h e b i r t h and e n t h u s i a s m f o r d o i n g so were r e l a t e d t o t h e number of c l a s s e s husbands had a t t e n d e d ( l o w e s t r=.43, p<.05; see T a b l e 5 ) . (d) Most husbands (n=24) were p e r c e i v e d as b e i n g i n t e r e s t e d i n becoming 62 i n v o l v e d w i t h i n f a n t c a r e (A:40-41). Wives j u d g e d t h e i r husbands' p r e p a r a t i o n f o r t h i s t a s k on a f i v e - p o i n t s c a l e ("very w e l l - p r e p a r e d " - " v e r y u n p r e p a r e d " ) : one was r e p o r t e d t o be v e r y w e l l - p r e p a r e d , n i n e were r e p o r t e d as p r e p a r e d , f i f t e e n as somewhat p r e p a r e d ( m i d p o i n t o f s c a l e ) , one as u n p r e p a r e d and one as v e r y u n p r e p a r e d . Husbands' i n t e r e s t i n i n f a n t c a r e and j u d g e d p r e p a r a t i o n were c o r r e l a t e d w i t h t h e number o f c l a s s e s a t t e n d e d by w i v e s ( l o w e s t r=.52, p<.01; see T a b l e 5 ) , b u t n o t t o t h e number o f c l a s s e s a t t e n d e d by husbands, w h i c h makes sense i f we r e c a l l t h a t i t i s t h e w i v e s ' p e r c e p t i o n s w h i c h a r e b e i n g measured. I n f u t u r e r e s e a r c h , i n f o r m a t i o n c o n c e r n i n g husbands' f e e l i n g s , a t t i t u d e s , and b e h a v i o u r s h o u l d be o b t a i n e d d i r e c t l y f rom them r a t h e r t h a n o n l y f r o m t h e i r w i v e s . F o r one t h i n g , t h e r e a p p e a r s t o be an emphasis i n t h e l o c a l p r e n a t a l c l a s s e s upon i n v o l v e m e n t o f t h e husband o r p a r t n e r , and s e v e r a l s u b j e c t s and t h e i r husbands e x p r e s s e d s u r p r i s e (and perhaps o f f e n c e ) a t t h e f a c t t h a t t h i s r e s e a r c h p r o j e c t d i d n o t d i r e c t l y i n v o l v e t h e husband i n e i t h e r q u e s t i o n n a i r e s o r i n t e r v i e w s . As s o c i a l norms have changed w i t h r e g a r d t o male and f e m a l e r o l e s , e x p e c t a t i o n s about t h e r o l e and a c t i v i t i e s o f f a t h e r s have a l s o changed, and t h e s e changes s h o u l d be r e f l e c t e d i n r e s e a r c h . A s i d e from t h i s , t h e p r o b l e m of r e c e i v i n g o n l y s o c i a l l y d e s i r a b l e i n f o r m a t i o n i s compounded by t h e f a c t t h a t w i v e s may f e e l i t i s s o c i a l l y d e s i r a b l e f o r t h e i r husbands t o have t h e same f e e l i n g s and a t t i t u d e s as t h e y have. I n a d d i t i o n , w i v e s may be i n v e s t e d i n s e e i n g t h e i r husbands' a t t i t u d e s and f e e l i n g s as s i m i l a r t o t h e i r own. A s e p a r a t e i n s t r u m e n t c o n s t r u c t e d and t e s t e d f o r husbands t o use w o u l d be u s e f u l i n t h i s k i n d o f r e s e a r c h , b o t h as a measure o f a c t u a l s u p p o r t a v a i l a b l e and as a measure o f p o s s i b l e d i s c r e p a n c y between w i v e s ' p e r c e p t i o n s and husbands' a c t u a l a t t i t u d e s , f e e l i n g s and i n t e n t i o n s . I n any c a s e , t h e i t e m s i n c l u d e d i n t h e P r e n a t a l Q u e s t i o n n a i r e do s e r v e as a measure of t h e e x t e n t t o w h i c h w i v e s p e r c e i v e t h e i r husbands as s u p p o r t i v e . 3. S u b j e c t s ' e x p e r i e n c e i n p r e n a t a l c l a s s e s was t h e t h i r d a r e a of i n t e r e s t i n t h e P r e n a t a l Q u e s t i o n n a i r e . T h i s was measured i n terms o f number o f c l a s s e s a t t e n d e d , s a t i s f a c t i o n w i t h c l a s s e s and t o p i c s c o v e r e d , r e p o r t o f how much was l e a r n e d and how many recommended books were r e a d (A:6-14). A l l b u t one s u b j e c t a t t e n d e d p r e n a t a l c l a s s e s , and e i g h t e e n out o f t h e t w e n t y - s i x went t o a l l t h e c l a s s e s o f f e r e d i n t h e c o u r s e t h e y t o o k . As s u b j e c t s r e p o r t e d i t , t h e t o p i c s c o v e r e d i n t h e c l a s s e s , e.g., p h y s i o l o g y , e x e r c i s e s , i n f o r m a t i o n a b out newborns, i n f o r m a t i o n about c h i l d c a r e , and n u t r i t i o n , were f a i r l y u n i f o r m . Seven s u b j e c t s l i s t e d a t l e a s t one t o p i c t h e y f e l t s h o u l d have been c o v e r e d w h i c h was l e f t u n c o v e r e d . Some of t h e s e were b i r t h c o n t r o l , i n f a n t d evelopment, m a r i t a l a d j u s t m e n t , d i f f i c u l t d e l i v e r i e s , c a e s a r i a n s e c t i o n and b i r t h p r o b l e m s . The t o p i c most o f t e n m entioned as i n a d e q u a t e l y c o v e r e d was c h i l d a n d/or i n f a n t c a r e . F o u r t e e n s u b j e c t s r e p o r t e d t h e y were v e r y p l e a s e d w i t h t h e c l a s s e s , t h r e e were p l e a s e d , f i v e were l e s s t h a n p l e a s e d , two were d i s a p p o i n t e d and one was v e r y d i s a p p o i n t e d . R a t i n g s o f how much t h e y had l e a r n e d ( " l e a r n e d a l o t " - " l e a r n e d . v e r y l i t t l e " ) were i d e n t i c a l t o e x p r e s s e d s a t i s f a c t i o n f o r 20 s u b j e c t s , and v a r i e d by o n l y one p o i n t f o r t h e r e m a i n i n g s i x . E i g h t e e n s u b j e c t s r e p o r t e d h a v i n g r e a d a t l e a s t one book s u g g e s t e d i n t h e c l a s s e s (a l i s t o f t h e books' r e a d i s i n c l u d e d i n A p p e n d i x R ) . I t i s n o t e w o r t h y t h a t s u b j e c t s r e p o r t e d b e i n g g e n e r a l l y q u i t e p l e a s e d w i t h t h e i r c l a s s e s p r i o r t o t h e b i r t h o f t h e i r i n f a n t s , b u t n o t e s from t h e p o s t p a r t u m i n t e r v i e w s c o n d u c t e d l a t e r u n i f o r m l y i n d i c a t e d t h a t t h e s e mothers f e l t v e r y u n p r e p a r e d f o r i n f a n t c a r e , and f e l t t h a t t h e c l a s s e s s h o u l d have g i v e n more i n f o r m a t i o n about t a k i n g c a r e o f t h e i n f a n t once s/he was b o r n . One s u b j e c t c o m p l a i n e d , "They a c t e d as i f THE BIRTH was t h e end, r a t h e r t h a n t h e b e g i n n i n g ! " D e s p i t e t h i s h i n d s i g h t p e r s p e c t i v e , t h e q u e s t i o n s i n t h e p r e n a t a l q u e s t i o n n a i r e a p p e a r t o have been adequate f o r a s s e s s i n g s u b j e c t s ' e x p e r i e n c e i n t h e c l a s s e s and t h e i r s a t i s f a c t i o n w i t h them i n t h e l a s t t r i m e s t e r o f ' p r e g n a n c y . 4. S u b j e c t s ' p r e p a r a t i o n f o r l a b o u r and d e l i v e r y was t h e f o u r t h a r e a of i n t e r e s t i n t h e p r e n a t a l Q u e s t i o n n a i r e , and was measured by t h r e e s e t s o f i t e m s . (a) S u b j e c t s were a s k e d t o .rate t h e i r ^ e x p e c t a t i o n s of l a b o u r and d e l i v e r y on a f i v e - p o i n t s c a l e ( " e a s y " - " d i f f i c u l t " ) ( A : 3 0 ) . E l e v e n s u b j e c t s r e p o r t e d e x p e c t i n g t h e i r l a b o u r and d e l i v e r y t o be easy o r f a i r l y e a s y , t w e l v e as n e i t h e r easy n o r d i f f i c u l t , and f o u r as f a i r l y d i f f i c u l t o r d i f f i c u l t . I n t h e f u t u r e , q u e s t i o n s '-regarding s p e c i f i c c o n c e r n s about t h e b i r t h s h o u l d be i n c l u d e d f o r a more c o m p l e t e p i c t u r e o f t h e s e k i n d s o f e x p e c t a t i o n s . (b) R e s p o n s e s . t o t h r e e i t e m s c o n c e r n i n g t h e use o f drugs d u r i n g l a b o u r  and d e l i v e r y , and r e q u e s t s f o r s p e c i a l h o s p i t a l a rrangements (A:31-33) showed t h a t twenty-two s u b j e c t s had d i s c u s s e d t h e use o f drugs w i t h t h e i r p h y s i c i a n s and n i n e f e l t t h e y would l e a v e t h e d e c i s i o n up t o t h e i r d o c t o r . L e a v i n g t h i s d e c i s i o n t o t h e d o c t o r was found t o be n e g a t i v e l y c o r r e l a t e d w i t h s a t i s f a c t i o n about and amount l e a r n e d i n p r e n a t a l c l a s s e s (r=—.88, p .01, and r=-.66, p .05, r e s p e c t i v e l y ) . E i g h t e e n s u b j e c t s p l a n n e d t o use no d r u g s d u r i n g t h e b i r t h o r t o use d r u g s o n l y i f n e c e s s a r y , and f o u r r e p o r t e d t h a t t h e y w o u l d p r o b a b l y o r d e f i n i t e l y use drugs d u r i n g l a b o u r and d e l i v e r y . No q u e s t i o n s were asked c o n c e r n i n g the s u b j e c t ' s i n f o r m a t i o n about t h e e f f e c t o f p e r i n a t a l m e d i c a t i o n on t h e i n f a n t o r on t h e mother. T h i s was n o t l i s t e d by s u b j e c t s as a t o p i c c o v e r e d by p r e n a t a l c l a s s e s , n o r was i t l i s t e d as a t o p i c s u b j e c t s f e l t s h o u l d have been c o v e r e d . F u t u r e q u e s t i o n n a i r e s s h o u l d i n c l u d e i t e m s on t h i s t o p i c as an a d d i t i o n a l i n d i c a t i o n of t h e t h o r o u g h n e s s w i t h w h i c h s u b j e c t s p r e p a r e t h e m s e l v e s f o r t h e b i r t h e x p e r i e n c e . (c) T w e n t y - s i x s u b j e c t s p l a n n e d t o have a p a r t n e r w i t h them d u r i n g l a b o u r and t w e n t y - f o u r p l a n n e d f o r a p a r t n e r d u r i n g d e l i v e r y ; a l l i n d i c a t e d t h a t t h e i r husband wo u l d be t h e i r p a r t n e r (A:34-35). 65 A l t h o u g h t h e Items used t o a s s e s s p r e p a r a t i o n f o r b i r t h showed l o w r e s p o n s e v a r i a t i o n ( s t a n d a r d d e v i a t i o n s ranged f r o m .13 t o . 8 9 ) , n o t e s f r o m p r e n a t a l i n t e r v i e w s i n d i c a t e d t h a t d u r i n g t h e l a s t t r i m e s t e r , most s u b j e c t s were l o o k i n g f o r w a r d o p t i m i s t i c a l l y t o t h e b i r t h b o t h as an end t o t h e w a i t i n g p e r i o d o f pregnancy and as an o p p o r t u n i t y t o see whether t h e i n f o r m a -t i o n t h e y had l e a r n e d i n t h e i r c l a s s e s w o u l d be u s e f u l . I n p o s t p a r t u m i n t e r v i e w s , most s u b j e c t s e x p r e s s e d t h e v i e w t h a t t h e y had been v e r y u n p r e p a r e d f o r t h e i r l a b o u r and d e l i v e r y e x p e r i e n c e s and had g r e a t l y u n d e r -e s t i m a t e d b o t h t h e p r o l o n g e d e f f o r t r e q u i r e d and t h e i n t e n s i t y o f the p a i n i n v o l v e d . They i n d i c a t e d t h a t t h e f o c u s o f t h e p r e n a t a l c l a s s e s was on t h e " e a s e " o f c h i l d b i r t h and t h a t t h e more u n p l e a s a n t a s p e c t s were d e a l t w i t h o n l y b r i e f l y . An a l t e r n a t i v e e x p l a n a t i o n o f t h e d i s c r e p a n c y between p r e n a t a l and p o s t n a t a l r e p o r t e d s a t i s f a c t i o n w i t h p r e n a t a l c l a s s e s may be t h a t s u b j e c t s s e l e c t i v e l y a t t e n d e d t o t h e i n f o r m a t i o n g i v e n i n t h e c l a s s e s , and chose t o l i s t e n t o , o r remember, o n l y t h e i n f o r m a t i o n w h i c h c o n f i r m e d t h e i r e x p e c t a t i o n s . P l a y i n g down t h e d i f f i c u l t a s p e c t s o f t h e b i r t h e x p e r i e n c e a p p e ars t o be a t e c h n i q u e on t h e p a r t o f p r e n a t a l c l a s s c u r r i c u l a e f o r a v o i d i n g the c r e a t i o n o f a n e g a t i v e s e l f - f u l f i l l i n g p r o p h e c y w h e r e i n f e a r and f e a r - r e l a t e d p h y s i c a l t e n s i o n l e a d t o g r e a t e r p a i n and s u f f e r i n g and i n some c a s e s , p r o l o n g e d l a b o u r and d i f f i c u l t d e l i v e r y . However, s u b j e c t s seemed t o f e e l i n r e t r o s p e c t t h a t t h i s " s l a n t i n g " o f t h e c l a s s e s c o n t r i b u t e d t o u n r e a l i s t i c e x p e c t a t i o n s o f c h i l d b i r t h and p o s s i b l y t o a f e e l i n g o f f a i l u r e f o r t h o s e women who were u n a b l e t o c o n t i n u e w i t h o u t drugs t o combat t h e p a i n and e x h a u s t i o n . I n any c a s e , t h e q u e s t i o n s on t h e p r e n a t a l q u e s t i o n n a i r e r e g a r d i n g p r e p a r a t i o n f o r t h e b i r t h e x p e r i e n c e , l i k e t h e q u e s t i o n s c o n c e r n i n g p r e n a t a l c l a s s e s , appear t o be adequate f o r a s s e s s i n g l a s t - t r i m e s t e r a t t i t u d e s and e x p e c t a t i o n s and a r e u s e f u l f o r c o m p a r i s o n w i t h a c t u a l e x p e r i e n c e s i n l o n g i t u d i n a l r e s e a r c h . 66 5. S u b j e c t ' s c o n f i d e n c e I n t h e i r c a r e g i v i n g a b i l i t y (A:39) was a s s e s s e d on a f i v e - p o i n t s c a l e ("very w e l l - p r e p a r e d " - " v e r y u n p r e p a r e d " ) . E l e v e n s u b j e c t s f e l t t h e y were v e r y w e l l - p r e p a r e d , n i n e f e l t t h e y were p r e p a r e d , and s i x f e l t t h e y were o n l y somewhat p r e p a r e d . I t i s i n t e r e s t i n g t h a t o n l y t h e f i r s t t h r e e p o i n t s o f t h i s s c a l e were used by s u b j e c t s t o d e s c r i b e t h e m s e l v e s , i n d i c a t i n g t h a t t h e y f e l t g e n e r a l l y c o n f i d e n t . However, as was n o t e d e a r l i e r , i n subsequent p o s t p a r t u m i n t e r v i e w s mothers d e s c r i b e d t h e m s e l v e s as f e e l i n g q u i t e u n p r e p a r e d f o r c a r e g i v i n g r e s p o n s i b i l i t i e s . On a n o t h e r s c a l e ("a l o t o f e x p e r i e n c e " - " n o e x p e r i e n c e " ) , seven s u b j e c t s i n d i c a t e d t h e y had a g r e a t d e a l o f e x p e r i e n c e w i t h young c h i l d r e n o r i n f a n t s , e i g h t r e p o r t e d some e x p e r i e n c e , s i x r e p o r t e d o n l y a moderate amount, two l i t t l e and two none ( A : 5 7 ) . (b) S u b j e c t s were asked about t h e i r a b i l i t y t o u n d e r s t a n d and r e s p o n d t o  s i g n a l s t h e i r i n f a n t m i ght use t o communicate h i s o r h e r needs ( A : 4 7 ) . I n a f r e e - r e s p o n s e f o r m a t , f o u r t e e n s u b j e c t s i n d i c a t e d t h e y thought t h e i r baby would communicate by c r y i n g and/or f u s s i n g o n l y , seven s u g g e s t e d c r y i n g and o t h e r s i g n a l s s u c h as f a c i a l e x p r e s s i o n s o r n o i s e s , and two m e n t i o n e d o n l y ways o t h e r t h a n c r y i n g . Four p r o s p e c t i v e mothers f e l t t h e y w o u l d be u n a b l e t o u n d e r s t a n d t h e i r i n f a n t ' s s i g n a l s . Responses t o an i t e m c o n c e r n i n g s u b j e c t s ' a n t i c i p a t e d a b i l i t y t o c a l m a c r y i n g baby (A:48) showed t h a t e i g h t i n d i c a t e d t h e y w o u l d do so by p i c k i n g up o r h o l d i n g t h e baby, t h i r t e e n s a i d t h e y would c u d d l e o r g i v e a f f e c t i o n t o t h e baby, and t h r e e gave a b s t r a c t r e s p o n s e s , s u c h as "make the baby more s e c u r e " . Three s u b j e c t s f e l t t h e y would n o t know how t o be e f f e c t i v e i n q u i e t i n g a c r y i n g i n f a n t ; two of t h e s e women had a l s o f e l t t h e y would be u n a b l e t o u n d e r s t a n d t h e i r i n f a n t ' s s i g n a l s . 6. The p r o j e c t e d r o l e o f t h e i n f a n t i n t h e mother's l i f e was t h e s i x t h a r e a o f i n t e r e s t i n v e s t i g a t e d by t h e P r e n a t a l Q u e s t i o n n a i r e . I t was a s s e s s e d by f o u r s e t s o f i t e m s c o n c e r n i n g t h e s u b j e c t s ' j o b s and p l a n s t o r e t u r n t o work, a n t i c i p a t i o n o f n e e d i n g h e l p a t home a f t e r r e t u r n i n g from h o s p i t a l , p r o j e c t e d 67 image o f t h e i n f a n t , and a n t i c i p a t e d changes i n t h e mother's l i f e c a u s e d by the i n f a n t ' s e x i s t e n c e . (a) W o r k / s c h o o l p l a n s (A:15-17). Four s u b j e c t s were s t i l l w o r k i n g o r g o i n g t o s c h o o l when i n t e r v i e w e d p r e n a t a l l y , twenty had p r e v i o u s l y worked o r gone t o s c h o o l b u t had s t o p p e d a t some p o i n t d u r i n g t h e i r p r e g n a n c y , and t h r e e had n o t worked o r gone t o s c h o o l p r i o r t o t h e pregnancy. A l l who were s t i l l w o r k i n g o r g o i n g t o s c h o o l (A:4) r e p o r t e d t h a t t h e y p l a n n e d t o r e t u r n ; o f the twenty who had a l r e a d y s t o p p e d work o r s c h o o l , t w e l v e p l a n n e d t o r e t u r n . Ten o f t h e s e and a l l o f t h o s e s t i l l w o r k i n g p l a n n e d t o r e t u r n t o work o r s c h o o l w i t h i n t h e f i r s t n i n e months o f t h e i r i n f a n t s ' l i v e s . A c o r r e l a t i o n o f -.49 (p<.01) between w i v e s ' H o l l i n g s h e a d o c c u p a t i o n s c o r e s and t h e i n f a n t ' s age when s u b j e c t s p l a n n e d t o r e t u r n t o work ( A : 1 7 ) , i n d i c a t e d t h a t t h o s e women who p l a n n e d t o r e t u r n t o work soon a f t e r t h e i n f a n t ' s b i r t h had j o b s o f h i g h e r s t a t u s . H i g h e r s t a t u s j o b s may be r e l a t e d t o a s t r o n g e r commitment t o the j o b o r t o c a r e e r g o a l s , w h i c h c o u l d a c c o u n t f o r t h e s e women's d e s i r e s t o r e t u r n t o t h e i r work as soon as p o s s i b l e . U n f o r t u n a t e l y , no q u e s t i o n s were i n c l u d e d w h i c h c o v e r e d c h i l d - c a r e arrangements so no assessment o f t h e e x t e n t and adequacy o f t h e mother's p l a n s c o u l d be made. (b) A n t i c i p a t i o n o f n e e d i n g h e l p a t home (A:42-44). S u b j e c t s g e n e r a l l y f e l t t h e y w o u l d need h e l p a t home ( o n l y s e v e n f e l t t h e y would need no h e l p a t a l l ) , b u t a l t h o u g h twenty thought h e l p would be r e q u i r e d , o n l y f i f t e e n had even d i s c u s s e d arrangements f o r h e l p . These f i f t e e n s u b j e c t s m a i n l y a n t i c i p a t e d a v i s i t f rom a mother o r m o t h e r - i n - l a w f o r a s h o r t p e r i o d o f t i m e . A l t h o u g h a l l who had a r r a n g e d h e l p i n d i c a t e d t h e y were " v e r y p l e a s e d " o r " p l e a s e d " w i t h t h e ar r a n g e m e n t s , a t l e a s t one s u b j e c t c o n f i d e d a t t h e i n t e r v i e w t h a t she was n o t l o o k i n g f o r w a r d t o h e r m o t h e r - i n - l a w ' s v i s i t a t a l l , and had t h e f e e l i n g t h a t h e r m o t h e r - i n - l a w would want t o l o o k a f t e r t h e baby and l e a v e t h e c o o k i n g and h o u s e c l e a n i n g t o h e r . M a t e r i a l from p o s t p a r t u m i n t e r v i e w s 68 i n d i c a t e s t h a t t h e q u e s t i o n o f n e e d i n g h e l p a f t e r t h e baby a r r i v e d i s a n o t h e r c a s e of f o r e s i g h t v e r s u s h i n d s i g h t : a t one month p o s t p a r t u m , most women s a i d t h e y had f a i l e d t o a n t i c i p a t e how t i r e d t h e y would be , how u n a b l e t h e y w o u l d be t o do a n y t h i n g b u t l o o k a f t e r the baby, and how much t h e y c o u l d have used h e l p o r were g r a t e f u l f o r t h e h e l p t h e y d i d have d u r i n g t h e f i r s t few weeks. (c) S u b j e c t s ' image of t h e i r e x p e c t e d i n f a n t was a s s e s s e d by t h r e e i t e m s . On a f i v e - p o i n t s c a l e i n d i c a t i n g s e x p r e f e r e n c e ( " r e a l l y want a boy"-"no p r e f e r e n c e " - " r e a l l y want a g i r l " ) ( A:27-28), twenty e x p r e s s e d no p r e f e r e n c e and of t h e s e , t h i r t e e n r e p o r t e d t h e i r husbands a l s o had no p r e f e r e n c e . Not one s u b j e c t e x p r e s s e d " r e a l l y w a n t i n g " a g i r l , and o n l y two " p r e f e r r e d " a g i r l . F i v e s u b j e c t s " r e a l l y wanted" a boy. Hoffman (1977) r e p o r t s a s i m i l a r p a t t e r n o f p r e f e r e n c e f o r males among p r o s p e c t i v e p a r e n t s i n t h e U n i t e d S t a t e s . Twenty-one of the c o u p l e s i n t h e p r e s e n t s t u d y had a l r e a d y chosen names f o r t h e i r i n f a n t . Twelve s u b j e c t s r e p o r t e d h a v i n g a q u i t e c l e a r p i c t u r e of what i t would be l i k e t o have a baby ( " q u i t e clear"-"somewhat h a z y " - " q u i t e u n c l e a r " ) ( A : 4 6 ) . F o u r t e e n r e p o r t e d a c l e a r o r somewhat ha z y p i c t u r e , and one f e l t she had a q u i t e u n c l e a r p i c t u r e . H a v i n g a c l e a r p i c t u r e o f what i t w o u l d be l i k e t o have an i n f a n t was found t o be p o s i t i v e l y c o r r e l a t e d w i t h t h e number o f p r e n a t a l c l a s s e s a t t e n d e d by w i v e s and husbands ( l o w e s t r=.41, p<.05), and t h e e x t e n t of p r e p a r a t i o n f o r i n f a n t c a r e f o r b o t h p a r e n t s ( l o w e s t r=.42, p<.05). (d) A n t i c i p a t i o n o f l i f e changes and r e s t r i c t i o n s due t o i n f a n t (A:59, 6 2 ) . S u b j e c t s r a t e d t h e e x t e n t t o w h i c h t h e y a n t i c i p a t e d t h a t t h e baby would r e s t r i c t t h e i r l i v e s on f i v e - p o i n t s c a l e s ("a g r e a t d e a l " - " n o t a t a l l " ) ( A : 5 9 ) . W i t h r e g a r d t o s c h o o l o r work r e s t r i c t i o n , seven r e p o r t e d a n t i c i p a t i n g a t l e a s t some r e s t r i c t i o n and e i g h t r e p o r t e d a n t i c i p a t i n g l i t t l e o r n o t r e s t r i c t i o n ; w i t h r e g a r d t o t h e i r s o c i a l l i v e s , f i v e r e p o r t e d a n t i c i p a t i n g 69 a g r e a t d e a l o f r e s t r i c t i o n , f i f t e e n a t l e a s t some r e s t r i c t i o n and seven l i t t l e o r no r e s t r i c t i o n . The c o r r e l a t i o n between a n t i c i p a t i o n o f work r e s t r i c -t i o n and a s o c i a l r e s t r i c t i o n was n o t s i g n i f i c a n t . When as k e d about t h e e x t e n t t o w h i c h t h e y a n t i c i p a t e d changes i n t h e i r m a r i t a l r e l a t i o n s h i p due t o t h e baby ( A : 6 2 ) , t h r e e a n t i c i p a t e d a g r e a t d e a l o f change, n i n e a n t i c i p a t e d a t l e a s t some change and f i f t e e n a n t i c i p a t e d l i t t l e o r no change. Of t h o s e who d i d a n t i c i p a t e some change, s i x a n t i c i p a t e d p o s i t i v e change, s u c h as b e i n g b r o u g h t c l o s e r t o g e t h e r , seven a n t i c i p a t e d n e g a t i v e change, such as h a v i n g l e s s t i m e f o r each o t h e r , and f o u r a n t i c i p a t e d mixed change. 7. Arrangements f o r c h i l d c a r e was t h e s e v e n t h a r e a o f i n t e r e s t e x p l o r e d by t h e P r e n a t a l Q u e s t i o n n a i r e , and was a s s e s s e d by i t e m s a s k i n g about p l a n s and a r r a n g e m e n t s f o r t h e new baby and about t h e number o f books r e a d . E i g h t e e n s u b j e c t s p l a n n e d t o b r e a s t - f e e d , two p l a n n e d t o b o t t l e - f e e d and s e v e n p l a n n e d to use b o t h b r e a s t - and b o t t l e - f e e d i n g (A:45-46). A l l t h o s e who p l a n n e d t o mix b r e a s t - and b o t t l e - f e e d i n g were a l s o p l a n n i n g t o r e t u r n t o work o r s c h o o l . A t t h e t i m e o f t h e p r e n a t a l i n t e r v i e w , twenty-two had a l r e a d y a r r a n g e d a room o r space f o r t h e baby, t w e n t y - f o u r had c l o t h i n g r e a d y f o r t h e baby, twenty-one had f u r n i t u r e f o r t h e baby and f o u r t e e n had a c q u i r e d t o y s f o r t h e baby ( A : 5 2 ) . T w e n t y - t h r e e had r e a d a t l e a s t one book and t e n of t h e t w e n t y -t h r e e had r e a d a t l e a s t f i v e books i n p r e p a r a t i o n f o r t h e new baby ( A : 5 4 ) . These q u e s t i o n s w o u l d seem adequate t o a s s e s s some a s p e c t s o f p r e n a t a l p r e p a r a -t i o n . A g a i n , t h e q u e s t i o n o f how w e l l - p r e p a r e d a s u b j e c t a c t u a l l y was t o d e a l w i t h t h e problems t h a t a r o s e i n l e a r n i n g t o c a r e f o r h e r i n f a n t were l a r g e l y u n a n t i c i p a t e d a t t h e t i m e o f t h e p r e n a t a l i n t e r v i e w , and t h e adequacy o r i n a d e q u a c y o f p r e p a r a t i o n , w h i c h was r a r e l y a m a t t e r o f h a v i n g t h e p r o p e r equipment, became e v i d e n t o n l y l a t e r . 8. S u b j e c t s ' p r e n a t a l i n v o l v e m e n t w i t h and p r e d i c t i o n o f p a r e n t - i n f a n t  a t t a c h m e n t was t h e e i g h t h a r e a e x p l o r e d by t h e P r e n a t a l Q u e s t i o n n a i r e , u s i n g 70 two s e t s o f i t e m s . (a) P l a n s f o r m o t h e r - i n f a n t c o n t a c t i n h o s p i t a l . On a f i v e - p o i n t s c a l e ("very m u c h " - " u n d e c i d e d " - " p r o b a b l y n o t " ) , twenty-one s u b j e c t s i n d i c a t e d t h a t t h e y wanted t o have t h e i r i n f a n t w i t h them r i g h t a f t e r t h e b i r t h , f o u r were u n d e c i d e d , and two f e l t t h e y would n o t want t o have t h e baby w i t h them. (A: 3 8 ) . On a n o t h e r s c a l e ("as much as p o s s i b l e " - " a b o u t h a l f t h e t i m e " - " o n l y f o r f e e d i n g s " ) , e i g h t e e n s u b j e c t s i n d i c a t e d t h e i r w i s h t o have t h e i r i n f a n t s t a y i n t h e i r h o s p i t a l room a g r e a t d e a l o f t h e t i m e , e i g h t wanted t h e i n f a n t w i t h them o n l y some o f the t i m e , and one wanted the i n f a n t w i t h h e r o n l y f o r f e e d i n g ( A : 3 7 ) . The w i s h t o have t h e i n f a n t s t a y i n t h e mother's h o s p i t a l room was p o s i t i v e l y c o r r e l a t e d w i t h h a v i n g a c l e a r p i c t u r e o f t h e i n f a n t (A:46) (r=.63, p<.01). (b) S u b j e c t s were asked t o p r e d i c t t h e c o u r s e o f t h e i r r e l a t i o n s h i p w i t h  t h e i r i n f a n t by s t a t i n g when t h e y t h o u g h t m o t h e r - i n f a n t and f a t h e r - i n f a n t r e l a t i o n s h i p s would d e v e l o p (A:49-51). Twenty r e p o r t e d t h e y had a l r e a d y d e v e l o p e d a s t r o n g f e e l i n g f o r t h e i r i n f a n t , two p r e d i c t e d t h e y w o u l d do so a t b i r t h , f o u r s a i d t h e y would w i t h i n two weeks a f t e r b i r t h , and one by a month a f t e r b i r t h . I n c o n t r a s t , t h r e e f e l t t h e i r baby had a l r e a d y d e v e l o p e d s t r o n g f e e l i n g s f o r them, t w e l v e t h o u g h t t h o s e f e e l i n g s w o u l d d e v e l o p d u r i n g t h e f i r s t two weeks o f t h e i n f a n t ' s l i f e , f i v e t h o u g h t t h e y w o u l d d e v e l o p d u r i n g t h e f i r s t month, f o u r by t h r e e months and two n o t u n t i l s i x months o r l a t e r ; one was u n a b l e t o p r e d i c t when h e r i n f a n t would d e v e l o p a s t r o n g f e e l i n g f o r h e r . Seven s u b j e c t s f e l t t h e baby would d e v e l o p a s t r o n g f e e l i n g f o r i t s f a t h e r d u r i n g t h e f i r s t two weeks o f l i f e , n i n e by a month, f o u r by t h r e e months, t h r e e by s i x months and two l a t e r t h a n s i x months; two were u n a b l e t o p r e d i c t . Only n i n e s u b j e c t s p r e d i c t e d t h a t mother and i n f a n t would d e v e l o p s t r o n g f e e l i n g s f o r one a n o t h e r a t t h e same t i m e ; a l l t h e o t h e r s t h o u g h t t h e baby would come t o f e e l c l o s e t o them l a t e r . E i g h t f e l t t h e r e l a t i o n s h i p would 71 be i n b a l a n c e i n terms o f m u t u a l f e e l i n g s by two weeks p o s t p a r t u m , b u t f o u r t h o u g h t t h e p r o c e s s would t a k e a month, t h r e e t h o u g h t i t would t a k e t h r e e months and two t h o u g h t s i x months. T h i r t e e n s u b j e c t s f e l t t h e i r i n f a n t w o u l d d e v e l o p s t r o n g f e e l i n g s f o r mother and f a t h e r a t about t h e same t i m e , and a l l o t h e r s t hought t h e baby's f e e l i n g s f o r t h e mother wo u l d come f i r s t . S u b j e c t s ' p r e d i c t i o n o f t h e i n f a n t ' s e a r l y a t t a c h m e n t t o mother and f a t h e r was c o r r e l a t e d w i t h h a v i n g a c l e a r p i c t u r e of the i n f a n t ( l o w e s t r=.45, p_<.05), w i t h a low s c a l e d s c o r e f o r p h y s i c a l problems e x p e r i e n c e d d u r i n g pregnancy (r=.45, p_<.05) and w i t h a g r e a t e r number o f p r e n a t a l c l a s s e s a t t e n d e d by mother and f a t h e r ( l o w e s t _r=.49, p_<.05). M o t h e r ' s p r e d i c t i o n o f e a r l y a t t a c h m e n t t o t h e i n f a n t was p o s i t i v e l y c o r r e l a t e d w i t h h e r f e e l i n g s o f s e l f - c o n f i d e n c e i n h e r p r e p a r a t i o n f o r i n f a n t c a r e (r=.41, p_<.01). The f a c t t h a t many mothers do n o t f e e l t h e i r i n f a n t s w i l l r e c i p r o c a t e t h e i r s t r o n g f e e l i n g s soon a f t e r b i r t h may be h e l p f u l i n p r e d i c t i n g l a t e r d i f f i c u l t i e s i n a d j u s t m e n t . B. F a c t o r A n a l y s i s of P r e n a t a l Q u e s t i o n n a i r e U s i n g a l l a v a i l a b l e s u b j e c t s (n=137: 27 from t h e Core group p l u s 110 from t h e Q u e s t i o n n a i r e g r o u p ) , f o r t y i t e m s from t h e P r e n a t a l Q u e s t i o n n a i r e t r h i c h had t h e g r e a t e s t v a r i a n c e were i n c l u d e d i n a f a c t o r a n a l y s i s (see T a b l e 6 ) . A minimum r e s i d u a l s o l u t i o n was computed f o r t h e c o r r e l a t i o n m a t r i x w i t h s q u a r e d m u l t i p l e c o r r e l a t i o n s as o r i g i n a l communality e s t i m a t e s on t h e d i a g o n a l ( o r i g i n a l and f i n a l , i t e r a t e d c o m m u n a l i t i e s a r e p r o v i d e d i n T a b l e 6 ) . The number of f a c t o r s was d e t e r m i n e d on t h e b a s i s o f t h e number o f e i g e n v a l u e s o f t h e decomposed c o r r e l a t i o n m a t r i x w h i c h were g r e a t e r t h a n 1 ( T a b l e 7 ) , and was c o n f i r m e d by a s c r e e p l o t . The m a t r i x o f r e s i d u a l s u s i n g t h i s s o l u t i o n showed no v a l u e s g r e a t e r t h a n .18. Ten f a c t o r s were t a k e n out and a V a r i m a x r o t a t i o n was p e r f o r m e d , r e s u l t i n g i n an o r t h o g o n a l s o l u t i o n . The p r o p o r t i o n _ o f t h e v a r i a n c e a c c o u n t e f o r by e a c h f a c t o r i s p r o v i d e d i n T a b l e 7. The r o t a t e d f a c t o r s and t h e v a r i a b l e s l o a d i n g on e a c h f a c t o r a r e p r e s e n t e d i n T a b l e 8. A l t h o u g h t e n f a c t o r s i s a l a r g e number t o t a k e o u t o f a c o r r e l a t i o n m a t r i x c o n s i s t i n g o f f o r t y v a r i a b l e s , t h e r e i s a c t u a l l y no t h e o r e t i c a l r e a s o n t o e x p e c t any p a r t i c u l a r number o f f a c t o r s f r o m t h e s e d a t a . As shown i n T a b l e 6, F a c t o r I , " I n i t i a l R e a c t i o n s t o P r e g n a n c y " , a c c o u n t s f o r b o t h w i v e s ' and h u s b a n d s ' f e e l i n g s upon l e a r n i n g o f t h e p r e g n a n c y and w h e t h e r t h e p r e g n a n c y was p l a n n e d . F a c t o r I I , " H u s b a n d " , a c c o u n t s f o r t h e s u b j e c t ' s p e r c e p t i o n s o f h e r h u s b a n d ' s s u b s e q u e n t f e e l i n g s r e g a r d i n g t h e p r e g n a n c y and h i s p r e p a r a t i o n f o r and i n t e n t i o n t o become i n v o l v e d i n f a n t c a r e . The m o t h e r ' s w i s h t o keep h e r i n f a n t i n h e r h o s p i t a l room a f t e r t h e b i r t h , w h i c h l o a d s on t h i s f a c t o r , may i n d i c a t e a g e n e r a l p o s i t i v e f e e l i n g t o w a r d t h e i n f a n t and a w i s h t o be i n v o l v e d w i t h h i m o r h e r w h i c h i s i n p a r t b a s e d upon t h e s u p p o r t she f e e l s she h a s and w i l l h a v e f r o m h e r h u s b a n d . F a c t o r I I I , " P r e s e n t F e e l i n g s " , a c c o u n t s f o r t h e s u b j e c t ' s l a t e r f e e l i n g s t o w a r d t h e p r e g n a n c y , h e r p r e n a t a l f e e l i n g o f a t t a c h m e n t t o h e r i n f a n t and h e r c u r i o s i t y t o a c t u a l l y s e e h e r b a b y . F a c t o r I V , " P h y s i c a l F e e l i n g s " , a c c o u n t s f o r t h e p h y s i c a l p r o b l e m s e x p e r i e n c e d d u r i n g p r e g n a n c y , t h e a c c o m p a n y i n g e m o t i o n a l f e e l i n g s o f b e i n g c o n t e n t , r e l a x e d and c o m f o r t a b l e a s s o c i a t e d w i t h f e w e r p r o b l e m s , and t h e r e l a t i o n s h i p o f t h e s e t o p r o j e c t e d e x p e c t a t i o n s o f l a b o u r and d e l i v e r y . The age o f t h e m o t h e r l o a d s n e g a t i v e l y on t h i s f a c t o r , i n d i c a t i n g e i t h e r an o l d e r woman w i t h f e w e r p h y s i c a l p r o b l e m s and more p o s i t i v e e m o t i o n a l f e e l i n g s , o r a y o u n g e r woman w i t h a g r e a t e r number o f p r o b l e m s and more n e g a t i v e f e e l i n g s . P o s s i b l y t h e p r e s e n c e o f t h e v a r i a b l e , number o f b o o k s r e a d , c a n p r o v i d e a n e x p l a n a t i o n f o r t h i s s e e m i n g l y c o u n t e r - i n t u i t i v e c o m b i n a t i o n o f v a r i a b l e s ( m a t e r n a l age and p h y s i c a l p r o b l e m s ) . I t may be t h a t o l d e r women, who h a v e augmented t h e i r g r e a t e r g e n e r a l e x p e r i e n c e w i t h 73 i n f o r m a t i o n from books t h e y have r e a d , have tended t o downplay t h e i r p h y s i c a l p r o b l e m s , b e l i e v i n g them t o be a n o r m a l accompaniment t o pregnancy. Such women might be l e s s l i k e l y t o even r e p o r t t h e s e p r o b l e m s , and would f e e l e m o t i o n a l l y p o s i t i v e about t h e pregnan c y i n s p i t e o f d i f f i c u l t i e s . The younger woman w i t h l e s s e x p e r i e n c e and a l s o l e s s i n f o r m a t i o n from books ( h a v i n g a c t u a l l y r e a d fewer b o o k s ) , might n o t have r e a l i z e d t h a t v a r i o u s p h y s i c a l problems a r e q u i t e n o r m a l d u r i n g p r e g n a n c y , and t h e r e f o r e t h e s e problems would tend t o assume a g r e a t e r i m p o r t a n c e i n h e r assessment o f h e r pregnancy: she might be more l i k e l y t o r e p o r t a g i v e n p r o b l e m , and t h e s e problems might be more l i k e l y t o i n f l u e n c e h e r e m o t i o n a l f e e l i n g s as w e l l . A l t e r n a t i v e l y , o l d e r women may have t a k e n b e t t e r p r e n a t a l c a r e o f t h e m s e l v e s because o f a d v i c e and i n f o r m a t i o n g a i n e d from t h e books t h e y r e a d , and might a c t u a l l y have had fewer problems d u r i n g t h e i r p r egnancy. F a c t o r V, " E x p e r i e n c e i n P r e n a t a l C l a s s " , a c c o u n t s f o r s u b j e c t s ' f e e l i n g s about t h e p r e n a t a l c l a s s e s t h e y a t t e n d e d , i n terms o f t h e amount t h e y f e l t t h e y had l e a r n e d and t h e i r g e n e r a l s a t i s f a c t i o n w i t h t h e c l a s s e s . F a c t o r V I , " F a m i l y A t t a c h m e n t " , a c c o u n t s f o r p r e d i c t e d i n f a n t a t t a c h m e n t t o mother and t o f a t h e r , and the mother's a n t i c i p a t i o n o f h e r husband's s u p p o r t d u r i n g l a b o u r and d e l i v e r y . T h i s f a c t o r a p p e ars t o i n d i c a t e a g e n e r a l e x p e c t a t i o n o f f a m i l y members' attachment and c l o s e n e s s t o one a n o t h e r . F a c t o r V I I , " E x p e c t a t i o n s o f C h i l d C a r e " , r e l a t e s m a t e r n a l e d u c a t i o n l e v e l t o h a v i n g a c l e a r p i c t u r e o f what i t would be l i k e t o have an i n f a n t , t o e x p e r i e n c e w i t h young i n f a n t s , t o a n t i c i p a t i o n o f n e e d i n g h e l p and t o s e l f - c o n f i d e n c e i n a b i l i t y t o c a r e f o r an i n f a n t . I n t h i s f a c t o r , a l o w e r l e v e l o f e d u c a t i o n i s r e l a t e d t o what might be c a l l e d a n a i v e p i c t u r e o f t h e a p p r o a c h i n g s i t u a t i o n : t h e a s s e r t i o n o f h a v i n g a c l e a r p i c t u r e o f what i t w i l l be l i k e t o c a r e f o r an i n f a n t i n s p i t e , o f h a v i n g l i t t l e e x p e r i e n c e w i t h young i n f a n t s , a d e n i a l o f t h e need f o r h e l p a t home a f t e r t h e b i r t h , and perhaps an o v e r - c o n f i d e n t assessment o f 74 c a r e g i v i n g a b i l i t y . The more h i g l y e d u c a t e d woman, t h e n , has a l e s s c l e a r p i c t u r e , perhaps because o f more e x p e r i e n c e w i t h i n f a n t s and some knowledge o f t h e i r v a r i a b i l i t y ; t h i s e x p e r i e n c e p o s s i b l y r e s u l t e d i n an e x p r e s s e d need f o r h e l p and a l e s s c o n f i d e n t assessment o f c a r e g i v i n g a b i l i t y . F a c t o r V I I I , "Work P l a n s " , a c c o u n t s o n l y f o r p l a n s t o r e t u r n t o work o r s c h o o l a f t e r t h e b i r t h o f t h e i n f a n t . F a c t o r I X , " A n t i c i p a t i o n of t h e F u t u r e " , a c c o u n t s f o r t h e a n t i c i p a t e d r e s t r i c t i o n of f u t u r e work and s o c i a l l i f e w i t h t h e a r r i v a l o f t h e i n f a n t , accompanied by a n t i c i p a t e d changes i n t h e m a r i t a l r e l a t i o n s h i p a l s o due t o t h e i n f a n t ' s a r r i v a l , i n s p i t e o f e n e r g e t i c f e e l i n g s a t p r e s e n t and few changes i n l i f e s t y l e c a u s e d by t h e p regnancy. F a c t o r X, " L i v i n g w i t h Baby", a c c o u n t s f o r t h e w i s h t o have t h e i n f a n t s t a y i n t h e mother's h o s p i t a l room, a l a c k o f c o n c e r n about s p o i l i n g t h e baby, m a t e r n a l c o n f i d e n c e t h a t the baby w i l l be a b l e t o communicate w i t h h e r , and t h e number o f books r e a d w h i c h were s u g g e s t e d by p r e n a t a l c l a s s e s . A l t h o u g h t h e f a c t o r a n a l y s i s o f t h e P r e n a t a l Q u e s t i o n n a i r e d i d c o n f i r m t h e n o t i o n t h a t t h e r e were s e p a r a t e a s p e c t s of p r e n a t a l a t t i t u d e s and e x p e c t a t i o n s , i t d i d n o t c o n f i r m t h e i n t u i t i v e g r o u p i n g o f i t e m s h y p o t h e s i z e d a p r i o r i t o r e f l e c t t h o s e a t t i t u d e s and e x p e c t a t i o n s . I t i s p o s s i b l e t h a t , s i n c e the number o f v a r i a b l e s e n t e r i n g t h e f a c t o r a n a l y s i s was r e s t r i c t e d b ecause o f the number o f s u b j e c t s a v a i l a b l e , a t r u e p i c t u r e o f t h e P r e n a t a l Q u e s t i o n n a i r e was n o t o b t a i n e d . I n any c a s e , i t would appear t h a t t h e use o f a f a c t o r a n a l y t i c t e c h n i q u e d i d n o t c o n t r i b u t e much a d d i t i o n a l i n f o r m a t i o n t o t h a t o b t a i n e d from c o r r e l a t i o n a l a n a l y s i s o f t h e q u e s t i o n n a i r e a l o n e . C. I n f a n t Temperament P r e d i c t i o n and R e p o r t ( A p p e n d i c e s B and C) The I n f a n t Temperament P r e d i c t i o n was d e v e l o p e d t o be a measure o f t h e mother's p r e n a t a l e x p e c t a t i o n o f i n f a n t b e h a v i o u r and c o n s i s t s o f p r e d i c t i o n on f i f t e e n i t e m s c o n c e r n e d w i t h i n f a n t r e s p o n s e t o s p e c i f i c s i t u a t i o n s , 75 a c t i v i t i e s and e v e n t s . The Temperament R e p o r t , w h i c h c o n s i s t s o f t h e same f i f t e e n i t e m s , i s a measure o f t h e i n f a n t ' s temperament as p e r c e i v e d by t h e mother a t one month p o s t p a r t u m . Because t h e r e a r e no e s t a b l i s h e d temperament i n s t r u m e n t s f o r use w i t h v e r y young i n f a n t s w i t h w h i c h t h e ITP and ITR c o u l d be compared, t h e c o e f f i c i e n t a l p h a (Cronbach, 1974) was used t o a s s e s s t h e i n t e r n a l c o n s i s t e n c y o f t h e i n s t r u m e n t s , t h a t i s , as an i n d i c a t i o n o f how w e l l any g i v e n i t e m was r e l a t e d t o t h e t o t a l i n s t r u m e n t . C o e f f i c i e n t a l p h a f o r t h e ITP was .55, f o r t h e ITR, .05, i n d i c a t i n g t h a t i n t e r n a l c o n s i s t e n c y , w h i l e somewhat h i g h e r f o r t h e P r e d i c t i o n t h a n f o r t h e R e p o r t , was g e n e r a l l y low f o r b o t h . T h i s i s i n t e r p r e t e d t o mean t h a t t h e i t e m s making up t h e i n s t r u m e n t s a r e r e f l e c t i n g more tha n one u n d e r l y i n g f a c t o r and t h a t b o t h p r e d i c t e d and p e r c e i v e d temperament a r e m u l t i - r a t h e r t h a n u n i - f a c t o r i a l . The r e s u l t s o f t h e ITP showed low b e t w e e n - s u b j e c t r e s p o n s e v a r i a t i o n : f o r t e n o f t h e f i f t e e n i t e m s , h a l f o r more tha n h a l f t h e s u b j e c t s chose t h e same r e s p o n s e ; f o r t h e r e m a i n i n g f i v e i t e m s t h e r e s p o n s e s were f a i r l y e v e n l y s p l i t between two o f t h e a l t e r n a t i v e s w i t h v e r y few o r no s u b j e c t s c h o o s i n g t h e t h i r d ( C h i - s q u a r e s a r e r e p o r t e d i n T a b l e 9 ) . P r e n a t a l s u b j e c t s g e n e r a l l y p r e d i c t e d a baby who w o u l d be f a i r l y easy to c a r e f o r , who would adapt t o a c o n v e n i e n t s c h e d u l e o f s l e e p i n g , w a k i n g and f e e d i n g ( B : l - 3 ) who w o u l d g i v e c l e a r s i g n a l s as t o h i s / h e r needs ( B : 5 - 6 ) , who w o u l d e n j o y c a r e g i v i n g a c t i v i t i e s s u c h as c h a n g i n g and b a t h i n g ( B : 7 - 8 ) , be a c t i v e and a l e r t t o t h e s t i m u l a t i o n p r o v i d e d by o b j e c t s and p e o p l e ( B : 9 - 1 0 ) , 1 2 , 1 4 ) , b u t be s e l f -r e g u l a t i n g (B:4) and g e n e r a l l y g u i d e d by h i s / h e r own mood (B:11,13,15). D u r i n g t h e p r e n a t a l i n t e r v i e w s many s u b j e c t s l a u g h i n g l y i n d i c a t e d t h a t t h e y had f i l l e d o u t t h e ITP t o d e s c r i b e t h e baby t h e y "hoped f o r " , and i t would appear t h a t t h e i n t e r n a l c o n s i s t e n c y o f t h i s i n s t r u m e n t ( i . e . , alpha=.55) i s a r e f l e c t i o n o f t h i s g e n e r a l o p t i m i s m w h i c h seems to be s h a r e d by e x p e c t a n t p a r e n t s . The 76 f a c t t h a t some o f t h e c h a r a c t e r i s t i c s t h e p a r e n t s want o r e x p e c t i n an i n f a n t a r e i n c o m p a t i b l e w i t h one a n o t h e r , e.g., t o adapt t o a s c h e d u l e b u t t o r e g u l a t e h i s o r h e r own b e h a v i o u r , does n o t d e t e r them f r o m h o p i n g f o r t h e " b e s t of a l l p o s s i b l e w o r l d s . " The e x t r e m e l y low a l p h a a s s o c i a t e d w i t h t h e ITR a p p e a r s t o r e f l e c t the m u l t i - f a c t o r c h a r a c t e r o f i n f a n t temperament as p e r c e i v e d by p a r e n t s . T h i r t e e n out o f f i f t e e n i t e m s had one a l t e r n a t i v e chosen s i g n i f i c a n t l y more o f t e n t h a n t h e o t h e r two a l t e r n a t i v e s ( C h i - s q u a r e s p r o v i d e d i n T a b l e 7 ) . F o r seven o f t h e i t e m s t h e m i d d l e a l t e r n a t i v e was c h o s e n , f o r f o u r i t e m s t h e a l t e r n a t i v e i n d i c a t i n g t h e " e a s y " i n f a n t was chosen more o f t e n and f o r o n l y two, t h e a l t e r n a t i v e i n d i c a t i n g t h e " d i f f i c u l t " i n f a n t was chosen more o f t e n . The f a c t t h a t o n l y a chance number of i n t e r c o r r e l a t i o n s f o r t h i s i n s t r u m e n t were s i g n i f i c a n t l e n d s s u p p o r t t o t h e n o t i o n t h a t i n f a n t temperament i s p e r c e i v e d and r e p o r t e d by p a r e n t s t o have many f a c e t s . A l l c r o s s - c o r r e l a t i o n s between t h e same i t e m s as p r e d i c t e d and as r e p o r t e d were n o n - s i g n i f i c a n t . T h i s would i n d i c a t e t h a t p a r e n t s were u n a b l e t o a c c u r a t e l y p r e d i c t t h e i r i n f a n t ' s temperament o r r e s p o n s e t o v a r i o u s s i t u a t i o n s . I t i s r e a s o n a b l e t h a t t h i s s h o u l d be the c a s e , as most p a r e n t s e x p e c t i n g t h e i r f i r s t c h i l d w o u l d have v e r y l i t t l e i d e a o f what l i v i n g w i t h an i n f a n t would be l i k e . However, i t w i l l be r e c a l l e d t h a t 70% o f t h e s e s u b j e c t s f e l t t h e y had a " q u i t e c l e a r " o r " c l e a r " p i c t u r e o f what i t w o u l d be l i k e t o have a new baby ( P r e n a t a l Q u e s t i o n n a i r e A : 5 6 ) . The r e s u l t s o f t h e ITP show t h a t t h e y do i n d e e d have a c l e a r p i c t u r e , b u t i t i s v e r y i d e a l i z e d , and not b orne out i n r e a l i t y . D. C h a r t V a r i a b l e s (Appendix J) I n f o r m a t i o n g a t h e r e d from h o s p i t a l c h a r t s gave a p r o f i l e o f l a b o u r and d e l i v e r y e x p e r i e n c e s and i n f a n t outcome. D e s c r i p t i v e s t a t i s t i c s w i l l be i n c l u d e d h e r e , and c o r r e l a t i o n s w i t h o t h e r v a r i a b l e s w i l l be d i s c u s s e d i n l a t e r s e c t i o n s . F o r some v a r i a b l e s , c h a r t i n f o r m a t i o n was a v a i l a b l e f o r o n l y t w e n t y - s i x o f t h e t w e n t y - s e v e n s u b j e c t s . The a v e r a g e l e n g t h o f l a b o u r was t w e l v e h o u r s , seven m i n u t e s , r e s u l t i n g i n twenty-two v a g i n a l d e l i v e r i e s and f i v e c a e s a r i a n s e c t i o n s , a p r o p o r t i o n w h i c h r e f l e c t s t h e c u r r e n t r a t e o f c a e s a r i a n s e c t i o n i n l o c a l h o s p i t a l s ( Kayce, 1978). F i v e s u b j e c t s had s t i m u l a t e d l a b o u r , f o u r by an a r t i f i c i a l r u p t u r e o f t h e membranes, and two by i n j e c t i o n w i t h p i t o c i n . T h i r t e e n o f the twenty-two v a g i n a l d e l i v e r i e s i n v o l v e d the use o f f o r c e p s . Seventeen s u b j e c t s had a n a l g e s i a a d m i n i s t e r e d t o them, and f o r t w e n t y -t h r e e , some t y p e o f a n e s t h e s i a was use d : e i g h t had l o c a l a n e s t h e s i a ( m o s t l y f o r e p i s i o t o m y r e p a i r ) , e i g h t had r e g i o n a l a n e s t h e s i a ( e . g . , e p i d u r a l ) and seven had a g e n e r a l a n e s t h e t i c ( t h e f i v e c a e s a r i a n s e c t i o n s and two o t h e r s u b j e c t s ) . T h i r t e e n males and f o u r t e e n f e m a l e s were b o r n ; s e v e n t e e n o f t h e i n f a n t s went t o t h e r e g u l a r n u r s e r y on t h e m a t e r n i t y f l o o r , and t e n went t o the I n t e n s i v e Care N u r s e r y ( t h e f i v e c a e s a r i a n s e c t i o n s and f i v e o t h e r s ) . Apgar s c o r e s a t one m i n u t e ranged from 4 t o 9; t h e mean s c o r e was 7.5. Twelve i n f a n t s had s c o r e s o f 7 o r l e s s , f o u r t e e n had s c o r e s o f 8 o r 9. Apgar s c o r e s a t f i v e m i n u t e s were 8 (n=4, 9 (n=16) and 10 (n=6); t h e mean s c o r e was 9.1. I n f a n t s t a k e n t o t h e I n t e n s i v e Care N u r s e r y were k e p t t h e r e an a v e r a g e o f 30.5 • h o u r s ( r a n g e : 12-72 h o u r s ) . The average h o s p i t a l s t a y was 5.7 days (range 4-7). A l l mothers went home, w i t h t h e i r i n f a n t s ; one mother had a p o s t -partum hemorrhage a f t e r r e t u r n i n g home w h i c h r e s u l t e d i n h e r subsequent h o s p i t a l i z a t i o n and s e p a r a t i o n from h e r i n f a n t f o r s e v e r a l d a y s . 78 E. H o s p i t a l D i a r y ( A p p e n d i c e s D and E) The h o s p i t a l d i a r y as used t o a s s e s s the amount o f c o n t a c t mothers had w i t h t h e i r i n f a n t s i m m e d i a t e l y f o l l o w i n g d e l i v e r y and d u r i n g t h e h o s p i t a l s t a y . D e s c r i p t i v e s t a t i s t i c s w i l l be i n c l u d e d h e r e ; c o r r e l a t i o n s w i t h o t h e r v a r i a b l e s w i l l be d i s c u s s e d i n l a t e r s e c t i o n s . D i a r y i n f o r m a t i o n was o b t a i n e d from n i n e t e e n s u b j e c t s b u t b e c a u s e n o t a l l s u b j e c t s p r o v i d e d c o m p l e t e i n f o r m a t i o n , f o r c e r t a i n v a r i a b l e s d i a r y d a t a a r e a v a i l a b l e f o r fewer t h a n n i n e t e e n s u b j e c t s . T h i r t e e n o f t h e s u b j e c t s h e l d t h e i r i n f a n t s r i g h t a f t e r b i r t h and f i v e b r e a s t - f e d on t h e caseroom t a b l e . M others r e p o r t e d s p e n d i n g an a v e r a g e of f o u r t e e n m i n u t e s w i t h t h e i r i n f a n t s i m m e d i a t e l y f o l l o w i n g d e l i v e r y ( r a n g e : 2-45 m i n u t e s ) and t h e y w a i t e d an a v e r a g e o f 7.4 h o u r s u n t i l t h e y n e x t saw t h e i r i n f a n t s ( r a n g e : 2-24 h o u r s ) , when t h e y s p e n t an a v e r a g e o f 38 m i n u t e s w i t h him o r h e r ( r a n g e : 3 m i n u t e s t o 2.5 h o u r s ) . I n a l l , mothers e s t i m a t e d s p e n d i n g an a v e r a g e o f two h o u r s w i t h t h e i r i n f a n t s d u r i n g the f i r s t t w e l v e h o u r s o f t h e i n f a n t ' s l i f e ( r a n g e : 1-6 h o u r s ) . On t h e f i r s t f o u r days o f t h e h o s p i t a l s t a y , mothers r e p o r t e d s p e n d i n g an a v e r a g e o f 5.1, 7.9, 9.1 and 7.4 h o u r s r e s p e c t i v e l y w i t h t h e i r i n f a n t s d u r i n g t h e day and e v e n i n g ( r a n g e s : 1-12, 2-13, 3-13, 3-13 h o u r s r e s p e c t i v e l y ) . I n a d d i t i o n , t w e l v e mothers spent a t l e a s t p a r t o f t h e f i r s t n i g h t w i t h t h e i r i n f a n t s , e l e v e n s p e n t .at l e a s t p a r t of t h e second n i g h t , and t w e l v e s p e n t a t l e a s t p a r t o f t h e t h i r d n i g h t w i t h t h e i r i n f a n t s . The i n f o r m a t i o n from t h e D i a r y was u s e f u l b u t s e v e r a l s u b j e c t s were u n a b l e t o f i l l i t o u t . Some had d i f f i c u l t y u n d e r s t a n d i n g how t o use i t , and some f e l t i t was t o o t ime-consuming. Based on t h e i n f o r m a t i o n r e c e i v e d from s u b j e c t s , a r e v i s e d d i a r y form was d e v e l o p e d . I t i s i n c l u d e d i n A p p e n d i x P and seems t o have g a i n e d b e t t e r a c c e p t a n c e i n a r e l a t e d r e s e a r c h p r o j e c t . I t was f ound t h a t C h a r t v a r i a b l e s and D i a r y i t e m s were g e n e r a l l y u n r e l a t e d t o one a n o t h e r ; however, l o n g e r l a b o u r and use o f drugs d u r i n g l a b o u r and d e l i v e r y were r e l a t e d t o a l o n g e r h o s p i t a l s t a y (r=.97 and r=.92 r e s p e c t i v e l y , p_<.01), as woul d be e x p e c t e d . I t was a l s o found t h a t l o n g e r l a b o u r was r e l a t e d t o a g r e a t e r amount o f time s p e n t w i t h t h e i n f a n t a f t e r b i r t h (r=.71, _p_<.01). T h i s may be because t h e newborn i s g e n e r a l l y g i v e n t o the mother t o h o l d w h i l e she i s i n -the r e c o v e r y room, and as t h e r e c o v e r y p e r i o d m i ght be l o n g e r f o r a l o n g e r l a b o u r , t h e mother who had e x p e r i e n c e d a l o n g e r l a b o u r w o u l d have a l o n g e r t i m e t o be w i t h h e r i n f a n t a f t e r t h e b i r t h . F. B e h a v i o u r Record < i(Appendices F and G) The B e a v h i o u r r e c o r d was d e v e l o p e d i n o r d e r t o have a d i r e c t , o b s e r v a t i o n -a l r e c o r d o f m o t h e r - i n f a c t i n t e r a c t i o n w h i c h c o u l d be r e l a t e d t o p r e n a t a l and p e r i n a t a l v a r i a b l e s . B o t h m a t e r n a l and i n f a n t b e h a v i o u r were r e c o r d e d , b u t t h e emphasis was on m a t e r n a l b e h a v i o u r . A r e p o r t on i n t e r o b s e r v e r agreement i s f o l l o w e d by a d i s c u s s i o n o f the problems e n c o u n t e r e d u s i n g t h i s r e c o r d i n g system. I n t e r o b s e r v e r agreement. O b s e r v e r s were t r a i n e d i n two ways: u s i n g v i d e o t a p e s made d u r i n g home v i s i t s , and u s i n g a c t u a l home v i s i t s . V i d e o t a p e s were made t o show a mother and a one-month o l d i n f a n t d u r i n g f e e d i n g , c a r e g i v i n g and p l a y a c t i v i t i e s , and were s i m i l a r i n c o n t e n t t o t h e h o m e - v i s i t s e s s i o n s w h i c h were used f o r b o t h t r a i n i n g and a c t u a l d a t a c o l l e c t i o n . The second o b s e r v e r was t h e same t h r o u g h o u t t r a i n i n g and r e l i a b i l i t y s e s s i o n s . R a te o f i n t e r o b s e r v e r agreement was c a l c u l a t e d by t h e f u n c t i o n : number o f agreements/(number o f agreements = number o f d i s a g r e e m e n t s ) . Four o n e - h a l f hour ta p e s e s s i o n s and two one-hour l i v e s e s s i o n s were used t o c a l c u l a t e agreement; t h e h i g h e s t r a t e o f agreement i s r e p o r t e d h e r e . Agreement o v e r a l l b e h a v i o u r c a t e g o r i e s f o r any g i v e n o b s e r v a t i o n s e s s i o n ranged from .63 t o .77; agreement i n i n d i v i d u a l c a t e g o r i e s r a n g e d f r o m .50 t o 80 t o 1.00. F o r 26 o u t o f 41 c a t e g o r i e s , agreement was g r e a t e r t h a n .75, and f o r an a d d i t i o n a l e i g h t c a t e g o r i e s i t was g r e a t e r t h a n .60. A l i s t o f b e h a v i o u r c a t e g o r i e s and r a t e o f agreement f o r each i s p r o v i d e d i n T a b l e 10. The d i f f i c u l t y w i t h w h i c h agreement was a c h i e v e d was i n p a r t due t o some b e h a v i o u r c a t e g o r i e s w h i c h p r o v e d t o have low f r e q u e n c y a c r o s s a l l o b s e r v a t i o n s e s s i o n s . I n s i x o u t o f the seven c a t e g o r i e s f o r w h i c h o b s e r v e r s f a i l e d t o r e a c h even .60 agreement, t h e mean f r e q u e n c y o v e r a l l t w e n t y - s e v e n s u b j e c t -o b s e r v a t i o n s was 10.3 o r l e s s ; t h a t i s , t h e s e b e h a v i o u r s were o b s e r v e d t o o c c u r d u r i n g an a v e r a g e o f o n l y 10 out o f 240 f i f t e e n - s e c o n d p e r i o d s . I n any g i v e n o b s e r v a t i o n s e s s i o n , t h e y were l i k e l y t o n o t o c c u r a t a l l . The p r o b l e m o f l o w f r e q u e n c y f o r i n t e r o b s e r v e r agreement i s as f o l l o w s : i f , f o r example, "nickname" ( w h i c h had a mean f r e q u e n c y o f 3.0) o c c u r r e d t w i c e i n a g i v e n o b s e r v a t i o n s e s s i o n and each o b s e r v e r r e c o r d e d i t once and m i s s e d i t once, t h e i r r a t e o f o v e r a l l agreement would be 1.00 i f th e y r e c o r d e d t h e same o c c u r r e n c e and z e r o i f th e y each r e c o r d e d a d i f f e r e n t o c c u r r e n c e . I n c o n t r a s t , f o r a h i g h - f r e q u e n c y b e h a v i o u r s u c h as " v o c a l i z e " , w h i c h had a mean f r e q u e n c y o f 110, i f each o b s e r v e r m i s s e d one v o c a l i z a t i o n , t h e r a t e o f agreement would s t i l l be v e r y h i g h , i . e . , 100/110, o r .98. Thus t h e i n c l u s i o n o f l o w -f r e q u e n c y b e h a v i o u r s i n t h i s r e c o r d i n g system b r o u g h t t h e o v e r a l l r a t e o f i n t e r o b s e r v e r agreement down; by removing t h e l o w - f r e q u e n c y b e h a v i o u r s ( t h o s e w i t h a mean o b s e r v e d f r e q u e n c y l e s s t h a n 12 out o f 240 f i f t e e n - s e c o n d p e r i o d s ) , o v e r a l l agreement r i s e s t o .85. A r e l a t e d i s s u e i n e v a l u a t i n g t h i s system i s t h e i n c l u s i o n o f b e h a v i o u r s w h i c h were d i f f i c u l t t o o b s e r v e a c c u r a t e l y . F o r example, i t was d i f f i c u l t f o r the o b s e r v e r t o see whether mother and i n f a n t were i n e y e - t o - e y e c o n t a c t w h i l e s t i l l a t t e m p t i n g t o rem a i n u n o b t r u s i v e and n o n - i n t e r f e r i n g . I f t h e o b s e r v e r was i n a p o s i t i o n t o see the i n f a n t ' s e y e s , i t was o f t e n i m p o s s i b l e t o s i m u l t a n e o u s l y w a t c h t h e mother's e y e s . I n some c a s e s , even when b o t h 81 mother and i n f a n t c o u l d be c l o s e l y w a tched, i t was n o t p o s s i b l e t o be c o m p l e t e l y c e r t a i n t h a t t h e i r eyes were i n d e e d f i x e d upon one a n o t h e r . I n one p a i r , f o r example, t h e i n f a n t appeared t o be making eye c o n t a c t w i t h h i s mother; however, a f t e r t h e o b s e r v a t i o n p e r i o d ended and t h e o b s e r v e r was i n t e r a c t i n g w i t h t h e i n f a n t , she ( t h e o b s e r v e r ) f ound t h a t t h e i n f a n t a v e r t e d h i s gaze f r o m h e r eyes w h i l e s t i l l l o o k i n g a t h e r f a c e . Thus i t was u n c l e a r whether t h e m o t h e r - i n f a n t p a i r had a c t u a l l y been i n eye c o n t a c t when t h e y were o b s e r v e d , o r whether t h e i n f a n t had a v e r t e d h i s gaze when l o o k i n g a t h i s mother as he had done w h i l e l o o k i n g a t t h e o b s e r v e r . There i s no way o f knowing what the c a s e a c t u a l l y was f o r t h i s i n f a n t , o r f o r any o t h e r i n f a n t , s h o r t o f a s k i n g t h e mother i f h e r i n f a n t was l o o k i n g d i r e c t l y a t h e r . F o r t u n a t e l y most b e h a v i o u r c a t e g o r i e s were n o t found t o be so e l u s i v e : p o s t u r a l o r p o s i t i o n a l b e h a v i o u r s s u c h as c l o s e o r l o o s e c o n t a c t , en f a c e p o s i t i o n o r l o o k i n g c o u l d be r e a d i l y o b s e r v e d and r e c o r d e d , and v e r b a l b e h a v i o u r s were s i m p l e t o o b s e r v e and r e c o r d . B e h a v i o u r s i n v o l v i n g f a c i a l e x p r e s s i o n s , however, such as " s m i l e " o r " p l a y - f a c e " , were a t t i m e s d i f f i c u l t t o o b s e r v e i f t h e mother's h a i r f e l l a c r o s s h e r f a c e as she l o o k e d down a t h e r i n f a n t , w h i c h sometimes happened. The c a t e g o r y " s e c u r e s " , w h i c h i s d e f i n e d as m a t e r n a l b e h a v i o u r d e s i g n e d t o p r e v e n t t h e i n f a n t f r o m f a l l i n g out of an i n f a n t s e a t o r r o l l i n g o f f a change t a b l e , e t c . , was f ound t o have more meaning i f i t was o b s e r v e d n o t t o o c c u r t h a n i f i t d i d o c c u r . Because most mothers a u t o m a t i c a l l y p l a c e t h e i r i n f a n t i n a s e c u r e p o s i t i o n , a mother who f a i l s t o do so i s g i v i n g a g r e a t d e a l o f i n f o r m a t i o n about h e r a b i l i t y o r w i l l i n g n e s s t o a t t e n d t o h e r c h i l d ' s s a f e t y . T h i s was o b s e r v e d i n o n l y one mother, who l e f t h e r i n f a n t i n a dangerous p o s i t i o n t h r e e t i m e s d u r i n g t h e one-hour o b s e r v a t i o n p e r i o d . I n e f f e c t , t h i s b e h a v i o u r c a t e g o r y i s more u s e f u l as a n o m i n a l c a t e g o r y t h a n as one f o r w h i c h a c t u a l f r e q u e n c y has much meaning. A mother who l e a v e s h e r 82 infant i n danger may merely be i n need of intervention or assistance to help her r e a l i z e what she i s doing, or the s i t u a t i o n may be more serious, and she may be "at r i s k " for c h i l d abuse or neglect. In any case, t h i s behaviour category was a low-frequency one, and the amount of information i t can contribute i s l i m i t e d i f the data are analyzed only i n terms of frequency. The mean frequencies of occurrence for each behaviour category, along with the number of subjects f o r whom the behaviour was recorded at l e a s t once are shown i n Table 8. Several behaviour categories may be more useful i f used as nominal variables than i f treated as i n t e r v a l data. The low-frequency behaviours discussed e a r l i e r can be meaningful clues to the nature of the mother-infant r e l a t i o n s h i p because of, rather than i n s p i t e of, t h e i r low frequency. The frequency of commonly observed behaviours t e l l s us l i t t l e about the q u a l i t y of an i n d i v i d u a l r e l a t i o n s h i p ; f o r example, since mothers generally hold t h e i r infants i n a close-contact p o s i t i o n during feeding, knowing that a mother held her infant i n t h i s p o s i t i o n f o r a great deal of the observation period may be more of an i n d i c a t i o n that a feeding session was observed than that the mother had feeli n g s of warmth and closeness for her i n f a n t . On the other hand, a mother who "requests a response" from her infant by attempting to e l i c i t a smile or a v o c a l i z a t i o n i s giving an i n d i c a t i o n that she knows enough about infant c a p a b i l i t i e s to t r y to get her baby to respond, and that she cares enough about her r e l a t i o n s h i p with her infant to spend her time and energy making t h e i r i n t e r a c t i o n more meaningful f o r both of them. Her attachment or commitment i s perhaps best measured i n th i s way, rather than as a function of the gross amount of behaviour she ex h i b i t s . There are other behaviours which could be seen s i m i l a r l y — play and play-face, providing v i s u a l and auditory stimulation, and perhaps c a l l i n g the infant by name or nickname. Further discussion of t h i s issue, and of s p e c i f i c elements of research design and instruments used i n t h i s study and 83 t h e e f f e c t s of t h e s e upon t h e v a l i d i t y o f t h e i n f o r m a t i o n g a t h e r e d f o l l o w s i n a l a t e r s e c t i o n . G. M a t e r n a l B e h a v i o u r Composites (Appendix S) A n o t h e r a p p r o a c h t o t h e i s s u e u n d e r l y i n g t h e p r e v i o u s d i s c u s s i o n — t h a t o f q u a l i t y v e r s u s q u a n t i t y -- was t a k e n . S i n c e e x a m i n a t i o n of i n d i v i d u a l b e h a v i o u r f r e q u e n c i e s d i d n o t appear t o p r o v i d e enough i n f o r m a t i o n about p a t t e r n s of m a t e r n a l b e h a v i o u r , a more m o l a r l e v e l o f a n a l y s i s , w h e r e i n i n d i v i d u a l b e h a v i o u r s were grouped t o g e t h e r t o f o r m b e h a v i o u r a l c o m p o s i t e s , was u s e d . The M a t e r n a l Composites were d e t e r m i n e d a p r i o r i , and were t h e o r g a n i z i n g p r i n c i p l e f o r g e n e r a t i n g t h e i n d i v i d u a l b e h a v i o u r c a t e g o r i e s t o be o b s e r v e d . I n p r a c t i c e , t h e y were d e r i v e d by s i m p l y summing a c r o s s s p e c i f i c i n d i v i d u a l b e h a v i o u r c a t e g o r i e s . The r a t i o n a l e was t o sum a c r o s s c a t e g o r i e s w h i c h s e r v e d the same f u n c t i o n , t h e r e b y a c c o u n t i n g f o r i n d i v i d u a l d i f f e r e n c e s i n m a t e r n a l s t y l e . Thus, f o r example, a mother who shows h e r i n f a n t a t o y i s n o t d i f f e r e n t f r o m a mother who shakes a r a t t l e f o r h e r i n f a n t i f b o t h a c t i v i t i e s a r e seen as p r o v i d i n g s t i m u l a t i o n f o r the i n f a n t . R a t h e r t h a n d i f f e r e n t i a t e t h e s e two mothers by t h e a c t u a l method used t o s t i m u l a t e t h e i r i n f a n t s ( v i s u a l v e r s u s a u d i t o r y ) , t h e y would b o t h be s c o r e d as p r o v i d i n g one ( o r more) f i f t e e n - s e c o n d p e r i o d w o r t h o f s t i m u l a t i o n . The e i g h t M a t e r n a l Composites a r e l i s t e d and d e f i n e d i n A p p e n d i x S, and t h e c o r r e l a t i o n s among t h e s e e i g h t groups o f b e h a v i o u r s a r e shown i n T a b l e 11. On t h i s l e v e l o f a n a l y s i s , p a t t e r n s began t o emerge. Three o f t h e S o c i a l Engagement c a t e g o r i e s ( V i s u a l , V o c a l and P l a y Engagement) and C o n t i n g e n t Response were s i g n i f i c a n t l y i n t e r c o r r e l a t e d ( l o w e s t r=.44, p_<.05; mean r=.58, p_<.01) and were c o r r e l a t e d w i t h P r o v i d i n g S t i m u l a t i o n ( l o w e s t r=.30, p_<.05, mean _r=.45, p_<.05), and G i v i n g A f f e c t i o n ( l o w e s t _r-.36, p_<.10; mean r=.44, p_<.05). The f o u r t h S o c i a l Engagement c a t e g o r y , T a c t i l e Engagement, 84 was u n r e l a t e d t o t h e o t h e r s , p r o b a b l y because one o f i t s subsumed b e h a v i o u r c a t e g o r i e s was d e f i n e d t o i n c l u d e r h y t h m i c p a t t i n g , w h i c h was g e n e r a l l y o b s e r v e d as p a r t o f f e e d i n g and b u r p i n g r a t h e r t h a n s o c i a l i n t e r a c t i o n . P h y s i c a l C o n t a c t and C a r e g i v i n g were m a r g i n a l l y i n t e r c o r r e l a t e d (r_=.36, p_<.10), b u t were o n l y s p a r e s e l y r e l a t e d t o t h e o t h e r b e h a v i o u r g r o u p s : t h e c o r r e l a t i o n between P h y s i c a l C o n t a c t and T a c t i l e Engagement (r=.50, p_<.01) p r o b a b l y r e f l e c t s t h e f a c t t h a t h o l d i n g and p a t t i n g a r e b o t h p a r t o f t h e f e e d i n g s i t u a t i o n . Time s p e n t C a r e g i v i n g was n e g a t i v e l y r e l a t e d t o t i m e s p e n t i n V i s u a l Engagement (r=-.41, p_<.05). Thus t h e r e i s e v i d e n c e f o r s e p a r a t e c o n s t e l l a t i o n s o f m a t e r n a l b e h a v i o u r w h i c h do n o t appear t o be r e l a t e d — c o n t a c t and c a r e g i v i n g v e r s u s i n t e r a c t i o n , s t i m u l a t i o n and a f f e c t i o n . The use o f t h e s e b e h a v i o u r a l c o m p o s i t e s seems t o be a more m e a n i n g f u l way t o l o o k a t t h e o b s e r v a t i o n a l d a t a on i t s own. L e t us see how t h e y r e l a t e t o p r e n a t a l and p e r i n a t a l v a r i a b l e s as w e l l as t o o t h e r p o s t p a r t u m v a r i a b l e s . H. M a t e r n a l C o m p o s i t e s — c o r r e l a t i o n w i t h o t h e r v a r i a b l e s (a) M a t e r n a l Composites — P r e n a t a l Q u e s t i o n n a i r e The number o f s i g n i f i c a n t c o r r e l a t i o n s between M a t e r n a l C omposites and P r e n a t a l Q u e s t i o n n a i r e i t e m r e s p o n s e s exceeded t h e chance l e v e l , and some p a t t e r n s a p p e a r e d . The c o r r e l a t i o n s a r e p r o v i d e d i n T a b l e 12. ( I t s h o u l d be n o t e d t h a t some c o r r e l a t i o n s r e p o r t e d i n t h e T a b l e a r e n e g a t i v e b e c a u s e t h e s c a l e s used i n t h e P r e n a t a l Q u e s t i o n n a i r e a r e c o n s t r u c t e d so t h a t a s c o r e o f 1 i n d i c a t e s t h e most p o s i t i v e r e s p o n s e . T h e r e f o r e , i f a p o s i t i v e r e s p o n s e t o a p r e n a t a l q u e s t i o n i s p o s i t i v e l y r e l a t e d t o a h i g h M a t e r n a l Composite s c o r e , t h e c o r r e l a t i o n w i l l be n e g a t i v e . Because t h i s i s c o n f u s i n g , t h e c o r r e l a t i o n s have been r e f l e c t e d ( i . e . , t h e s i g n has been changed) where n e c e s s a r y i n b o t h t h e t a b l e s and t h e t e x t . ) More t i m e s p e n t i n P h y s i c a l C o n t a c t w i t h t h e i n f a n t a t one month was r e l a t e d t o t h e mother's w i s h d u r i n g t h e l a s t t r i m e s t e r o f p regnancy t o have h e r i n f a n t i n h e r h o s p i t a l room a f t e r t h e b i r t h (r_=.43, p_<.05); t o h e r p r e d i c t i o n t h a t she would c a l m a c r y i n g i n f a n t by p i c k i n g him up r a t h e r t h a n by g i v i n g a f f e c t i o n (r_=.43, p_<.05); t o h a v i n g an u n c l e a r p i c t u r e of what i t w o u l d be l i k e t o have a new baby (_r=.43, p_<.05); and t o p r e d i c t i n g a p o s i t i v e change i n h e r r e l a t i o n s h i p w i t h h e r husband (r=.50, p<'05). Thus a mother who spends t i m e i n p h y s i c a l c o n t a c t w i t h h e r i n f a n t i s one who w i s h e d p r e n a t a l l y t o have c o n t a c t w i t h h e r i n f a n t , and whose p r e d i c t i o n o f h e r own b e h a v i o u r showed a l i m i t e d r e p e r t o i r e o f r e s p o n s e s t o t h e i n f a n t , p erhaps due t o t h e f a c t t h a t she d i d n o t have a c l e a r : p i c t u r e of l i f e w i t h a new baby. T h i s u n c l e a r p i c t u r e may a l s o be r e s p o n s i b l e f o r h e r f a i l u r e t o c o n s i d e r t h a t t h e n e c e s s a r y t i m e s p e n t c a r i n g f o r a new i n f a n t would p r o b a b l y t a k e away from t i m e w h i c h husband and w i f e u s u a l l y s p e n t t o g e t h e r . More t i m e s p e n t i n o v e r a l l S o c i a l Engagement was c o r r e l a t e d w i t h t h e r e t r o s p e c t i v e r e p o r t of a p o s i t i v e i n i t i a l f e e l i n g about t h e p r e g n a n c y (r=.39, p_<.05) and t h e p r e d i c t i o n of b e i n g w e l l - p r e p a r e d f o r c a r e g i v i n g t a s k s (r=.40, p_<.05). More t i m e s p e n t i n V o c a l Engagement was r e l a t e d t o r e p o r t i n g i n i t i a l p o s i t i v e f e e l i n g s toward pregnancy (r=.37, _p_<.10); f e e l i n g w e l l -p r e p a r e d t o c a r e f o r t h e i n f a n t (r=.45, p_<.05); a n t i c i p a t i o n o f n e e d i n g h e l p a t home a f t e r the b i r t h (r=.36, p_<.10); and p r e d i c t i o n of i n f a n t ' s e a r l y a t t a c h m e n t t o mother (r=.38, p_<.05) and f a t h e r (r=.43, p_<.05). More t i m e s p e n t i n T a c t i l e Engagement was r e l a t e d t o m a t e r n a l p r e d i c t i o n o f c a l m i n g a c r y i n g baby by p i c k i n g him/her up (r_=.40, p<.05). Thus p r e d i c t i o n of u s i n g t a c t i l e s t i m u l a t i o n ( i . e . , p i c k i n g baby up) was r e l a t e d t o a c t u a l o b s e r v e d t a c t i l e b e h a v i o u r . Time s p e n t i n P l a y Engagement was r e l a t e d t o a p r e n a t a l l a c k o f c o n c e r n f o r s p o i l i n g t h e i n f a n t (r_=.44, p_<.05) and p r e d i c t i o n o f n e g a t i v e changes i n t h e m a r i t a l r e l a t i o n s h i p as a r e s u l t o f h a v i n g a baby (r=.41, p_<.05). Here we see t h a t t h e p r e n a t a l b e l i e f t h a t t h e i n f a n t cannot be 86 s p o i l e d by m a t e r n a l a t t e n t i o n i s r e l a t e d t o t h e p o s t p a r t u m o b s e r v a t i o n o f t h e mother g i v i n g h e r i n f a n t a t t e n t i o n . S i m i l a r l y , t h e b e l i e f t h a t t i m e s p e n t w i t h t h e i n f a n t m i ght t a k e t i m e away from t h e mother's r e l a t i o n s h i p w i t h h e r husband was r e l a t e d t o a c t u a l l y s p e n d i n g t i m e i n t e r a c t i n g w i t h t h e i n f a n t . More t i m e s p e n t i n G i v i n g A f f e c t i o n was r e l a t e d t o p r e n a t a l p r e d i c t i o n of c o n f i d e n c e i n c a r e g i v i n g (r=.46, p_<.05), a n t i c i p a t i o n o f b e i n g a b l e t o u n d e r -s t a n d n o n - c r y i n g s i g n a l s from t h e i n f a n t (r=.44, p_<.05), and p r e d i c t i o n o f e a r l y a t t a c h m e n t o f baby t o mother (r=.46, p_<.05). Thus t h e a n t i c i p a t i o n o f a c l o s e and u n d e r s t a n d i n g r e l a t i o n s h i p between mother and baby was r e l a t e d t o o b s e r v e d m a t e r n a l a f f e c t i o n a t e b e h a v i o u r . C o n t i n g e n t Response was c o r r e l a t e d w i t h p r e d i c t i o n o f e a r l y i n f a n t - m o t h e r and i n f a n t - f a t h e r a t t a c h m e n t (r=.49, p_<.05; r=.50, p_<.01), and m a r g i n a l l y c o r r e l a t e d w i t h p r e d i c t e d m o t h e r - i n f a n t a t t a c h m e n t (r=.36, p_<.10). Time s p e n t i n C a r e g i v i n g a t one month was c o r r e l a t e d w i t h p r e n a t a l p r e d i c t i o n o f i n f a n t - m o t h e r a t t a c h m e n t (r=.38, p_<.05). More t i m e s p e n t P r o v i d i n g S t i m u l a t i o n f o r t h e i n f a n t a t one month was r e l a t e d t o p o s i t i v e f e e l i n g s upon f i r s t l e a r n i n g o f t h e p r e g n a n c y , ( r = .49, p_<.01). I n summary, t h e r e appears to be a c o n s t e l l a t i o n o f b e h a v i o u r s and a t t i t u d e s w h i c h b r i d g e t h e p r e n a t a l - t o - p o s t p a r t u m p e r i o d . We have seen t h a t o b s e r v a t i o n o f t h e mother e n g a g i n g i n r e s p o n s i v e , s o c i a l s t i m u l a t i o n and a f f e c t i o n a t e b e h a v i o u r i n t h e p o s t p a r t u m p e r i o d i s r e l a t e d t o p o s i t i v e f e e l i n g s about p r e g n a n c y d u r i n g t h e p r e n a t a l p e r i o d , t o a n t i c i p a t i o n o f d e a l i n g w i t h c a r e g i v i n g and i n f a n t s i g n a l s w i t h c o n f i d e n c e , t o b e i n g u n c o n c e r n e d t h a t p i c k i n g up o r p l a y i n g w i t h t h e i n f a n t might s p o i l him o r h e r , t o a n t i c i p a t i o n o f n e e d i n g h e l p a t home a f t e r t h e b i r t h , t o a f e e l i n g t h a t c l o s e t i e s between mother, i n f a n t and f a t h e r would be e s t a b l i s h e d e a r l y , and t o an awareness t h a t t i m e spent c a r i n g f o r t h e i n f a n t m i g h t d e t r a c t f r o m t h e m a r i t a l r e l a t i o n s h i p . I n o t h e r words, we see t h a t a group o f p r e n a t a l a t t i t u d e s r e f l e c t i n g a 87 s e n s i t i v e , c o n f i d e n t , r e a l i s t i c e x p e c t a n t mother i s r e l a t e d t o s e n s i t i v e , i n t e r a c t i v e behavour as o b s e r v e d a t one month p o s t p a r t u m . Thus t h e r e does appear t o be a r e l a t i o n s h i p between p r e n a t a l a t t i t u d e s and p o s t n a t a l b e h a v i o u r when m a t e r n a l b e h a v i o u r i s t a k e n a t a m o l a r l e v e l , w h e r e i n v a r i o u s i n d i v i d u a l b e h a v i o u r s a r e grouped t o g e t h e r t o f o r m c o m p o s i t e s w h i c h can t h e n r e f l e c t t h e f u n c t i o n r a t h e r t h a n t h e a c t u a l f o r m o f v a r i o u s m o l e c u l a r b e h a v i o u r s . (b) M a t e r n a l Composites — C h a r t V a r i a b l e s and D i a r y The number of s i g n i f i c a n t c o r r e l a t i o n s between M a t e r n a l Composites and C h a r t V a r i a b l e s o r D i a r y i t e m s was below chance l e v e l ; t h e r e seems t o be no s y s t e m a t i c r e l a t i o n s h p between t h e s e p e r i n a t a l v a r i a b l e s and t h e M a t e r n a l C o m p o s i t e s . (c) M a t e r n a l Composites — I n f a n t B e h a v i o u r s S i m i l a r l y t h e number o f c o r r e l a t i o n s between i n f a n t b e h a v i o u r s and m a t e r n a l c o m p o s i t e s was b e l o w chance l e v e l , and w h i l e i t w o u l d be f o o l i s h t o c o n c l u d e t h a t t h e r e i s no r e l a t i o n s h i p between m a t e r n a l and i n f a n t b e h a v i o u r , perhaps i t i s the case t h a t we have n o t measured i n f a n t b e h a v i o u r i n enough d e t a i l t o c a p t u r e t h e n a t u r e o f t h e r e l a t i o n s h i p . I . M a t e r n a l Care R a t i n g S c a l e s ( A p p e n d i c e s H and I ) L e t us now t u r n t o a d i f f e r e n t p r o c e d u r e w h i c h may be a n o t h e r u s e f u l way t o a s s e s s q u a l i t y of m a t e r n a l b e h a v i o u r as d i s t i n c t f r o m q u a n t i t y . F o l l o w i n g t h e one-month p o s t p a r t u m home v i s i t , t h e o b s e r v e r f i l l e d o ut a s e t o f e i g h t e e n s c a l e s d e v e l o p e d by Mary A i n s w o r t h (1977) upon w h i c h o v e r a l l m a t e r n a l b e h a v i o u r was r a t e d . These s c a l e s a r e c o n c e r n e d w i t h t h e mother's g e n e r a l a t t i t u d e , h e r s y n c h r o n i z a t i o n of c a r e g i v i n g w i t h h e r i n f a n t ' s needs and rhythms, h e r a v a i l a b i l i t y t o , i n t e r a c t i o n w i t h , and p h y s i c a l and s o c i a l c o n t a c t w i t h h e r i n f a n t , t h e e f f e c t i v e n e s s o f h e r r e s p o n s e t o h e r i n f a n t ' s c r i e s , and h e r encouragement o f t h e i n f a n t ' s s e n s o r i m o t o r a c h i e v e m e n t . H i g h 88 r a t i n g s on t h e s e s c a l e s i n d i c a t e s e n s i t i v i t y , warmth, a f f e c t i o n , and e f f e c t i v e n e s s o f c a r e . A n a l y s e s i n v o l v i n g the s c a l e s r e v e a l e d t h a t t h e y were a l l h i g h l y i n t e r c o r r e l a t e d ( T a b l e 1 3 ) , and were h i g h l y c o r r e l a t e d w i t h many o f t h e M a t e r n a l Composites ( T a b l e 1 4 ) . They were a l s o found t o be c o r r e l a t e d w i t h some I n f a n t B e h a v i o u r s and i n f a n t outcome a f t e r d e l i v e r y ( T a b l e 1 5 ) , and w i t h some i t e m s from t h e P r e n a t a l Q u e s t i o n n a i r e ( T a b l e 1 6 ) . The M a t e r n a l R a t i n g s were f o u n d t o be u n r e l a t e d t o t h e D i a r y i t e m s , (a) M a t e r n a l R a t i n g s — M a t e r n a l C o m p o s i t e s ( T a b l e 14) The r a t i n g s f o r M a t e r n a l A t t i t u d e ( m a t e r n a l p e r c e p t i o n o f t h e i n f a n t , d e l i g h t e x p r e s s e d i n t h e i n f a n t , a c c e p t a n c e o f t h e i n f a n t , and a b i l i t y t o g i v e i n f o r m a t i o n about t h e i n f a n t ) were c o r r e l a t e d w i t h o b s e r v e d V i s u a l Engagement (r=.43, p_<.05; £=.33, p_<.10; r=.48, p_<.05; r=.33, p_<.10), V o c a l Engagement (r=.54, p_<.10; r=.45, p_<.05; r=.53, p_<.01; r=. 42; p_<. 05) , P l a y Engagement (r=.61, .53, .62, .51; £<.01 f o r a l l ) , S o c i a l Engagement (r=.65, .53, .62, .51, p_<.01 f o r a l l ) , G i v i n g A f f e c t i o n (r=.38, p_<.05; r=.33, £<-10; r=.41, p_<.05; r=.34, p_<.10), C o n t i n g e n t Response (r=.57, .50, .56, .55, p_<.01 f o r a l l ) , and P r o v i d i n g S t i m u l a t i o n (r=.33, p_<.10; r=.54, p_<.01; r=.41, p_<.05 f o r d e l i g h t , a c c e p t a n c e and i n f o r m a t i o n r e s p e c t i v e l y ) . O n l y t h e r a t i n g s f o r M a t e r n a l P e r c e p t i o n were s i g n i f i c a n t l y c o r r e l a t e d w i t h o b s e r v e d P h y s i c a l C o n t a c t (r=.47, p_<.05), and T a c t i l e Engagement (r=.41, p_<.05). M a t e r n a l r a t i n g s f o r A v a i l a b i l i t y ( a v a i l a b i l i t y o f mother f o r i n f a n t , amount and a p p r o p r i a t e n e s s o f i n t e r a c t i o n p r o v i d e d ) were c o r r e l a t e d w i t h o b s e r v e d V i s u a l Engagement (r=.53, p_<.01; r=.62, p_<.01; r=.46, p_<.05), V o c a l Engagement (r=.49, .79, .69, p_<.01 f o r a l l ) , P l a y Engagement (r=.60, .71, .71, p_<.01 f o r a l l ) , S o c i a l Engagement (r=.60, .79, .67, p_<.01 f o r a l l ) , P r o v i d i n g S t i m u l a t i o n (r=.37, p<.10; r=.54, .51, p_<.01 f o r b o t h ) , G i v i n g A f f e c t i o n (r_=.41, p_<.05; r=.55, p_<.01; r=.41, p_<.05), and C o n t i n g e n t Response (r=.60, .69, .56, p_<.01 f o r a l l ) . M a t e r n a l r a t i n g s f o r C o n t a c t (amount o f 89 p h y s i c a l c o n t a c t , q u a l i t y o f p h y s i c a l c o n t a c t ) were c o r r e l a t e d w i t h o b s e r v e d P h y s i c a l C o n t a c t (rj=.68, D_<.01, r = . 4 l , p<.05), V o c a l Engagement (r=.41, .47, p_<.05 f o r b o t h ) , S o c i a l Engagement (r=.52, .48; p_<.01 f o r b o t h ) , P r o v i d i n g S t i m u l a t i o n (r=.39, .40; p_<.05 f o r b o t h ) , and C o n t i n g e n t Response (r=.41, .45; p_<.05 f o r b o t h ) . I n a d d i t i o n , r a t i n g s o f amount ( b u t n o t q u a l i t y ) o f p h y s i c a l c o n t a c t were c o r r e l a t e d w i t h o b s e r v e d V i s u a l Engagement (r=.34, p_<.10) and T a c t i l e Engagement (r=.47, _p_<.05). R a t i n g s o f q u a l i t y o f p h y s i c a l c o n t a c t (but n o t q u a n t i t y ) were r e l a t e d t o o b s e r v e d P l a y Engagement (r=.41, j><.05). M a t e r n a l r a t i n g s f o r I n t e r a c t i o n (amount of v i s u a l c o n t a c t , amount o f a u d i t o r y c o n t a c t and f r e q u e n c y of p l a y i n t e r a c t i o n ) were c o r r e l a t e d w i t h o b s e r v e d V i s u a l Engagement (r=.39, p_<.0.5; r=.57, .60; _p<.01 f o r b o t h ) , V o c a l Engagement (r=.46, p_<.05; r=.66, .78, p_<.01 f o r b o t h ) , P l a y Engagement (£=.50, .55, .74, p<.01 f o r a l l ) , S o c i a l Engagement (r=.51, .67, .78, p_<.01 f o r a l l ) , G i v i n g A f f e c t i o n (r=.39, .46, £<.05; £=.58, _p<.01), and C o n t i n g e n t Response (£=.47, jp<. 05; £=.55, .64, p<.01 f o r b o t h ) . I n a d d i t i o n , t h e r a t i n g f o r amount o f v i s u a l c o n t a c t was c o r r e l a t e d w i t h o b s e r v e d P h y s i c a l C o n t a c t (r=.53, _p<.01). The r a t i n g f o r amount o f a u d i t o r y c o n t a c t and f r e q u e n c y o f p l a y i n t e r a c t i o n were c o r r e l a t e d w i t h o b s e r v e d P r o v i d i n g S t i m u l a t i o n (£=.39, p<.05; r=.51, p_<.01). M a t e r n a l r a t i n g s o f F a c i l i t a t i o n o f Development ( s t i m u l u s p o t e n t i a l o f t h e e n v i r o n m e n t and encouragement of s e n s o r i m o t o r a c h i e v e m e n t ) were c o r r e l a t e d w i t h o b s e r v e d V o c a l Engagement (r=.48, p_<.05; r=.62, p<.01), P l a y Engagement (r=.55, .79, _p<.01 f o r b o t h ) , S o c i a l Engagement (r=.51, .71, p<.01 f o r b o t h ) , P r o v i d i n g S t i m u l a t i o n (r=.55, .50, p_<.01 f o r b o t h ) , and C o n t i n g e n t Response (r=.47, p<.05; r=.51, p_<.01). I n a d d i t i o n , encouragement o f s e n s o r i m o t o r achievement was c o r r e l a t e d w i t h o b s e r v e d V i s u a l Engagement (r=.55, p_<.01) and A f f e c t i o n (r=.43, p<.05). The r a t i n g s o f E f f e c t i v e n e s s o f Response t o I n f a n t C r y i n g were s i g n i f i c a n t l y c o r r e l a t e d w i t h o b s e r v e d P h y s i c a l C o n t a c t (r=.61, p_<.01), V i s u a l 90 Engagement (r=.39, p_<.05), V o c a l Engagement (r=.49, p_<.01), S o c i a l Engagement (r=.56, p_<.01), and P l a y Engagement (r=.41, p_<.05), and m a r g i n a l l y c o r r e l a t e d w i t h T a c t i l e Engagement (r_=.34, p_<.10), G i v i n g A f f e c t i o n (£=.34, p_<.10), and C o n t i n g e n t Response (r=.37, p_<. 10) . R a t i n g s f o r F e e d i n g ( s u n c h r o n y of f e e d i n g i n t e r v e n t i o n , amount and r a t e o f f e e d i n g ) were l a r g e l y u n r e l a t e d t o t h e M a t e r n a l C o m p o s i t e s , e x c e p t t h a t t h e r a t i n g f o r f e e d i n g was c o r r e l a t e d w i t h o b s e r v e d V o c a l Engagement (r=.43, p_<.05) , P r o v i d i n g S t i m u l a t i o n (r=.34, £<.10), and C o n t i n g e n t Response (r=.42, p_<.05). The r a t i n g f o r amount o f f o o d was m a r g i n a l l y c o r r e l a t e d w i t h o b s e r v e d P l a y Engagement (r=.35, p_<.10), t h e r a t i n g f o r s y n c h r o n y o f f e e d i n g i n t e r v e n t i o n was c o r r e l a t e d w i t h o b s e r v e d P l a y Engagement (r=.36, p_<.10), P r o v i d i n g S t i m u l a t i o n (r=.47, p_<.05), and C o n t i n g e n t Response (r=.37, p_<.10). I t i s n o t e w o r t h y t h a t no M a t e r n a l Care R a t i n g s were s i g n i f i c a n t l y c o r r e l a t e d w i t h t h e o b s e r v e d M a t e r n a l C o m p o s i t e , C a r e g i v i n g . T h i s may be seen as l e n d i n g s u p p o r t t o t h e n o t i o n f o r w h i c h p r e v i o u s d a t a have g i v e n e v i d e n c e t h a t t h e r e i s a c o n s t e l l a t i o n o f m a t e r n a l i n t e r a c t i v e b e h a v i o u r w h i c h i s s e p a r a t e from a c o n s t e l l a t i o n o f m a t e r n a l c a r e g i v i n g b e h a v i o u r . S i m i l a r l y , t h e M a t e r n a l R a t i n g s f o r f e e d i n g b e h a v i o u r were l a r g e l y u n r e l a t e d t o b o t h t h e o t h e r M a t e r n a l R a t i n g s ( s ee T a b l e 1 3 ) , and t h e M a t e r n a l C omposites (see T a b l e 1 4 ) . The e x t e n t t o w h i c h t h e M a t e r n a l R a t i n g s and t h e M a t e r n a l C o m p o s i t e s were found c o r r e l a t e d was u n d o u b t e d l y i n f l u e n c e d i n p a r t by t h e f a c t t h a t t h e y were n o t c o m p l e t e l y i n d e p e n d e n t measures, i . e . , t h e o b s e r v e r , a f t e r r e c o r d i n g t h e b e h a v i o u r w h i c h makes up t h e M a t e r n a l Composite s c o r e s , f i l l e d out t h e M a t e r n a l R a t i n g S c a l e s . P e r c e p t i o n s about c e r t a i n a s p e c t s o f b e h a v i o u r r a t e d on t h e s c a l e s came i n p a r t from the d i r e c t o b s e r v a t i o n o f t h e mother's b e h a v i o u r d u r i n g t h e one=hour o b s e r v a t i o n ; f o r o t h e r s c a l e s , e.g., G e n e r a l A t t i t u d e and F a c i l i t a t i o n o f Development, i n f o r m a t i o n from t h e i n t e r v i e w 91 and/or t h e o b s e r v e r ' s p e r c e p t i o n o f t h e s i t u a t i o n were t h e m a j o r s o u r c e s o f i n f o r m a t i o n used t o f i l l out t h e s c a l e s . I t i s perhaps w o r t h n o t i n g t h a t t h e M a t e r n a l R a t i n g s can o n l y be made on t h e b a s i s o f o b s e r v a t i o n , and were d e v e l o p e d t o be used i n c o n j u n c t i o n w i t h s y s t e m a t i c o b s e r v a t i o n a l methods. A l s o , d e s p i t e t h e i n t e r d e p e n d e n t n a t u r e o f t h e s c a l e s and t h e o b s e r v a t i o n a l d a t a , t h e y need n o t have t u r n e d o u t t o be so h i g h l y and e x t e n s i v e l y c o r r e l a t e d . That t h e y a r e c o r r e l a t e d l e n d s v a l i d i t y t o b o t h : c l i n i c a l j udgments, " s u b j e c t i v e " as t h e y a r e , were f o u n d t o be s u p p o r t e d by more o b j e c t i v e l y documented o b s e r v a t i o n s of a c t u a l b e h a v i o u r . From t h e p o i n t of v i e w o f t h i s r e s e a r c h p r o j e c t , w h i c h i s c o n c e r n e d w i t h t h e development and v a l i d a t i o n o f i n s t r u m e n t s f o r s t u d y i n g m a t e r n a l b e h a v i o u r , i t i s e s p e c i a l l y e n c o u r a g i n g t h a t t h e o b s e r v a t i o n a l s y s t e m d e v e l o p e d e x p r e s s l y f o r t h i s p r o j e c t was shown t o be r e l a t e d t o an i n s t r u m e n t d e v e l o p e d i n d e p e n d e n t l y by a n o t h e r r e s e a r c h e r t o measure q u a l i t y of m a t e r n a l b e h a v i o u r . (b) M a t e r n a l R a t i n g s — I n f a n t B e h a v i o u r ( T a b l e 15) M a t e r n a l R a t i n g s were found t o be r e l a t e d t o some i n f a n t b e h a v i o u r s . The amount o f t i m e t h e i n f a n t was o b s e r v e d t o be f o c u s i n g a t t e n t i o n upon t h e mother was found t o be p o s i t i v e l y c o r r e l a t e d w i t h m a t e r n a l r a t i n g s f o r amount o f i n t e r a c t i o n (r=.45, p_<.05), a p p r o p r i a t e n e s s o f i n t e r a c t i o n (r=.39, _p_<.10), v i s u a l c o n t a c t (r==.42, _p_<.05), a u d i t o r y c o n t a c t (r=.33, p<.10), f r e q u e n c y o f p l a y i n t e r a c t i o n (r=.40, _p_<.05) and encouragement o f s e n s o r i m o t o r achievement (r=.43, p_<.05). The amount o f t i m e the i n f a n t was o b s e r v e d t o spend f o c u s i n g on o b j e c t s was n e g a t i v e l y c o r r e l a t e d w i t h m a t e r n a l r a t i n g s f o r p e r c e p t i o n o f t h e i n f a n t (r=-.39, p<.05), e x p r e s s e d d e l i g h t i n t h e i n f a n t (r=-.42, _p<.05), a v a i l a b i l i t y o f mother t o t h e i n f a n t (r=-.35, p_<.10), amount arid q u a l i t y o f p h y s i c a l c o n t a c t (r=-.45, -. 38, p_<.05) , m a t e r n a l r e s p o n s e t o c r y i n g (r=-.61, p_<.01) and amount o f a u d i t o r y c o n t a c t (r=-.54, p_<.01). Thus, t o t h e e x t e n t t h a t t h e i n f a n t a t t e n d e d t o h i s o r h e r mother, t h e mother responded by p r o v i d i n g i n t e r a c t i o n and i n t e r p e r s o n a l s t i m u l a t i o n f o r t h e i n f a n t ; w hereas, t o t h e e x t e n t t h a t t h e i n f a n t a t t e n d e d t o o b j e c t s , t h e mother was seen t o be l e s s i n t e r a c t i v e , i . e . , she was l e s s a v a i l a b l e t o t h e i n f a n t , she p r o v i d e d l e s s p h y s i c a l c o n t a c t and was l e s s e f f e c t i v e i n r e s p o n d i n g t o t h e i n f a n t ' s c r y . No c a u s a l i n f e r e n c e s a r e made about t h e d i r e c t i o n o f t h e e f f e c t s , o f c o u r s e . I n deed, a h y p o t h e s i s c o n g r u e n t w i t h a f u l l y i n t e r a c t i o n a l model i n w h i c h b o t h mother and i n f a n t c o n t r i b u t e t o and a r e a f f e c t e d by b e h a v i o u r w i t h i n t h e s y s t e m i s p r o p o s e d : t h e d r i v i n g f o r c e b e h i n d t h e r e l a t i o n s h i p i s a s p i r a l o f i n t e r a c t i o n , i n w h i c h s p e c i f i c k i n d s o f b e h a v i o u r i n i t i a t e d by one member o f t h e dyad a r e responded t o by t h e o t h e r i n a manner w h i c h r e i n f o r c e s t h e o r i g i n a l b e h a v i o u r , t h e r e b y s e t t i n g a p a t t e r n o f i n t e r a c t i o n . To t a k e an extreme example, a mother who o b s e r v e s h e r i n f a n t l o o k i n g a t o b j e c t s b u t who cann o t seem t o get him t o f o c u s upon h e r may c o n c l u d e t h a t he p r e f e r s t o l o o k a t o b j e c t s r a t h e r t h a n a t p e o p l e , and may i n t e r a c t l e s s w i t h him. The i n f a n t ' s o p p o r t u n i t i e s f o r v i s u a l s t i m u l a t i o n a r e th u s r e d u c e d , and he i s l e f t w i t h l i t t l e t o a t t e n d t o e x c e p t o b j e c t s . He t h e n c o n t i n u e s t o l o o k a t o b j e c t s a l l t h e more i n t e n t l y , t h e r e b y r e i n f o r c i n g t h e mother's e r r o n e o u s c o n c l u s i o n t h a t he p r e f e r s them t o h e r . She may t h e n w i t h d r a w even more from him, r e d u c i n g h i s p o t e n t i a l f i e l d a g a i n , and she may a l s o b e g i n t o r e s p o n d l e s s t o o t h e r k i n d s o f i n f a n t s i g n a l s such as c r y i n g . I t i s easy t o see t h a t t h i s k i n d o f downward s p i r a l w h i c h G o l d b e r g (1977) has r e c e n t l y d i s c u s s e d , c o u l d c o n t i n u e u n t i l a s e r i o u s s t a t e o f a f f a i r s between mother and i n f a n t s e t i n . (c) M a t e r n a l R a t i n g s -- I n f a n t Outcome ( T a b l e 15) One o f t h e C h a r t V a r i a b l e s , " I n f a n t outcome" (whether t h e i n f a n t went t o th e r e g u l a r n u r s e r y o r t o t h e i n t e n s i v e c a r e n u r s e r y a f t e r b i r t h ) was s t r o n g l y c o r r e l a t e d w i t h t h e M a t e r n a l R a t i n g s , a l t h o u g h o t h e r c h a r t v a r i a b l e s were n o t found t o be h i g h l y c o r r e l a t e d w i t h t h e M a t e r n a l R a t i n g s . The i n f a n t b e i n g s e n t t o t h e i n t e n s i v e c a r e n u r s e r y a f t e r b i r t h was c o r r e l a t e d w i t h r a t i n g s a t one month o f m a t e r n a l p e r c e p t i o n o f t h e i n f a n t (r=.44, p_<.05), d e l i g h t e x p r e s s e d i n t h e i n f a n t (r==.51, p<.01), a c c e p t a n c e o f t h e i n f a n t (r=.41, p_<.05), a b i l i t y t o g i v e i n f o r m a t i o n about t h e i n f a n t (r=.44, p_<.05), amount o f f o o d o f f e r e d (r=.51, p<.01), a p p r o p r i a t e n e s s o f i n t e r a c t i o n (r=.43, p_<.05), and amount o f p h y s i c a l and v i s u a l c o n t a c t (r=.42, .43, p_<.05). Thus t o t h e e x t e n t t h a t t h e i n f a n t was s e p a r a t e d f r o m h i s o r h e r mother a f t e r b i r t h , mothers were r a t e d as h a v i n g a more p o s i t i v e a t t i t u d e , and as o f f e r i n g more f o o d , c o n t a c t and i n t e r a c t i o n a t one month p o s t p a r t u m . P o s s i b l y t h e c o n c e r n engendered by t h e f a c t t h a t t h e s e i n f a n t s were i n I n t e n s i v e Care caused t h e i r mothers t o become c o n c e r n e d about t h e i r p h y s i c a l c o n d i t i o n and t o be more d e v o t e d t o t h e i r c a r e even a f t e r b e i n g a t home f o r one month. K l a u s and K e n n e l l (1976) have found t h a t a mother's d i s t r e s s w h i c h i s r e l a t e d t o b e i n g s e p a r a t e d f r o m h e r s i c k i n f a n t t e n d s t o e x t e n d t h r o u g h o u t t h e e a r l y months o f t h e i n f a n t ' s l i f e , l o n g a f t e r t h e i n f a n t r e t u r n s t o a h e a l t h y c o n d i t i o n . I n t h e p r e s e n t s t u d y , however, t h e r e were no s i g n i f i c a n t c o r r e l a t i o n s found between l e n g t h o f p e r i n a t a l s e p a r a t i o n and any of t h e M a t e r n a l Care R a t i n g s , c o n t r a r y t o what would be e x p e c t e d on t h e b a s i s o f o t h e r a s p e c t s o f K l a u s and K e n n e l l ' s work, (d) M a t e r n a l R a t i n g s -,- P r e n a t a l Q u e s t i o n n a i r e ( T a b l e 16) M a t e r n a l R a t i n g s made by t h e o b s e r v e r a t one month p o s t p a r t u m were s i g n i f i c a n t l y c o r r e l a t e d w i t h s e v e r a l i t e m s on t h e P r e n a t a l Q u e s t i o n n a i r e (Appendix A ) . ( A g a i n i t s h o u l d be n o t e d t h a t t h e s i g n o f t h e c o r r e l a t i o n s has been r e f l e c t e d i n t h e t e x t and t a b l e s t o a v o i d c o n f u s i o n . ) I t i s i n t e r e s t i n g t h a t t h e b e s t p r e n a t a l p r e d i c t o r o f t h e M a t e r n a l R a t i n g s a t one month p o s t p a r t u m was t h e mo t h e r - t o - b e ' s own p r e d i c t i o n o f m o t h e r - i n f a n t a t t a c h m e n t ( A : 4 9 ) ; t h i s i t e m was c o r r e l a t e d w i t h a l l f o u r s u b - s c a l e s o f r a t e d M a t e r n a l A t t i t u d e ( l o w e s t r=.52, p_<.01; mean r = . 5 4 ) , a l l t h r e e s u b - s c a l e s o f r a t e d A v a i l a b i l i t y ( l o w e s t r=.42, £<.05; mean r = . 4 4 ) , b o t h 94 s u b s c a l e s o f r a t e d C o n t a c t (r=.47, p_<.05 f o r b o t h s u b s c a l e s ) , r a t e d E f f e c t i v e n e s s o f Response t o C r y i n g (r_=.51, p_<.01), and w i t h a l l t h r e e s u b s c a l e s o f r a t e d I n t e r a c t i o n ( l o w e s t r=.34, p_<.10; mean r=.45, p_<.05). P r e n a t a l m a t e r n a l p r e d i c t i o n o f m o t h e r - i n f a n t a t t a c h m e n t was a l s o c o r r e l a t e d w i t h amount and r a t e o f f e e d i n g a t one month (r=.39, and .42, r e s p e c t i v e l y , p_<.05 f o r b o t h ) and w i t h encouragement of s e n s o r i m o t o r a chievement (r=.49, p_<.01) . P r e n a t a l p r e d i c t i o n o f c o n f i d e n c e i n c a r e g i v i n g a b i l i t y (A:39) was a n o t h e r P r e n a t a l Q u e s t i o n n a i r e w h i c h p r e d i c t e d w e l l t o the M a t e r n a l R a t i n g s a t one month p o s t p a r t u m . Responses t o t h i s i t e m were s i g n i f i c a n t l y c o r r e l a t e d w i t h t h r e e o f t h e r a t e d A t t i t u d e s u b s c a l e s (r=.56, p_<.01 f o r m a t e r n a l p e r c e p t i o n o f t h e i n f a n t ; r=.39, p_<.05 f o r d e l i g h t e x p r e s s e d i n t h e i n f a n t ; r=.44, p_<.05 f o r a c c e p t a n c e o f t h e i n f a n t ) , w i t h a l l t h r e e s u b s c a l e s o f r a t e d A v a i l a b i l i t y ( l o w e s t r=.38, p_<.05; mean r = . 4 5 ) , w i t h b o t h s u b s c a l e s o f r a t e d C o n t a c t ( l o w e s t £=.35, p<.05; mean r = . 4 4 ) , w i t h E f f e c t i v e n e s s o f Response t o  C r y i n g (r=.43, p_< .05), and w i t h t h e s u b s c a l e s a u d i t o r y c o n t a c t (r=.46, p_<.05), f r e q u e n c y o f p l a y i n t e r a c t i o n (r=.33, p_<.10), encouragement o f s e n s o r i m o t o r a chievement (r=.39, p_<.01) and r a t e o f f e e d i n g (r=.41, _p_<.05). A t h i r d s i g n i f i c a n t p r e d i c t o r was p r e n a t a l a b i l i t y t o p i c t u r e what i t wou l d be l i k e t o have a new i n f a n t ( A : 5 6 ) . T h i s i t e m was s i g n i f i c a n t l y c o r r e l a t e d w i t h a l l f o u r s u b s c a l e s o f A t t i t u d e ( l o w e s t r=.35, p_<.10; mean r=.38, p_<.05), b o t h s u b s c a l e s o f C o n t a c t (r=.53, .50, p_<.01 f o r b o t h ) , E f f e c t i v e n e s s o f Response t o C r y i n g (r=.48, p_<.05), b o t h s u b s c a l e s o f F a c i l i t a t i o n o f Development (r=.49, .47, p_<.01 f o r b o t h ) and w i t h t h e s u b s c a l e s f o r r a t e d amount o f v i s u a l c o n t a c t (r=.55, p_<.01), f r e q u e n c y o f p l a y i n t e r a c t i o n (r=.33, p_<.01) and amount o f f o o d o f f e r e d (r=.40, p_<.05). A f o u r t h p r e d i c t o r o f the m a t e r n a l r a t i n g s a t one month was a p r e n a t a l l a c k o f c o n c e r n f o r s p o i l i n g t h e i n f a n t ( A : 6 0 ) ; t h i s i t e m was r e l a t e d t o 95 t h r e e o f t h e r a t e d A t t i t u d e s u b s c a l e s (_r=.41, p_<.05 f o r m a t e r n a l p e r c e p t i o n o f i n f a n t ; r=.40, p_<.05 f o r a c c e p t a n c e o f t h e i n f a n t ; r=.48, p_<.05 f o r a b i l i t y t o g i v e i n f o r m a t i o n about t h e i n f a n t ) , two of t h e s u b s c a l e s f o r F e e d i n g (r=.51, p_<.01 f o r s y n c h r o n y o f f e e d i n g i n t e r v e n t i o n ; r_=.49, p_<.01 f o r amount o f f o o d o f f e r e d ) , a l l t h r e e s u b s c a l e s f o r A v a i l a b i l i t y ( l o w e s t r=.39, p_<.05, mean r = . 4 6 ) , and w i t h t h e s u b s c a l e s f o r r a t e d q u a l i t y of p h y s i c a l c o n t a c t (r=.33, p_<.10), f r e q u e n c y o f p l a y i n t e r a c t i o n (r=.40, p_<.05) and encouragement o f s e n s o r i m o t o r a chievement (r=.42, p_<.05). There were o t h e r i t e m s f r o m t h e P r e n a t a l Q u e s t i o n n a i r e w h i c h were s i g n i f i c a n t l y c o r r e l a t e d w i t h t h e M a t e r n a l R a t i n g S c a l e s (see T a b l e 1 6 ) , b u t t h e s e f o u r appear t o show th e most c o n s i s t e n t p a t t e r n s of r e l a t i o n s h i p . I t i s q u i t e i n t e r e s t i n g t h a t t h e s e f o u r i t e m s a r e a l l c o n c e r n e d w i t h p r e d i c t i o n o f t h e f u t u r e r e l a t i o n s h i p w i t h t h e i n f a n t — t h a t i s , h a v i n g a c l e a r p i c t u r e o f t h e i n f a n t , a n t i c i p a t i n g m o t h e r - i n f a n t a t t a c h m e n t , h a v i n g s e l f - c o n f i d e n c e i n t h e a b i l i t y t o c a r e f o r t h e i n f a n t , and b e i n g unconcerned t h a t t h e i n f a n t ! w o u l d become s p o i l e d . The f a c t t h a t t h e s e a r e a l l c o r r e l a t e d w i t h h i g h r a t i n g s on t h e M a t e r n a l R a t i n g s s c a l e s can be seen as more e v i d e n c e t h a t p r e n a t a l a t t i t u d e toward t h e i n f a n t i s r e l a t e d t o p o s t p a r t u m b e h a v i o u r w i t h t h e baby. Thus t h e s e f i n d i n g s s u p p o r t t h e n o t i o n t h a t a mother's a t t a c h m e n t t o h e r baby b e g i n s t o d e v e l o p b e f o r e t h e b i r t h and s h o u l d be s t u d i e d l o n g i t u d i n a l -l y . J . P o s t p a r t u m Q u e s t i o n n a i r e (Appendix Q) ( N o t e s : S p e c i f i c i t e m s on t h e p o s t p a r t u m q u e s t i o n n a i r e w i l l be r e f e r r e d t o w i t h t h e s h o r t h a n d system o f a p p e n d i x l e t t e r and i t e m number. Thus q u e s t i o n 2 on t h e p o s t p a r t u m q u e s t i o n n a i r e w o u l d be r e f e r r e d t o as Q:2. A l l s c a l e s used were f i v e - p o i n t , L i k e r t - t y p e s c a l e s . When r e f e r r i n g t o a s p e c i f i c s c a l e , two o r t h r e e anchor p o i n t s w i l l be g i v e n . When two p o i n t s 96 a r e m e n t i o n e d , t h e f i r s t i s r a t e d 1 and t h e second i s r a t e d 5; when t h r e e p o i n t s a r e m e n t i o n e d , t h e f i r s t i s r a t e d 1, and second i s r a t e d 3 ( m i d p o i n t ) , and t h e t h i r d i s r a t e d 5.) The p o s t p a r t u m q u e s t i o n n a i r e was c o n s t r u c t e d on t h e b a s i s o f s i x a r e a s o f i n t e r e s t w h i c h were assumed t o be r e l a t e d t o p r e n a t a l , p e r i n a t a l and o t h e r p o s t p a r t u m v a r i a b l e s . Some i t e m s from the p r e n a t a l q u e s t i o n n a i r e were r e p e a t e d i n t h e p o s t p a r t u m q u e s t i o n n a i r e i n o r d e r t o a s s e s s changes of a t t i t u d e s and f e e l i n g s from t h e p r e n a t a l t o t h e p o s t p a r t u m p e r i o d . 1. P h y s i c a l c o n d i t i o n was a s s e s s e d by two s e t s o f i t e m s . (a) P h y s i c a l and e m o t i o n a l f e e l i n g s a t one month p o s t p a r t u m ( Q : l ) were a s s e s s e d by h a v i n g s u b j e c t s r a t e t h e i r o v e r a l l f e e l i n g s on s e v e n f i v e - p o i n t s c a l e s h a v i n g t h e f o l l o w i n g p a i r s o f a n c h o r p o i n t s : " v e r y e n e r g e t i c " - " v e r y t i r e d " ; " v e r y r e l a x e d " - " v e r y a n x i o u s " ; " v e r y c o m f o r t a b l e " - " v e r y u n c o m f o r t a b l e " ; " e l a t e d " - " d e p r e s s e d " ; " v e r y h a p p y " - " v e r y unhappy"; " c o n t e n t " - " i m p a t i e n t " ; " c u r i o u s " - " b o r e d " . The m i d p o i n t s f o r a l l s c a l e s were l a b e l l e d "normal f o r me". S u b j e c t s a c t u a l l y used a l l f i v e p o i n t s t o d e s c r i b e t h e m s e l v e s on t h e f i r s t f o u r s c a l e s ; f o r t h e n e x t two, t h e y used the f i r s t f o u r p o i n t s o n l y , and f o r t h e l a s t s c a l e t h e y used o n l y t h e f i r s t t h r e e p o i n t s t o d e s c r i b e t h e m s e l v e s . A t one month p o s t p a r t u m s u b j e c t s r a t e d t h e m s e l v e s as somewhat t i r e d (X=3.3), " n o r m a l l y " r e l a x e d (X=2.9), f a i r l y c o m f o r t a b l e (X=2.4), j u s t somewhat more e l a t e d t h a n n o r m a l (X=2.6), q u i t e happy (X=1.7), q u i t e c o n t e n t (X=1.8) and f a i r l y c u r i o u s (X=2.6). As can be seen i n T a b l e 17, r e p o r t i n g f e e l i n g r e l a x e d was c o r r e l a t e d w i t h r e p o r t i n g f e e l i n g c o m f o r t a b l e and c u r i o u s (r=.37, p_<.10; r=.45, _p<.05); r e p o r t i n g f e e l i n g happy was c o r r e l a t e d w i t h r e p o r t i n g f e e l i n g c o m f o r t a b l e and c u r i o u s (r=.48, .44 r e s p e c t i v e l y , _p<.05); and r e p o r t i n g f e e l i n g c o m f o r t a b l e was r e l a t e d t o r e p o r t i n g c o n t e n t and e l a t e d (r=.48, _p<.05; r=.59, p_<.01). A g a i n , as w i t h t h e p r e n a t a l q u e s t i o n n a i r e , t h e r e was a t e n d e n c y t o s e l f - r e p o r t as "normal f o r me" on most o f t h e s c a l e s . 97 (b) P h y s i c a l problems d u r i n g t h e p o s t p a r t u m p e r i o d were a s s e s s e d u s i n g a c h e c k l i s t (Q:2), and a t o t a l number o f problems f o r each s u b j e c t was d e r i v e d . S u b j e c t s r e p o r t e d h a v i n g z e r o t o s i x p r o b l e m s , w i t h t h e mean g r e a t e r t h a n two (X=2.4). S u b j e c t s ' r e p o r t s o f p h y s i c a l problems were d i s t r i b u t e d as shown i n T a b l e 18. Because t h e i n f a n t ' s h e a l t h i s as much a f a c t o r i n m a t e r n a l p o s t p a r t u m a d j u s t m e n t as i s the mother's own h e a l t h , a n o t h e r c h e c k l i s t i n q u i r e d about t h e i n f a n t ' s p h y s i c a l problems (Q:3). Mothers r e p o r t e d a range o f z e r o t o f o u r i n f a n t p r o b l e m s i n t h e f i r s t month a f t e r b i r t h , w i t h t h e mean g r e a t e r t h a n one (X=1.4). The d i s t r i b u t i o n o f s p e c i f i c i n f a n t p r o b l e m s i s p r o v i d e d i n T a b l e 18. On l y two s u b j e c t s had n e i t h e r seen n o r spoken t o t h e i r p h y s i c i a n c o n c e r n i n g i n f a n t o r m a t e r n a l problems (Q:4). The number of m a t e r n a l problems r e p o r t e d was s i g n i f i c a n t l y c o r r e l a t e d w i t h r e p o r t e d f e e l i n g s o f c u r i o s i t y b u t n o t w i t h o t h e r o v e r a l l f e e l i n g s ( Q : l ) ; women r e p o r t i n g a g r e a t e r number o f p h y s i c a l problems tended t o r e p o r t f e e l i n g more c u r i o u s r a t h e r t h a n more b o r e d (r=.52, p_<.01). A g r e a t e r number o f r e p o r t e d i n f a n t p roblems was s i g n i f i c a n t l y c o r r e l a t e d w i t h m a t e r n a l f e e l i n g s o f h a p p i n e s s (r=-.39, p_<.05) and c u r i o s i t y (r=-.48, p_<.05) b u t n o t w i t h o v e r a l l f e e l i n g s . I t s h o u l d be r e c a l l e d t h a t t h e s c a l e s o f c u r i o s i t y and h a p p i n e s s ( Q : l ) showed t h e l o w e s t range o f r e s p o n s e v a r i a t i o n o f a l l seven s c a l e s a s s e s s i n g p o s t p a r t u m f e e l i n g s ; p e r h a p s t h e c o u n t e r - i n t u i t i v e n a t u r e o f t h e s e c o r r e l a t i o n s ( i . e . , t h a t a g r e a t e r number o f b o t h i n f a n t and m a t e r n a l p roblems i s r e l a t e d t o more p o s i t i v e f e e l i n g s ) may be e x p l a i n e d by the s m a l l v a r i a t i o n o f r e s p o n s e t o t h e s e two s c a l e s . 2. H o s p i t a l e x p e r i e n c e s were a s s e s s e d u s i n g two s e t s o f i t e m s . (a) S u b j e c t s were a s k e d t o r a t e t h e i r l a b o u r and d e l i v e r y (Q:8,9) u s i n g f i v e p o i n t s c a l e s ( " e a s y " - " m e d i u m " - " d i f f i c u l t " ) . S u b j e c t s used a l l f i v e p o i n t s t o d e s c r i b e t h e i r e x p e r i e n c e s , and tended t o r a t e t h e i r l a b o u r as 98 b e i n g more d i f f i c u l t t h a n t h e i r d e l i v e r y (X=3.6 and 2.4, r e s p e c t i v e l y ) . R a t i n g s o f l a b o u r and d e l i v e r y were o n l y m a r g i n a l l y , b u t n e g a t i v e l y , i n t e r c o r r e l a t e d (r=-.38, p_<.10). Of 26 s u b j e c t s r e p o r t i n g on t h e i r l a b o u r , one r a t e d i t as e a s y , f o u r as f a i r l y e a s y , s i x as medium, e i g h t as f a i r l y d i f f i c u l t and seven as d i f f i c u l t . Of 24 r e p o r t i n g on t h e i r d e l i v e r y , n i n e r a t e d i t as e a s y , f i v e as f a i r l y e a s y , f i v e as medium, one as f a i r l y d i f f i c u l t and f o u r as d i f f i c u l t . Three s u b j e c t s who had c a e s a r i a n s e c t i o n s d i d n o t r e p o r t on t h e i r d e l i v e r i e s as t h e y had had g e n e r a l a n e s t h e s i a and f e l t t h e y were u n a b l e t o r a t e t h e i r d e l i v e r y as e i t h e r easy o r d i f f i c u l t . R a t i n g s o f l a b o u r and d e l i v e r y were found t o be l a r g e l y u n c o r r e l a t e d w i t h o t h e r P o s t p a r t u m Q u e s t i o n n a i r e i t e m s ; t h e y were, however, p o s i t i v e l y c o r r e l a t e d w i t h t h e number o f i n f a n t p h y s i c a l problems r e p o r t e d (r=.66, p_<.01 f o r l a b o u r ; r=.47, £<.05 f o r d e l i v e r y ) s u c h t h a t a g r e a t e r number o f i n f a n t p roblems r e p o r t e d was a s s o c i a t e d w i t h r e p o r t of more d i f f i c u l t l a b o u r and d e l i v e r y . These c o r r e l a t i o n s c o u l d be i n t e r p r e t e d t o mean t h a t a more d i f f i c u l t b i r t h e x p e r i e n c e c o n t r i b u t e d t o more p h y s i c a l problems f o r t h e s e newborns, o r t h a t mothers who were e x p e r i e n c i n g d i f f i c u l t i e s a t home due t o t h e i r i n f a n t s ' i l l n e s s r e t r o s p e c t i v e l y r e p o r t e d t h a t t h e i r b i r t h e x p e r i e n c e s were a l s o d i f f i c u l t . (b) S u b j e c t s were a s k e d t o r a t e t h e i r f e e l i n g s about h o s p i t a l e x p e r i e n c e s f o r t h e t i m e t h e y were i n the caseroom (Q:10) and f o r t h e t i m e t h e y s t a y e d on t h e m a t e r n i t y u n i t ( Q : l l ) . S c a l e s were a n c h o r e d as " v e r y h a p p y " - " n e u t r a l " -" v e r y unhappy". S u b j e c t s r e p o r t e d b e i n g q u i t e p o s i t i v e i n t h e i r f e e l i n g s about t h e i r s t a y on t h e m a t e r n i t y u n i t and t h e i r e x p e r i e n c e s i n t h e caseroom (X=2.03 and 1.93 r e s p e c t i v e l y ) . T h i r t e e n s u b j e c t s r e p o r t e d b e i n g v e r y happy i n t h e caseroom, t h r e e i n d i c a t e d t h a t t h e y were f a i r l y happy, e i t h e r were n e u t r a l and t h r e e were f a i r l y unhappy. No-one r e p o r t e d b e i n g v e r y unhappy. Twelve women r e p o r t e d b e i n g v e r y happy on t h e m a t e r n i t y u n i t , e i g h t were 99 f a i r l y happy, f i v e were n e u t r a l , one was f a i r l y unhappy and one was v e r y unhappy. These r a t i n g s were n o t s i g n i f i c a n t l y c o r r e l a t e d w i t h o t h e r P o s t p a r t u m Q u e s t i o n n a i r e i t e m s . A l l b u t one s u b j e c t d e s c r i b e d a t l e a s t one p l e a s i n g e x p e r i e n c e w h i l e on t h e m a t e r n i t y u n i t , and 19 out o f 27 a l s o d e s c r i b e d a t l e a s t one d i s p l e a s i n g e x p e r i e n c e (Q:12, 13). A l l s u b j e c t s had had a p a r t n e r w i t h them d u r i n g l a b o u r (Q:14) and 22 had had a p a r t n e r d u r i n g d e l i v e r y (Q:16); i n each c a s e t h e p a r t n e r was t h e husband. 3. P e r c e i v e d s u p p o r t o f husband was a s s e s s e d u s i n g two s e t s of i t e m s . (a) S u b j e c t s r e p o r t e d on how h a v i n g a p a r t n e r d u r i n g l a b o u r and d e l i v e r y had worked out (Q:15,17) ( " b e t t e r t h a n I e x p e c t e d " - " a l l r i g h t " - " n o t v e r y w e l l a t a l l " ) . The mean r a t i n g s were p o s i t i v e , and were s i m i l a r f o r l a b o u r and d e l i v e r y (X=1.2 and 1.3 r e s p e c t i v e l y ) . T w e n t y - t h r e e s u b j e c t s t h o u g h t h a v i n g a p a r t n e r d u r i n g l a b o u r was b e t t e r t h a n e x p e c t e d , two t hought i t had worked out q u i t e w e l l , and two f e l t i t had been a l l r i g h t . F o r d e l i v e r y , 19 s u b j e c t s i n d i c a t e d t h a t h a v i n g a p a r t n e r had been b e t t e r t h a n e x p e c t e d , and t h r e e r e p o r t e d i t had been a l l r i g h t . R e p o r t o f s a t i s f a c t i o n w i t h p a r t n e r d u r i n g l a b o u r was s i g n i f i c a n t l y c o r r e l a t e d w i t h r e p o r t f o r d e l i v e r y (r=.46, p<.05)..:. (b) S u b j e c t s were asked i f t h e i r husbands were p a r t i c i p a t i n g i n c a r i n g  f o r t h e i n f a n t (Q:19). The f i v e - p o i n t s c a l e was l a b e l l e d "a g r e a t d e a l " -"somewhat"-"not a t a l l " . F o u r t e e n r e p o r t e d t h a t t h e i r husband c a r e d f o r t h e i n f a n t a g r e a t d e a l , s i x r e p o r t e d t h a t t h e husband p a r t i c i p a t e d a f a i r amount ( r a t e d as 2 ) , and s e v e n r e p o r t e d t h a t t h e husband h e l p e d somewhat. No s u b j e c t i n d i c a t e d t h a t h e r husband p a r t i c i p a t e d v e r y l i t t l e o r n o t a t a l l . E i g h t husbands were r e p o r t e d t o be v e r y c o n f i d e n t (Q:20) ("very c o n f i d e n t " - " m i x e d f e e l i n g s " - " v e r y u n s u r e " ) about t h e i r a b i l i t y t o c a r e f o r t h e i n f a n t , e l e v e n as somewhat c o n f i d e n t , seven as h a v i n g mixed f e e l i n g s about c o n f i d e n c e i n c a r e g i v i n g , and one as b e i n g somewhat u n s u r e . No husband was j u d g e d t o be v e r y u n s u r e . M a t e r n a l r e p o r t s o f f e e l i n g happy, c o m f o r t a b l e , c o n t e n t , e l a t e d 100 and c u r i o u s were p o s i t i v e l y r e l a t e d t o t h e e x t e n t t o w h i c h husbands p a r t i c i p a t e d i n i n f a n t c a r e ( r e s p e c t i v e l y , r=.65, p_<.01; r=.44, .42, .43, p_<.05; r=.37, p_<. 10) . 4. The s u b j e c t ' s own c o n f i d e n c e i n c a r e g i v i n g and a c t u a l c a r e g i v i n g  b e h a v i o u r was a s s e s s e d by t h r e e s e t s o f i t e m s . (a) S u b j e c t s r a t e d t h e i r s e l f - c o n f i d e n c e i n t h e i r a b i l i t y t o c a r e f o r > t h e i r i n f a n t (Q:18) on a f i v e - p o i n t s c a l e ("very c o n f i d e n t " - " m i x e d f e e l i n g s " -" v e r y u n s u r e " ) . They d e s c r i b e d t h e m s e l v e s as f e e l i n g q u i t e c o n f i d e n t ; t h e mean r a t i n g was 1.6. F i f t e e n i n d i c a t e d t h a t t h e y were v e r y c o n f i d e n t , e i g h t were somewhat c o n f i d e n t and f o u r had mixed f e e l i n g s . No s u b j e c t r e p o r t e d h e r s e l f as u n s u r e o r v e r y u n s u r e o f h e r c a r e g i v i n g a b i l i t y a t one month p o s t p a r t u m . S e l f - c o n f i d e n c e was p o s i t i v e l y r e l a t e d t o r e p o r t i n g f e e l i n g r e l a x e d (r=.61, p_ .01) and n e g a t i v e l y r e l a t e d t o f e e l i n g c u r i o u s (r=-.61, p_<.01); i t was u n r e l a t e d t o o t h e r r e p o r t e d f e e l i n g s . The r e p o r t e d s e l f - c o n f i d e n c e o f mothers was p o s i t i v e l y c o r r e l a t e d w i t h t h e i r p e r c e p t i o n o f t h e i r husbands' c o n f i d e n c e i n c a r i n g f o r t h e i n f a n t (r=.51, p_<.01). S e l f - c o n f i d e n c e i n c a r e g i v i n g was n o t s i g n i f i c a n t l y c o r r e l a t e d w i t h o t h e r p o s t p a r t u m Q u e s t i o n n a i r e i t e m s . S eventeen mothers had had someone t o a s s i s t them d u r i n g t h e i r f i r s t month a t home (Q:21). Of t h e s e , t e n i n d i c a t e d t h a t t h e h e l p t h e y r e c e i v e d had been v e r y h e l p f u l , f i v e as q u i t e h e l p f u l and two as somewhat h e l p f u l (Q:22). (b) S u b j e c t s were a s k e d about t h e i r method, s c h e d u l e and s u c c e s s i n  f e e d i n g t h e i r i n f a n t s (Q:23-28). A t one month p o s t p a r t u m , n i n e t e e n s u b j e c t s were b r e a s t f e e d i n g , f o u r were f e e d i n g w i t h a b o t t l e and f o u r used b o t h b r e a s t and b o t t l e (Q:23). T h i r t e e n r e p o r t e d t h a t f e e d i n g was p r o g r e s s i n g v e r y s m o o t h l y , e i g h t r e p o r t e d t h a t i t was g o i n g s m o o t h l y , f o u r d e s c r i b e d i t as medium, one r e p o r t e d h a v i n g some problems and one r e p o r t e d h a v i n g a l o t o f problems (Q:27). R e p o r t i n g t h a t f e e d i n g was p r o g r e s s i n g w e l l was p o s i t i v e l y 101 c o r r e l a t e d w i t h e s t i m a t e s of s e l f - c o n f i d e n c e i n c a r i n g f o r t h e i n f a n t (r=.45, _p<.05), m a r g i n a l l y c o r r e l a t e d w i t h f e e l i n g r e l a x e d (r=.36, p<.10), and was found t o be u n r e l a t e d t o o t h e r P o s t p a r t u m Q u e s t i o n n a i r e i t e m s . C o r r e l a t i o n s between f e e d i n g p r o g r e s s and s e l f - c o n f i d e n c e c o n f i r m e d the i m p r e s s i o n s f r o m p o s t p a r t u m i n t e r v i e w s t h a t f e e d i n g problems o r t h e l a c k o f them dominated t h e mother's p e r c e p t i o n o f h e r own a d j u s t m e n t to h e r new i n f a n t . Of the t w e n t y - t h r e e mothers who were n u r s i n g t h e i r b a b i e s a t one month, e i g h t i n t e n d e d t o c o n t i n u e 2-3 more months, t h r e e i n t e n d e d t o c o n t i n u e 4-5 more months, f i v e p l a n n e d t o go on f o r 6-7 more months, f o u r e x p e c t e d t o c o n t i n u e 8-10 more months and t h r e e i n d i c a t e d t h a t t h e y w o u l d see how i t was w o r k i n g out b e f o r e d e c i d i n g (Q:28). (c) M o t h e r - i n f a n t c o m m unication was a s s e s s e d u s i n g f o u r i t e m s . On a f i v e - p o i n t s c a l e ("very w e l l " - " n o t v e r y w e l l a t a l l " ) s u b j e c t s r a t e d how w e l l t h e y f e l t t h e y were a b l e t o t e l l what t h e i r i n f a n t needed o r wanted (Q:34). The mean r a t i n g was 2.2, i n d i c a t i n g t h a t a t one month p o s t p a r t u m , mothers f e l t t h e y c o u l d t e l l f a i r l y w e l l what t h e i r i n f a n t s were s i g n a l l i n g . S i x mothers r e p o r t e d t h a t t h e y c o u l d t e l l v e r y w e l l , t h i r t e e n r e p o r t e d b e i n g a b l e t o t e l l f a i r l y w e l l , s i x f e l t t h e y were a b l e t o t e l l somewhat, one f e l t she had some d i f f i c u l t and one f e l t she had a q u i t e d i f f i c u l t t i m e t e l l i n g what h e r i n f a n t needed o r wanted. M o t h e r s ' e s t i m a t i o n o f t h e i r a b i l i t y t o t e l l what t h e i r i n f a n t s ' s i g n a l s meant was p o s i t i v e l y c o r r e l a t e d "with e s t i m a t i o n o f f e e d i n g p r o g r e s s (r=.66, p_<.01), a g a i n i n d i c a t i n g t h a t t h e d e t a i l s o f t h e r e l a t i o n s h i p between mother and i n f a n t appear t o r e v o l v e around p r o g r e s s o r problems i n f e e d i n g . When mothers were asked what s i g n a l s t h e i r i n f a n t used t o communicate w i t h them (Q:35), 11 m entioned c r y i n g o n l y , 12 m entioned c r y i n g and o t h e r n o n - c r y i n g s i g n a l s ( s u c h as f a c i a l e x p r e s s i o n s ) , and 4 m entioned b o t h c r y i n g and o t h e r s i g n a l s . S u b j e c t s were a s k e d what t h e i r r e s p o n s e s would be i f t h e i r i n f a n t were c r y i n g and t h e y were s u r e t h a t he/she was n o t hungry o r wet; t h e y were a s k e d t o check o f f as many r e s p o n s e s as woul d a p p l y u s i n g a p r e c o d e d c h e c k l i s t (Q:36). T w e n t y - t h r e e mothers r e p o r t e d t h a t t h e y w o u l d p i c k up o r r o c k t h e i n f a n t , and twenty-two w o u l d p a t o r t a l k t o t h e i n f a n t . O nly s i x t e e n s a i d t h e y would p l a y m u s i c , f o u r t e e n w o u l d g i v e t h e i n f a n t a p a c i f i e r , e i g h t would l e t t h e baby c r y i t o u t , s i x w o u l d f e e d t h e baby and t h r e e would g i v e t h e baby a t o y . The number o f d i f f e r e n t r e s p o n s e s t o i n f a n t c r y i n g ranged from one t o t e n ; t h e mean number o f r e s p o n s e s p e r s u b j e c t was g r e a t e r t h a n f i v e . The number o f r e s p o n s e s was c o r r e l a t e d w i t h t h e mother's i n d i c a t i o n o f the way t h e i r i n f a n t s s i g n a l l e d t h e i r needs (r=.42 p_<.05), such t h a t a h i g h e r number o f r e s p o n s e s was a s s o c i a t e d w i t h mother's r e p o r t t h a t t h e i n f a n t tended t o use n o n - c r y i n g s i g n a l s t o communicate w i t h h e r . T h i s appears t o i n d i c a t e t h a t a mother's a b i l i t y t o v a r y h e r r e p e r t o i r e o f r e s p o n s e s t o h e r i n f a n t i s r e l a t e d t o t h e i n f a n t ' s own a b i l i t y t o v a r y h i s o r h e r s i g n a l s o r to t h e mother's a b i l i t y t o p e r c e i v e v a r i o u s t y p e s o f s i g n a l s . A g a i n , t h e d i r e c t i o n o f i n f l u e n c e i s n o t known. When as k e d i f t h e y found i t d i f f i c u l t t o q u i e t t h e baby once he/she was c r y i n g o r f u s s i n g (Q:37) ("very e a s y " - " v e r y d i f f i c u l t " ) , t h e mothers i n d i c a t e d t h a t t h e y found i t f a i r l y d i f f i c u l t : t h e mean s c o r e was 2.6. Four mothers found i t v e r y e a s y , seven found i t e a s y , e l e v e n found i t somewhat d i f f i c u l t , t h r e e found i t q u i t e d i f f i c u l t and one f e l t i t was v e r y d i f f i c u l t t o q u i e t h e r c r y i n g i n f a n t . 5. S u b j e c t s ' own assessment o f p a r e n t - i n f a n t a t t a c h m e n t was measured u s i n g f i v e i t e m s . (a) On f o u r f i v e - p o i n t s c a l e s , mothers were a s k e d t o e s t i m a t e how c l o s e t h e y and t h e i r husbands f e l t t o t h e i r i n f a n t (Q:29,30) ("very c l o s e " - " s t i l l seem l i k e a s t r a n g e r " ) , and how c l o s e t h e y thought t h e i r i n f a n t f e l t t o h i s / h e r p a r e n t s (Q:31, 32) ("very c l o s e " - " n o t a t a l l c l o s e y e t " ) . The mean r e s p o n s e s f o r m o t h e r - i n f a n t and f a t h e r - i n f a n t a t t a c h m e n t were t h e same: X=1.3 f o r b o t h , . . . i n d i c a t i n g t h a t mothers f e l t q u i t e c l o s e t o t h e i r i n f a n t s a t one month p o s t p a r t u m , and j u d g e d t h a t t h e i r husbands f e l t t h e same. F o r i n f a n t - m o t h e r and i n f a n t - f a t h e r a t t a c h m e n t , however, mothers e s t i m a t e d t h a t t h e i r i n f a n t s f e l t somewhat c l o s e r t o t h e m s e l v e s (X=1.8) t h a n t o t h e i r husbands (X=2.1). (b) On a f i v e - p o i n t s c a l e ( " r i g h t a w a y " - " s t i l l don't f e e l t h a t way") s u b j e c t s r a t e d how soon t h e y began t o f e e l t h a t t h e baby was r e a l l y t h e i r s (Q:33). The mean r e s p o n s e (X=1.9) i n d i c a t e d t h a t mothers f e l t t h e i r i n f a n t was r e a l l y t h e i r s q u i t e soon; s i x t e e n mothers f e l t so r i g h t away, two f e l t t h a t way f a i r l y soon, seven f e l t t h a t way a f t e r some t i m e , one f e l t t h a t i t t o o k a l o n g t i m e and one r e p o r t e d t h a t she s t i l l d i d n ' t f e e l h e r baby was r e a l l y h e r s . M o t h e r s ' assessments o f p a r e n t - i n f a n t a t t a c h m e n t (Q:29-33) were s i g n i f i -c a n t l y i n t e r c o r r e l a t e d and c o r r e l a t e d w i t h o t h e r P o s t p a r t u m Q u e s t i o n n a i r e i t e m s (see T a b l e s 19 and 2 0 ) . A mother's assessment o f h e r a t t a c h m e n t t o h e r i n f a n t and h e r i n f a n t ' s a t t a c h m e n t t o h e r s e l f were h i g h l y c o r r e l a t e d (r=.71, p_<.01) and b o t h were r e l a t e d t o t h e mother's f e e l i n g t h a t t h e i n f a n t was h e r s v e r y soon (r=.54, p_<.01 f o r m o t h e r - i n f a n t a t t a c h m e n t ; r_=.53, p_<.01 f o r i n f a n t - m o t h e r a t t a c h m e n t ) ; t h e mother's e s t i m a t e s of f a t h e r - i n f a n t and i n f a n t - f a t h e r a t t a c h m e n t were a l s o p o s i t i v e l y c o r r e l a t e d (r=.43, _p_<.05). M a t e r n a l e s t i m a t i o n o f i n f a n t - f a t h e r a t t a c h m e n t was c o r r e l a t e d w i t h t h e e x t e n t t o w h i c h f a t h e r s were seen t o p a r t i c i p a t e i n i n f a n t c a r e (r=.44, p_<.05). I t i s q u i t e i n t e r e s t i n g t h a t whereas t h e mother's assessment o f h e r own a t t a c h m e n t t o t h e i n f a n t was n o t s i g n i f i c a n t l y c o r r e l a t e d w i t h h e r assessment o f h e r husband's a t t a c h m e n t t o t h e i n f a n t , h e r e s t i m a t e s of t h e i n f a n t ' s a t t a c h m e n t t o h e r s e l f and t o h e r husband were h i g h l y c o r r e l a t e d (r=.57, p_<.01). T h i s p a t t e r n o f c o r r e l a t i o n makes i t appear t h a t whereas mothers do d i f f e r e n t i a t e 104 t h e i r r e l a t i o n s h i p w i t h t h e i r i n f a n t f r o m t h a t o f t h e i r husbands (perhaps b e c a u s e t h e y f e e l t h e amount o f t i m e t h e y spend c a r i n g f o r t h e i n f a n t makes t h e i r r e l a t i o n s h i p t o him o r h e r s p e c i a l ) , t h e y do n o t p e r c e i v e t h e i n f a n t as b e i n g a b l e t o d i f f e r e n t i a t e between h i s o r h e r two p a r e n t s . An i n t e r e s t i n g p a t t e r n emerges from t h e c o r r e l a t i o n s between t h e s e a t t a c h m e n t i t e m s and o t h e r P o s t p a r t u m Q u e s t i o n n a i r e i t e m s . A mother's e s t i m a t e o f t h e e a s e w i t h w h i c h she f e l t a b l e t o r e a d h e r i n f a n t ' s s i g n a l s was h i g h l y r e l a t e d t o m o t h e r - i n f a n t a t t a c h m e n t and p e r c e i v e d i n f a n t - m o t h e r a t t a c h m e n t (r=.70 and .48, r e s p e c t i v e l y , p_<.01 f o r b o t h ) , and t o h e r f e e l i n g t h a t t h e i n f a n t was h e r s r i g h t away (r=.40, p_<.05); s i m i l a r l y , h e r r e p o r t o f b e i n g e a s i l y a b l e t o q u i e t h e r c r y i n g i n f a n t i s c o r r e l a t e d w i t h m o t h e r - i n f a n t (r=.37, j)<.10) and i n f a n t - m o t h e r a t t a c h m e n t (r=.45, p_<.05) and w i t h m a t e r n a l f e e l i n g t h a t t h e baby was h e r s soon (r=.43, p_<.05). However, t h e mother's e s t i m a t e o f f a t h e r - i n f a n t and i n f a n t - f a t h e r a t t a c h m e n t was n o t s i g n i f i c a n t l y r e l a t e d t o t h e s e v a r i a b l e s , b u t r a t h e r t o h e r r e p o r t s o f t h e number o f h e r own p h y s i c a l problems and t h e i n f a n t ' s p h y s i c a l problems (r=-.46, j ^ . 0 5 f o r number o f m a t e r n a l problems and i n f a n t - f a t h e r a t t a c h m e n t ; r_=-.52, p_>.01 f o r f o r t h e number o f i n f a n t problems and b o t h f a t h e r - i n f a n t and i n f a n t - f a t h e r a t t a c h m e n t ) . ( I t s h o u l d be n o t e d t h a t t h e s i g n o f t h e s e c o r r e l a t i o n s i s n e g a t i v e because a l a r g e r number o f p h y s i c a l p r oblems i s r e l a t e d t o an e s t i m a t e o f c l o s e a t t a c h m e n t , w h i c h i s s c o r e d as a low number on a f i v e - p o i n t s c a l e . ) T h i s p a t t e r n o f c o r r e l a t i o n may be i n d i c a t i v e o f one way i n w h i c h a new mother i s a b l e t o d e a l w i t h t h e f a c t t h a t c a r i n g f o r a new i n f a n t , d e s p i t e t h e many r e w a r d s , d e f i n i t e l y has u n p l e a s a n t a s p e c t s , i n terms o f b o t h h e r own p h y s i c a l c o n d i t i o n and i n f a n t problems w h i c h may c o n t r i b u t e an e x t r a b u r d e n t o h i s o r h e r c a r e . I t c o u l d be h y p o t h e s i z e d t h a t t h e mother does no t a l l o w h e r n e g a t i v e f e e l i n g s r e g a r d i n g t h e s e problems t o i n t e r f e r e w i t h h e r own r e l a t i o n s h i p t o t h e i n f a n t , b u t may p r o j e c t them o n t o h e r 105 p e r c e p t i o n o f t h e f a t h e r - i n f a n t r e l a t i o n s h i p . 6. The p e r c e i v e d r o l e o f t h e i n f a n t i n t h e mother's l i f e was a s s e s s e d u s i n g f o u r s e t s o f i t e m s . (a) A l l mothers i n d i c a t e d t h a t t h e i r i n f a n t l i k e d them t o spend t i m e w i t h  him o r h e r b e s i d e s t h e t i m e spent f e e d i n g , c h a n g i n g and b a t h i n g (Q:38); twenty-one r e p o r t e d t h e y s p e n t t i m e i n n o n - c a r e g i v i n g i n t e r a c t i o n more t h a n once a day, t h r e e r e p o r t e d i n t e r a c t i n g i n t h i s way once a day, and two d i d so l e s s t h a n once a day. (b) S u b j e c t s were asked t o e s t i m a t e t h e e x t e n t t o w h i c h h a v i n g a baby  r e s t r i c t e d t h e i r work, s c h o o l and s o c i a l l i v e s (Q:45). They r a t e d t h i s r e s t r i c t i o n on f i v e - p o i n t s c a l e s ("a g r e a t d e a l " - " n o t a t a l l " ) ; t h e mean r e s p o n s e r e g a r d i n g w o r k / s c h o o l (X=2.8) i n d i c a t e d t h a t h a v i n g an i n f a n t was f e l t t o be somewhat o f a r e s t r i c t i o n i n t h i s a r e a o f t h e m o t h e r s ' l i v e s . F i v e of t h e s i x t e e n mothers t o whom t h i s i t e m a p p l i e d i n d i c a t e d t h a t t h e i n f a n t c aused a g r e a t d e a l o f r e s t r i c t i o n , f o u r f e l t t h e y were f a i r l y r e s t r i c t e d , one f e l t she was somewhat r e s t r i c t e d , one f e l t she was n o t v e r y r e s t r i c t e d and f i v e f e l t no r e s t r i c t i o n s on t h e i r work o r s c h o o l l i f e as a f u n c t i o n o f h a v i n g a baby. The mothers a p p a r e n t l y f e l t l e s s r e s t r i c t e d w i t h r e g a r d t o t h e i r s o c i a l l i v e s . The mean r e s p o n s e t o t h i s i t e m was 3.2, w i t h a l l s u b j e c t s r e s p o n d i n g . F o u r mothers f e l t a g r e a t d e a l o f r e s t r i c t i o n , f o u r f e l t t h e y were f a i r l y r e s t r i c t e d , f i v e f e l t somewhat r e s t r i c t e d , e l e v e n f e l t l i t t l e r e s t r i c t i o n and t h r e e f e l t t h a t h a v i n g t h e baby had p l a c e d no r e s t r i c t i o n s a t a l l on t h e i r s o c i a l l i v e s . (c) S u b j e c t s were asked t o a s s e s s t h e e x t e n t t o w h i c h h a v i n g a baby had  a l t e r e d t h e i r m a r i t a l r e l a t i o n s h i p (Q:46,47). U s i n g a f i v e - p o i n t s c a l e ("a g r e a t d e a l " - " n o t a t a l l " ) t h e s u b j e c t s ' mean r e s p o n s e (X=3.7) showed t h a t a t one month p o s t p a r t u m , t h e s e new mothers f e l t t h e i r r e l a t i o n s h i p w i t h t h e i r husbands had been a l t e r e d q u i t e a b i t . However, o n l y two f e l t i t had been 106 a l t e r e d a g r e a t d e a l w h i l e f o u r f e l t i t had been a l t e r e d a f a i r amount and f i v e f e l t i t had been a l t e r e d somewhat; s i x f e l t i t had been a l t e r e d o n l y a l i t t l e and t e n f e l t t h a t t h e i r m a r i t a l r e l a t i o n s h i p had n o t been changed a t a l l . The mother's e s t i m a t e o f change i n t h e m a r i t a l r e l a t i o n s h i p was c o r r e l a t e d w i t h h e r s e l f - c o n f i d e n c e i n c a r e g i v i n g (r=.40, JD<.05) and h e r a b i l i t y t o u n d e r s t a n d h e r i n f a n t ' s s i g n a l s (r=.38, p_<.05), s u c h t h a t g r e a t e r change i n t h e h u s b a n d - w i f e r e l a t i o n s h i p was r e l a t e d t o g r e a t e r s e l f - c o n f i d e n c e and g r e a t e r a b i l i t y t o u n d e r s t a n d t h e i n f a n t ' s s i g n a l s . T h i s i s n o t s u r p r i s i n g , e s p e c i a l l y s i n c e t h e change s p e c i f i e d most o f t e n was h a v i n g l e s s t i m e t o g e t h e r (Q:47). Thus t h e t i m e t h e mother needs t o l e a r n how t o c a r e f o r h e r i n f a n t t a k e s t i m e away f r o m t h e m a r i t a l r e l a t i o n s h i p , w h i c h i n t u r n c a u s e s changes i n t h a t r e l a t i o n s h i p . Some r e c e n t work by P e d e r s e n and h i s c o l l e a g u e s ( P e d e r s e n , Anderson & C a i n , 1977) has g i v e n a t t e n t i o n t o t h e l i n k a g e s between the p a r e n t - i n f a n t and spouse r e l a t i o n s h i p s , and i n d i c a t e s t h a t t h e q u a l i t y o f t h e r e l a t i o n s h i p between husband and w i f e can a f f e c t m o t h e r - i n f a n t and f a t h e r - i n f a n t r e l a t i o n s h i p s b o t h n e g a t i v e l y and p o s i t i v e l y . The p r e s e n t r e s e a r c h , a l t h o u g h n o t s p e c i f i c a l l y d e s i g n e d t o s t u d y t h e r e l a t i o n s h i p o f t h e p a r e n t s , does appear t o l e n d some s u p p o r t t o t h e n o t i o n t h a t t h e t h r e e d y a d i c r e l a t i o n s h i p s among mother, f a t h e r and i n f a n t have a g r e a t d e a l o f i m p a ct upon each o t h e r . (d) When asked how o f t e n t h e y had been ou t o f t h e house w i t h o u t t h e i r  baby i n t h e f i r s t month (Q:48), t w e l v e mothers i n d i c a t e d t h e y had n o t y e t gone o u t a l o n e . O n l y one r e p o r t e d t h a t she had gone ou t s e v e r a l t i m e s p e r week, w h i l e two s a i d t h e y had been ou t once a week d u r i n g the month; f o u r had been out a l o n e two o r t h r e e t i m e s and e i g h t had been out o n l y once d u r i n g the f i r s t p o s t p a r t u m month. U s i n g a p r e c o d e d c h e c k l i s t , f o u r t e e n o f t h e mothers who had gone out w i t h o u t t h e i r i n f a n t s i n d i c a t e d how t h e y f e l t about d o i n g t h i s (Q:49). E l e v e n i n d i c a t e d t h a t i t f e l t good t o be o u t , b u t o n l y one f e l t 107 she w i s h e d she c o u l d go out more o f t e n t h a n she had. Four mothers i n d i c a t e d t h a t t h e y m i s s e d t h e i r b a b i e s , t h r e e w o r r i e d about them and one wondered i f she was d o i n g t h e r i g h t t h i n g by l e a v i n g h e r baby. However, t h i r t e e n out o f t h e f o u r t e e n were c o n f i d e n t t h a t t h e i r baby was b e i n g w e l l c a r e d f o r i n t h e i r absence by e i t h e r t h e i r husbands, r e l a t i v e s o r f r i e n d s . K. P o s t p a r t u m Q u e s t i o n n a i r e — c o r r e l a t i o n s w i t h o t h e r measures. L e t us now t u r n t o t h e r e l a t i o n s h i p s f ound between t h e P o s t p a r t u m Q u e s t i o n n a i r e and o t h e r measures, i n o r d e r t o a s s e s s t h e e x t e n t t o w h i c h p o s t p a r t u m a t t i t u d e s can be p r e d i c t e d from p r e n a t a l a t t i t u d e s , p e r i n a t a l e v e n t s and p o s t p a r t u m b e h a v i o u r . •1. P o s t p a r t u m Q u e s t i o n n a i r e — P r e n a t a l Q u e s t i o n n a i r e (a) P h y s i c a l and e m o t i o n a l f e e l i n g s . Of t h e seven s c a l e s a s s e s s i n g b o t h p r e n a t a l and p o s t p a r t u m f e e l i n g s , o n l y one, " e l a t e d " - " d e p r e s s e d " , was s i g n i f i c a n t l y c o r r e l a t e d a c r o s s t i m e (r=.40, p_<.05). T h i s would appear t o i n d i c a t e t h a t e m o t i o n a l f e e l i n g s c o n n e c t e d w i t h pregnancy and w i t h t h e e a r l y p o s t p a r t u m p e r i o d a r e more s i t u a t i o n - s p e c i f i c t h a n t h e y a r e s t a b l e . The number o f p h y s i c a l problems r e p o r t e d on t h e P r e n a t a l Q u e s t i o n n a i r e was c o r r e l a t e d w i t h t h e number o f m a t e r n a l p h y s i c a l problems r e p o r t e d on t h e P o s t p a r t u m Q u e s t i o n n a i r e (r=.42, p_<.05), i n d i c a t i n g p erhaps t h a t p h y s i c a l d i f f i c u l t i e s d u r i n g pregnancy may e x t e n d t h r o u g h t h e e a r l y p o s t n a t a l p e r i o d , o r t h a t g e n e r a l p o o r h e a l t h may a c c o u n t f o r p h y s i c a l p roblems i n b o t h p e r i o d s . (b) Support o f husband. P o s t p a r t u m r e p o r t of how h a v i n g t h e husband as a p a r t n e r d u r i n g l a b o u r and d e l i v e r y had worked out was u n r e l a t e d t o p r e n a t a l i t e m s w h i c h a s s e s s e d husband's s u p p o r t , as was p o s t p a r t u m r e p o r t o f how much t h e husband p a r t i c i p a t e d i n i n f a n t c a r e . However, how c o n f i d e n t t h e husband was j u d g e d t o be i n c a r i n g f o r t h e i n f a n t was p o s i t i v e l y r e l a t e d t o p r e n a t a l m a t e r n a l p r e d i c t i o n o f m o t h e r - i n f a n t a t t a c h m e n t (r=.43, p_<.05), and n e g a t i v e l y 108 c o r r e l a t e d w i t h mother's c l e a r p r e n a t a l p i c t u r e o f what i t w o u l d be l i k e t o have an i n f a n t (r=.51, _p_<.01). (c) H o s p i t a l e x p e r i e n c e s . P o s t p a r t u m r e p o r t o f how easy o r d i f f i c u l t l a b o u r and d e l i v e r y had been, and how s a t i s f i e d mothers had been w i t h t h e i r e x p e r i e n c e s i n the caseroom and on t h e m a t e r n i t y u n i t were u n r e l a t e d t o p r e n a t a l r e p o r t o f how much was l e a r n e d i n , o r s a t i s f a c t i o n w i t h p r e n a t a l c l a s s e s , o r w i t h p r e n a t a l e x p e c t a t i o n s o f l a b o u r and d e l i v e r y . P o s t p a r t u m r e p o r t of s a t i s f a c t i o n w i t h e x p e r i e n c e s i n t h e caseroom was s i g n i f i c a n t l y c o r r e l a t e d w i t h p r e n a t a l r e p o r t o f a p l a n n e d pregnancy (r=.58, p_<.01), and p r e n a t a l r e p o r t o f i n i t i a l m a t e r n a l f e e l i n g s toward p r e g n a n c y (r=.43, £<.05); r e p o r t o f s a t i s f a c t i o n w i t h e x p e r i e n c e s on t h e m a t e r n i t y f l o o r was s i g n i f i c a n t l y c o r r e l a t e d w i t h p r e n a t a l r e p o r t o f a p l a n n e d p r e g n a n c y (r=.49, JD<.01). Thus a l t h o u g h h o s p i t a l e x p e r i e n c e s as r e p o r t e d p o s t n a t a l l y were u n r e l a t e d t o p r e n a t a l e x p e c t a t i o n s of them, th e y were r e l a t e d t o p r e n a t a l a c c e p t a n c e o f t h e p r egnancy. The a c c e p t a n c e o f pregnancy i s u n d o u b t e d l y r e l a t e d t o an o v e r a l l a c c e p t a n c e o f t h e i d e a o f h a v i n g a baby, w h i c h would be an i m p o r t a n t m e d i a t i n g v a r i a b l e f o r f e e l i n g s d u r i n g t h e h o s p i t a l e x p e r i e n c e s l e a d i n g up t o and f o l l o w i n g t h e b i r t h o f t h e baby. (d) C o n f i d e n c e i n c a r e g i v i n g . P o s t p a r t u m e s t i m a t e s o f s e l f - c o n f i d e n c e i n c a r i n g f o r t h e i n f a n t and r e p o r t o f how f e e d i n g was p r o g r e s s i n g were u n r e l a t e d t o i t e m s on the P r e n a t a l Q u e s t i o n n a i r e . How l o n g t h e mother p l a n n e d t o n u r s e h e r i n f a n t ( r e p o r t e d p o s t n a t a l l y ) was s i g n i f i c a n t l y c o r r e l a t e d w i t h p r e n a t a l r e p o r t of how much had.been l e a r n e d i n , and s a t i s f a c t i o n w i t h , p r e n a t a l c l a s s e s (r=.62, JK.01; r=.52, p_<.05, r e s p e c t i v e l y ) , and was a l s o r e l a t e d t o t h e mother's f e e l i n g s toward pregnancy i n t h e t h i r d t r i m e s t e r (r=.43, p_<.05) and t o h e r p r e n a t a l e x p e c t a t i o n s o f l a b o u r and d e l i v e r y (r=.44, p_<.05). Thus, t h e l o n g e r a mother was p l a n n i n g t o n u r s e h e r i n f a n t , t h e more p o s i t i v e h e r p r e n a t a l f e e l i n g s had been. I t m ight be h y p o t h e s i z e d f r o m t h e s e f i n d i n g s 109 t h a t i n t e n t i o n t o c o n t i n u e n u r s i n g i s d e t e r m i n e d as much p r e n a t a l l y (by becoming e n t h u s i a s t i c about i t i n p r e n a t a l c l a s s e s , and by b e i n g g e n e r a l l y p o s i t i v e i n f e e l i n g s toward t h e pregnancy and t h e r e f o r e toward t h e i d e a o f h a v i n g a b a b y ) , as i t i s by t h e a c t u a l d a y - t o - d a y e x p e r i e n c e s o f b r e a s t f e e d i n g d u r i n g t h e e a r l y p o s t p a r t u m p e r i o d . The mother's p o s t p a r t u m r e p o r t o f h e r a b i l i t y t o u n d e r s t a n d h e r i n f a n t ' s s i g n a l s was s i g n i f i c a n t l y r e l a t e d t o h e r p r e d i c t i o n p r e n a t a l l y o f h e r a b i l i t y t o do so (r=.39, p_<.05), w h i c h l e n d s some s u p p o r t t o t h e i d e a t h a t p r e n a t a l e x p e c t a t i o n s w i t h r e g a r d t o c h i l d c a r e may be r e l a t e d t o a c t u a l p o s t p a r t u m b e h a v i o u r . The mother's p o s t p a r t u m r e p o r t o f how much d i f f i c u l t y she e x p e r i e n c e d i n q u i e t i n g h e r c r y i n g i n f a n t , however, was found t o be u n r e l a t e d t o any of t h e p r e n a t a l i t e m s . T h i s i s perhaps l e s s s u r p r i s i n g i f one r e c a l l s t h a t p r e n a t a l l y , mothers tended t o have a r a t h e r p o s i t i v e (perhaps u n r e a l i s t i c ) p i c t u r e o f what t h e i r i n f a n t w o u l d be l i k e . (e) R o l e o f the i n f a n t . P o s t p a r t u m i t e m s a s s e s s i n g t h e r o l e o f t h e i n f a n t i n t h e mother's l i f e — t h e r e s t r i c t i o n s on h e r w o r k / s c h o o l and s o c i a l l i f e , changes i n h e r r e l a t i o n s h i p w i t h h e r husband, and how much she had gone out w i t h o u t t h e baby — were found t o be u n r e l a t e d t o i t e m s p r e d i c t i n g t h e s e s o r t s o f changes on t h e P r e n a t a l Q u e s t i o n n a i r e . I t would t h e r e f o r e appear t h a t t h e k i n d s o f changes t h e mother would have t o make i n h e r l i f e t o accommodate t o h e r i n f a n t a r e q u i t e u n a n t i c i p a t e d d u r i n g t h e p r e n a t a l p e r i o d . ( f ) P a r e n t - i n f a n t a t t a c h m e n t . P r e n a t a l p r e d i c t i o n o f m o t h e r - i n f a n t a t t a c h m e n t was s i g n i f i c a n t l y c o r r e l a t e d w i t h p o s t p a r t u m e s t i m a t e s o f m o t h e r - i n f a n t a t t a c h m e n t (r=.62, p_.<01), i n f a n t - m o t h e r a t t a c h m e n t (£=.42, p_<.05), and i n f a n t - f a t h e r a t t a c h m e n t (r=.42, p_<.05). I n a d d i t i o n , p r e n a t a l p r e d i c t i o n o f i n f a n t - m o t h e r a t t a c h m e n t was s i g n i f i c a n t l y c o r r e l a t e d w i t h p o s t p a r t u m r e p o r t o f p e r c e i v e d i n f a n t - m o t h e r a t t a c h m e n t (r=.42, p_<.05). P o s t p a r t u m r e p o r t o f t h e mother's f e e l i n g t h a t h e r i n f a n t was r e a l l y h e r s soon 110 a f t e r b i r t h was s i g n i f i c a n t l y c o r r e l a t e d w i t h mother's p r e n a t a l f e e l i n g s toward pregnancy a f t e r she got used t o t h e i d e a t h a t she was p r e g n a n t (r=.39, • p_<.05) and d u r i n g t h e t h i r d t r i m e s t e r o f pregnancy (r=.39, p_<.05). Thus i t would appear t h a t a l t h o u g h t h e mo t h e r - t o - b e was u n a b l e t o p r e d i c t many t h i n g s about t h e p o s t p a r t u m p e r i o d , i n c l u d i n g how r e s t r i c t e d she woul d be by h a v i n g a new i n f a n t , she was w e l l a b l e t o p r e d i c t h e r own and h e r i n f a n t ' s a t t a c h m e n t ( m a t e r n a l p r e d i c t i o n o f f a t h e r ' s a t t a c h m e n t was n o t i n c l u d e d i n t h e P r e n a t a l Q u e s t i o n n a i r e ) . Thus, perhaps the most i m p o r t a n t k i n d s o f p r e d i c t i o n , t h a t i s , how c l o s e mother arid i n f a n t w o u l d be t o one a n o t h e r , were s u c c e s s f u l l y made by t h e s e women about t o have t h e i r f i r s t c h i l d . 2. P o s t p a r t u m Q u e s t i o n n a i r e — C h a r t V a r i a b l e s and D i a r y Items on t h e P o s t p a r t u m Q u e s t i o n n a i r e were n o t s y s t e m a t i c a l l y r e l a t e d t o C h a r t o r D i a r y v a r i a b l e s , a l t h o u g h a few i n t e r e s t i n g p a t t e r n s d i d emerge. P o s t p a r t u m p l a n t o c o n t i n u e b r e a s t f e e d i n g was found t o be c o r r e l a t e d w i t h d u r a t i o n o f l a b o u r , t y p e o f d e l i v e r y , and i n f a n t outcome (r=.60, .63, p_.<01 f o r b o t h ; r=.52, p_<.05, r e s p e c t i v e l y ) s u c h t h a t p l a n n i n g t o b r e a s t f e e d f o r a l o n g e r p e r i o d was r e l a t e d t o a l o n g e r l a b o u r , a more d i f f i c u l t d e l i v e r y ( i . e . c a e s a r i a n s e c t i o n ) , and t h e i n i t i a l a d m i s s i o n o f t h e i n f a n t t o t h e I n t e n s i v e Care N u r s e r y . A p o s s i b l e e x p l a n a t i o n f o r t h i s may be t h a t t h e l o n g e r l a b o u r , d i f f i c u l t d e l i v e r y , and t h e i n i t i a l s e p a r a t i o n o f mother and i n f a n t may have engendered igr.eater c o n c e r n c o n ^ h e p a r t ^ d f • th e mother f o r -the i n f a n t ' s h e a l t h and w e l l - b e i n g , w h i c h would i n t u r n p r e d i s p o s e h e r t o n u r s e h e r baby f o r a l o n g e r p e r i o d o f t i m e , as i f t o h e l p make up f o r any d i f f i c u l t i e s c a used by t h e b i r t h e x p e r i e n c e . The second c o r r e l a t i o n o f p a r t i c u l a r i n t e r e s t i s t h a t between m a t e r n a l p o s t p a r t u m e s t i m a t e o f m o t h e r - i n f a n t a t t a c h m e n t and the p r o p o r t i o n o f t i m e s p e n t w i t h t h e i n f a n t i n the f i r s t t w e l v e h ours a f t e r b i r t h (r=.66, p_<.05) such t h a t a r e p o r t o f g r e a t e r a t t a c h m e n t between mother and i n f a n t was r e l a t e d I l l t o f ewer h o u r s s p e n t t o g e t h e r i n t h e f i r s t t w e l v e h o u r s a f t e r t h e b i r t h . These two c o r r e l a t i o n s a r e s u p p o r t e d by a t h i r d c o r r e l a t i o n between number o f h o u r s s p e n t t o g e t h e r i n t h e f i r s t t w e l v e h o u r s a f t e r t h e b i r t h . These two c o r r e l a - . t i o n s a r e s u p p o r t e d by a t h i r d c o r r e l a t i o n between number o f h o u r s s p e n t t o g e t h e r and the mother's p o s t p a r t u m r e p o r t of when she f e l t t h e baby was r e a l l y h e r s (£=.69, p_<.01). A g a i n , a s m a l l e r p r o p o r t i o n o f t i m e s p e n t t o g e t h e r was r e l a t e d t o t h e mother's f e e l i n g t h a t t h e baby was r e a l l y h e r s q u i t e soon. These r e s u l t s appear t o be c o n t r a r y t o what would be e x p e c t e d i f the c o n c l u s i o n s drawn c o n c e r n i n g t h e work o f K l a u s and K e n n e l l (1976) a r e c o r r e c t . That i s , i t has been a s s e r t e d on t h e b a s i s of t h e r e s e a r c h o f K l a u s and K e n n e l l and t h e i r c o l l e a g u e s ( e . g . , K e n n e l l , J e r a u l d , W o l f e , C h e s t e r , K r e g e r , M c A l p i n e , S t e f f a & K l a u s , 1977) t h a t t h e c o u r s e o f m o t h e r - i n f a n t b o n d i n g i s f a c i l i t a t e d by a l l o w i n g t h e mother and i n f a n t t o be t o g e t h e r a f t e r t h e b i r t h and d u r i n g t h e f i r s t t w e l v e h o u r s o f t h e i n f a n t ' s l i f e . These c o n c l u s i o n s have been q u e s t i o n n e d e a r l i e r i n t h i s paper on t h e b a s i s o f s a m p l i n g b i a s and m e t h o d o l o g i c a l p r o b l e m s , and r e c e n t l y , K l a u s (1978) has i n d i c a t e d t h a t the p o p u l a r l y - s u p p o r t e d c o n c l u s i o n t h a t t h e f i r s t few h o u r s a f t e r b i r t h were a l l - i m p o r t a n t t o t h e f u t u r e r e l a t i o n s h i p o f mother and baby i s c o u n t e r -i n t u i t i v e and cannot be s u p p o r t e d by t h o u g h t f u l c o n s i d e r a t i o n o f t h e r e s e a r c h upon w h i c h i t i s based. I n t h e p r e s e n t r e s e a r c h , i t e m s c o n c e r n i n g t h e amount of t i m e mother and i n f a n t s p e n t t o g e t h e r a f t e r b i r t h were i n c l u d e d i n t h e D i a r y s p e c i f i c a l l y i n o r d e r t o g a t h e r i n f o r m a t i o n c o n c e r n i n g t h i s i s s u e . J u s t as i t would be unwise t o c o n c l u d e t h a t t h e f i r s t t w e l v e h o u r s a f t e r b i r t h a r e o f paramount i m p o r t a n c e t o t h e m o t h e r - i n f a n t r e l a t i o n s h i p had t h e s i g n s o f t h e c o r r e l a t i o n s been n e g a t i v e , i t would be e q u a l l y unwise t o c o n c l u d e on t h e b a s i s o f t h e s i g n s o f the c o r r e l a t i o n s w h i c h were f o u n d t h a t t h e f i r s t t w e l v e h o u r s o f t h e i n f a n t ' s l i f e a r e of no i m p o r t a n c e t o t h e m o t h e r - i n f a n t 112 r e l a t i o n s h i p . Without doubt, the s i t u a t i o n i s a great deal more complicated, and various in t e r a c t i o n s may be at work which would enhance or v i t i a t e the importance of the f i r s t few postpartum hours for any i n d i v i d u a l mother-infant p a i r . 3. Postpartum Questionnaire — Maternal Composites The Postpartum Questionnaire does not appear to be systematically correlated with the observed Maternal Composites, which are derived from observed maternal behaviour at one month postpartum. Physical and emotional f e e l i n g s , reports of experiences i n h o s p i t a l , husband's support, caregiving practices and variables r e l a t e d to the r o l e of the infant i n the mother's l i f e were a l l found to be unrelated to the Maternal Composites. One set of Postpartum Questionnaire items, those concerning maternal perception of parent-infant attachment, does appear to be re l a t e d to some of the Maternal Composites. Although reported mother-infant attachment was found to be correlated with the Maternal Composites Physical Contact (r=-.48, p_>.01), T a c t i l e Engagement (r=-.39, p_<.05), and o v e r a l l S o c i a l Engagement (r=-.39, p_<.05), such that report of closer attachment was re l a t e d to a greater amount of observed maternal s o c i a l and t a c t i l e behaviour, and to l e s s observed phys i c a l contact. Maternal estimation of fa t h e r - i n f a n t attachment was found to be correlated with observed maternal V i s u a l Engagement (r=-.38, p_<.05) and observed Caregiving (r=.43, p_.<05) such that mother's report of closer attachment of father to infant was r e l a t e d to more observed maternal v i s u a l behaviour toward the infant and to le s s observed maternal caregiving behaviour. Although these c o r r e l a t i o n s are somewhat sparse, parent-infant attachment as reported by the mother does appear to have some basis i n f a c t ; that i s , i t does appear to be re l a t e d to actual observed maternal behaviour. Response to the postpartum question concerning the mother's a b i l i t y to quiet her crying infant was found to be correlated with observed Physical Contact and T a c t i l e 113 Engagement (r=-.61, -.58 r e s p e c t i v e l y , p_<.01 f o r b o t h ) such t h a t m a t e r n a l r e p o r t o f ease i n q u i e t i n g t h e i n f a n t was r e l a t e d t o more o b s e r v e d p h y s i c a l c o n t a c t and t a c t i l e b e h a v i o u r . 4. P o s t p a r t u m Q u e s t i o n n a i r e — M a t e r n a l R a t i n g s ( T a b l e 21) As was found w i t h t h e M a t e r n a l C o m p o s i t e s , t h e r e a r e o n l y a few groups o f P o s t p a r t u m Q u e s t i o n n a i r e i t e m s w h i c h were s y s t e m a t i c a l l y r e l a t e d t o t h e m a t e r n a l R a t i n g S c a l e s . (Note: G e n e r a l l y , more p o s i t i v e r e s p o n s e s on t h e P o s t p a r t u m Q u e s t i o n n a i r e have been g i v e n l o w e r s c o r e s ( e . g . , one out o f f i v e ) , w h i l e t h e more p o s i t i v e M a t e r n a l R a t i n g s c o r e s a r e h i g h ( e . g . , n i n e out of . n i n e ) . Thus, n e g a t i v e c o r r e l a t i o n s w o u l d i n d i c a t e t h a t more p o s i t i v e r e s p o n s e s t o t h e q u e s t i o n n a i r e i t e m s a r e r e l a t e d t o more p o s i t i v e s c o r e s on t h e M a t e r n a l R a t i n g s c a l e s . C o n s i s t e n t w i t h e a r l i e r p r a c t i c e , t h e s i g n s o f t h e c o r r e l a t i o n s i n T a b l e 21 and i n t h e t e x t have been r e f l e c t e d t o a v o i d c o n f u s i o n . ) P o s t p a r t u m m a t e r n a l p e r c e p t i o n s o f m o t h e r - i n f a n t and i n f a n t - m o t h e r a t t a c h m e n t were found t o be c o r r e l a t e d w i t h s e v e r a l o f t h e M a t e r n a l R a t i n g s c a l e s : P e r c e p t i o n o f t h e i n f a n t (r=.61, .44, p_<.05 f o r b o t h ) , amount o f p h y s i c a l c o n t a c t (r=.40, .43, p_<.05 f o r b o t h ) , e f f e c t i v e n e s s o f r e s p o n s e t o i n f a n t c r y i n g (r=.48, .57, p_<.0i f o r b o t h ) , amount o f v i s u a l c o n t a c t (r=.55, .50, p_<.01) and t h e t o t a l M a t e r n a l R a t i n g s c o r e (r=.49, _p_<.01; r=.37, p_<.05). P e r c e p t i o n o f m o t h e r - i n f a n t a t t a c h m e n t was found t o be c o r r e l a t e d w i t h amount o f a u d i t o r y c o n t a c t (r=.40, j><.05) and encouragement o f s e n s o r i m o t o r d e v e l o p -ment (r=.46, p_<.05). I n a d d i t i o n , m a t e r n a l p e r c e p t i o n o f i n f a n t - m o t h e r and i n f a n t - f a t h e r a t t a c h m e n t was c o r r e l a t e d w i t h r a t e d a v a i l a b i l i t y o f t h e mother t o t h e i n f a n t (r_=.42, .46, r e s p e c t i v e l y , _p_<.05 f o r b o t h ) . A g a i n i t w o u l d appear t h a t m a t e r n a l s e l f - r e p o r t o f p a r e n t - i n f a n t a t t a c h m e n t i s a t l e a s t somewhat r e l a t e d t o an o b s e r v e r ' s p e r c e p t i o n o f t h a t a t t a c h m e n t . A mother's r e p o r t e d a b i l i t y to u n d e r s t a n d h e r i n f a n t ' s s i g n a l s was found 114 t o be c o r r e l a t e d w i t h m a t e r n a l p e r c e p t i o n of t h e i n f a n t (r=.56, p_<.01), amount o f v i s u a l c o n t a c t (r=.42, p_<.05). S i m i l a r l y , m a t e r n a l r e p o r t t h a t t h e i n f a n t u sed n o n - c r y i n g r a t h e r t h a n o n l y c r y i n g s i g n a l s t o communicate w i t h h e r was found t o be c o r r e l a t e d w i t h M a t e r n a l R a t i n g s f o r a b i l i t y t o g i v e i n f o r m a t i o n about the i n f a n t (r=.38, p_<.05), m a t e r n a l a v a i l a b i l i t y t o t h e i n f a n t (r=.44, p_<.05) and encouragement o f s e n s o r i m o t o r development (r=.40, p_<.05). (Note: t h e s e c o r r e l a t i o n s appear i n T a b l e 21 as p o s i t i v e b ecause m a t e r n a l r e p o r t of n o n - c r y i n g s i g n a l s was coded as a h i g h e r number t h a n was m a t e r n a l r e p o r t o f c r y i n g s i g n a l s . ) Thus o b s e r v e d m a t e r n a l s e n s i t i v i t y d i d show some r e l a t i o n s h i p t o m a t e r n a l s e l f - r e p o r t o f a b i l i t y t o be s e n s i t i v e t o t h e i n f a n t ' s c ommunications. M a t e r n a l p o s t p a r t u m r e p o r t o f a b i l i t y t o q u i e t a c r y i n g i n f a n t was f o u n d t o be c o r r e l a t e d w i t h M a t e r n a l R a t i n g s f o r amount of p h y s i c a l c o n t a c t (_r=.54, p_<.01), e f f e c t i v e n e s s o f r e s p o n s e t o i n f a n t c r y i n g (r=.39, p_<.05), amount of v i s u a l i n t e r a c t i o n (r=.46, p_<.05), encouragement o f s e n s o r i m o t o r development (£=.41, p_<.05) and t h e t o t a l M a t e r n a l R a t i n g s c o r e (r=.47j p_<.05). The number of d i f f e r e n t m a t e r n a l r e s p o n s e s t o a c r y i n g i n f a n t was found t o be c o r r e l a t e d w i t h amount o f i n t e r a c t i o n o f f e r e d (r=.43, p<.05), a p p r o p r i a t e n e s s o f i n t e r -a c t i o n (r=.57, p<.01), amount o f p h y s i c a l c o n t a c t (r=.39, p<.05), amount o f v i s u a l c o n t a c t (r=.47, p<.05), amount o f p l a y i n t e r a c t i o n (r=.46, p<.05), s t i m u l u s p o t e n t i a l o f t h e e n v i r o n m e n t (r=.41, p_<.05), encouragement o f s e n s o r i m o t o r development (r_=.43, _p_<.05), and t h e t o t a l M a t e r n a l R a t i n g s c o r e (r=.47, p_<.05). A g a i n , s e l f - r e p o r t o f s e n s i t i v i t y and e f f e c t i v e n e s s o f m a t e r n a l c o n t a c t were r e l a t e d t o o b s e r v a t i o n o f a c t u a l s e n s i t i v e and e f f e c t i v e b e h a v i o u r . G e n e r a l l y , i t would appear t h a t c o r r e l a t i o n s between t h e M a t e r n a l R a t i n g s c a l e s and t h e P o s t p a r t u m Q u e s t i o n n a i r e i t e m s l e n d s u p p o r t f o t h e v a l i d i t y o f some o f t h e s e l f - r e p o r t measures used i n t h i s r e s e a r c h . 115 CONCLUSION The g u i d i n g p u r p o s e b e h i n d t h i s r e s e a r c h was t o examine t h e u n d e r l y i n g p r e m i s e s o f and t h e methods used i n c u r r e n t r e s e a r c h on m a t e r n a l - i n f a n t b o n d i n g . The s p e c i f i c o b j e c t i v e s o f t h i s r e s e a r c h were t w o f o l d : t o t e s t measures and i n s t r u m e n t s f o r use i n s t u d y i n g t h e a t t i t u d e s and b e h a v i o u r w h i c h a r e components o f t h e m o t h e r - i n f a n t bond, and t o p r o v i d e i n f o r m a t i o n w h i c h would s u p p o r t t h e n o t i o n t h a t t h e m o t h e r ^ i n f a n t r e l a t i o n s h i p b e g i n s p r i o r t o t h e b i r t h o f t h e i n f a n t and s h o u l d l e g i t i m a t e l y be s t u d i e d l o n g i t u d i n a l l y , b e g i n n i n g b e f o r e p a r t u r i t i o n . The e x t e n t t o w h i c h t h e s e two o b j e c t i v e s were met w i l l now be e v a l u a t e d . E v a l u a t i o n o f I n s t r u m e n t s P r e n a t a l Q u e s t i o n n a i r e . The P r e n a t a l Q u e s t i o n n a i r e was d e s i g n e d t o a s s e s s p r e n a t a l a t t i t u d e s , e x p e c t a t i o n s and p r e p a r a t i o n f o r b i r t h , i n f a n t c a r e and the p a r e n t a l r o l e . The i n f o r m a t i o n g a i n e d from t h i s i n s t r u m e n t p r o v i d e d a p r o f i l e o f t h e e x p e c t a n t p a r e n t , and gave some i n s i g h t i n t o t h e s p e c i f i c c o n c e r n s and problems o f p a r e n t s e x p e c t i n g t h e i r f i r s t baby. I t i s i n t e r e s t i n g t h a t t h e i m p o r t a n c e o f many o f t h e s e c o n c e r n s , e.g., t h e t h o r o u g h n e s s o f p r e n a t a l c l a s s p r e p a r a t i o n , o r t h e r e a l i s t i c a n t i c i p a t i o n o f n e e d i n g h e l p a t home a f t e r t h e baby's b i r t h , d i d n o t become e v i d e n t t o t h e p a r e n t s u n t i l t h e p o s t p a r t u m p e r i o d . A l t h o u g h t h e f a c t o r a n a l y s i s o f t h e P r e n a t a l Q u e s t i o n n a i r e d i d n o t c o m p l e t e l y c o n f i r m t h e c h o i c e and o r g a n i z a t i o n o f i t e m s i n t h e Q u e s t i o n n a i r e , i t d i d p r o v i d e an i n d i c a t i o n t h a t t h e r e a r e s e v e r a l c o n s t e l l a -t i o n s o f a t t i t u d e s o r e x p e c t a t i o n s w h i c h a r e s a l i e n t t o t h e e x p e c t a n t p a r e n t . P r o b a b l y t h e most v a l u a b l e a s p e c t o f t h e P r e n a t a l Q u e s t i o n n a i r e was t h e s e t of i t e m s c o n c e r n e d w i t h p r e d i c t i o n o f p a r e n t - i n f a n t a t t a c h m e n t , w h i c h were found t o p r e d i c t w e l l t o v a r i o u s p o s t p a r t u m measures. A v a l u a b l e a d d i t i o n t o t h i s i n s t r u m e n t w o u l d be a s y s t e m a t i c method f o r c o d i n g open-ended q u e s t i o n s 116 r e g a r d i n g t h e e x p e c t a n t p a r e n t ' s own v i e w s of p a r e n t - i n f a n t a t t a c h m e n t , i n c l u d i n g t h e forms t h e y would e x p e c t t h a t a t t a c h m e n t t o t a k e , and t h e s t a g e s t h r o u g h w h i c h t h e y w o u l d e x p e c t the a t t a c h m e n t t o p r o g r e s s . A n o t h e r v a l u a b l e a d d i t i o n t o a P r e n a t a l Q u e s t i o n n a i r e o r i n t e r v i e w would be a method of a s s e s s i n g t h e n a t u r e and s t y l e o f t h e spouse r e l a t i o n s h i p . O t h e r r e s e a r c h e r s have begun to e x p l o r e t h e p a r e n t - i n f a n t t r i a d , and have f o u n d i n p r e l i m i n a r y r e s u l t s t h a t t h e spouse r e l a t i o n s h i p i s a f a c t o r i n b o t h th e m o t h e r - i n f a n t and f a t h e r - i n f a n t r e l a t i o n s h i p s ( P a r k e , O'Leary & West, 1972; P a r k e & Sawin, 1976; P e d e r s e n , A n d e r s o n and C a i n , 1977; S o u l e , 1974; Weinraub, 1978; Yarrow, 1974). I t w o u l d be e s p e c i a l l y v a l u a b l e t o know whether i n t e r a c t i v e s t y l e s g e n e r a l i z e from t h e spouse r e l a t i o n s h i p t o t h e p a r e n t - i n f a n t r e l a t i o n s h i p s , as t h i s would p r o v i d e a n o t h e r window i n t o t h e n a t u r e of c l o s e r e l a t i o n s h i p s . I n f a n t Temperament P r e d i c t i o n and R e p o r t . The I n f a n t Temperament P r e d i c t i o n and R e p o r t were d e s i g n e d t o a s s e s s p a r e n t a l e x p e c t a t i o n s and p e r c e p t i o n o f t h e i n f a n t ' s temperament o r s t y l e . E m p i r i c a l t e s t s of t h i s i n s t r u m e n t have shown t h a t t h e i r r e l i a b i l i t y i s g e n e r a l l y n o t h i g h , and t h e f a c t t h a t v e r y l i t t l e r e l a t i o n s h i p was found between b o t h ITP and ITR and o t h e r q u e s t i o n n a i r e s and measures used i n t h i s s t u d y w o u l d seem t o i n d i c a t e t h a t t h e y d i d n o t add much i n f o r m a t i o n t o t h e d a t a c o l l e c t e d i n o t h e r ways. The main f i n d i n g o b t a i n e d f o r t h e s e two measures was t h e l a c k of c o r r e l a t i o n between them, i n d i c a t i n g t h a t t h e r e a l i t y o f i n f a n t temperament and i n f a n t f u n c t i o n i n g comes as a s u r p r i s e t o new p a r e n t s , and has l i t t l e t o do w i t h t h e i r p r e n a t a l e x p e c t a t i o n s . The d i s c o n f i r m a t i o n o f t h e s e e x p e c t a t i o n s i s no doubt a f a c t o r i n o t h e r a s p e c t s o f p a r e n t - i n f a n t i n t e r a c t i o n ; however, th e p r e s e n t r e s e a r c h d i d n o t a t t e m p t t o measure t h a t i m p a c t . H o s p i t a l C h a r t arid D i a r y V a r i a b l e s . I n f o r m a t i o n r e g a r d i n g t h e c o u r s e o f l a b o u r and d e l i v e r y , p e r i n a t a l m e d i c a t i o n , i n f a n t outcome and p o s t p a r t u m 117 m e d i c a t i o n was t a k e n f r o m h o s p i t a l c h a r t s i n o r d e r t o d e t e r m i n e what c o n t r i b u t i o n t h e s e f a c t o r s made to t h e o v e r a l l m o t h e r - i n f a c t r e l a t i o n s h i p . A l t h o u g h b i r t h e x p e r i e n c e s and t h e e a r l y p o s t p a r t u m p e r i o d c o u l d n o t p o s s i b l y be c o n s i d e r e d t o be u n i m p o r t a n t i n t h e development of t h e m a t e r n a l - i n f a n t r e l a t i o n s h i p , t h e v a r i a b l e s measured were n o t found t o be h i g h l y r e l a t e d t o e i t h e r d i r e c t o b s e r v a t i o n o f m o t h e r - i n f a n t i n t e r a c t i o n , s u b j e c t i v e r a t i n g s o f m a t e r n a l b e h a v i o u r , o r s e l f - r e p o r t of m a t e r n a l a d j u s t m e n t . I t i s p o s s i b l e t h a t t h e i n f l u e n c e s o f t h e p e r i n a t a l - e a r l y p o s t n a t a l p e r i o d f a d e o v e r t h e f i r s t month o f t h e i n f a n t ' s l i f e as d a y - t o - d a y a c t i v i t i e s and e v e n t s t a k e on more i m p o r t a n c e . O b s e r v a t i o n s o f m o t h e r - i n f a n t i n t e r a c t i o n i n t h e e a r l y p o s t p a r t u m p e r i o d ( i . e . , w h i l e mother and i n f a n t a r e s t i l l i n h o s p i t a l ) would p r o b a b l y be h e l p f u l i n c l a r i f y i n g t h e r o l e o f p e r i n a t a l e v e n t s i n t h e d e v e l o p -ment o f m a t e r n a l a t t a c h m e n t . The H o s p i t a l D i a r y was a s e l f - r e p o r t measure d e s i g n e d t o p r o v i d e i n f o r m a t i o n about t h e amount o f m o t h e r - i n f a n t c o n t a c t e x p e r i e n c e d d u r i n g the h o s p i t a l s t a y . I n i t s p r e s e n t f o r m, t h e D i a r y was f o u n d t o be i n c o n v e n i e n t f o r s u b j e c t s t o u s e ; p o s s i b l y i n i