The Importance of Motherhood for Early Maternal Bonding and Engagement

Maternal and Child Health Journal (2026) 30:772–779 https://doi.org/10.1007/s10995-026-04272-1 BRIEF REPORT The Importance of Motherhood for Early Maternal Bonding and Engagement Karina M. Shreffler1 · Kayleigh Esparza2 · Tara Wyatt3 Received: 13 March 2025 / Accepted: 21 April 2026 / Published online: 20 May 2026 © The Author(s) 2026 Abstract Introduction Maternal perceptions about the importance of motherhood have been found to impact a variety of maternal well-being outcomes, but the impact of the importance of motherhood for the early maternal bonding relationship and on caregiving behaviors has not been explored. Examining attitudinal factors associated with maternal-infant bonding or early caregiving behaviors is essential for the development of effective interventions. Methods Using a clinic-based, urban sample of predominately low-income and diverse pregnant women (N = 177), we used hierarchical linear regression analysis to examine whether perceptions of the importance of motherhood measured during the first trimester predicted maternal-fetal bonding measured during the second trimester, caregiving engagement at two months postpartum, and postpartum bonding measured at six months postpartum, controlling for sociodemographic characteristics and prior outcomes. Results Perceived importance of motherhood was positively and significantly associated with higher maternal-fetal bonding (b = 1.28, p < .01), greater daily infant engagement (b = 0.57, p < .05), and higher postpartum bonding (b = 0.94, p < .01). Adjusting for prior outcomes to model temporal pathways revealed that the impact of perceived importance of motherhood for early engagement was fully attenuated by maternal-fetal bonding but remained a significant predictor of postpartum bonding. Discussion Perceiving motherhood as important promotes early maternal bonding and caregiving behaviors, which are critical for early infant development. Preconception or parenting education programs that strive to promote the importance of motherhood through mindfulness or maternal reflective functioning interventions should be considered. Significance What is Already Known on this Subject? Perceived importance of motherhood is associated with various maternal outcomes, including childbearing intentions and distress following involuntary childlessness and pregnancy loss. What this Study Adds? Perceptions of the importance of motherhood in early pregnancy are associated with early maternal bonding and caregiving behaviors. Screening for and enhancing women’s attitudes about motherhood and becoming a mother might be a critical target for intervention. Keywords Importance of motherhood · Bonding · Maternal · Pregnancy · Postpartum Karina M. Shreffler Kayleigh Esparza Tara Wyatt 13 1 Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Campus, 1100 N. Stonewall Ave., Oklahoma City, OK 73117, USA 2 Laureate Institute for Brain Research, Tulsa, OK, USA 3 Department of Human Development and Family Science, Oklahoma State University, Stillwater, OK, USA Maternal and Child Health Journal (2026) 30:772–779 773 Introduction Methods Motherhood is a salient identity for the majority of women in the U.S. (Katz-Wise et al., 2010). On average, women desire to have two children, and fewer than 15% of women report intentions to remain childless (Guzzo & Hayford, 2023). Perceived importance of motherhood has been associated with a variety of maternal outcomes, such as childbearing intentions (Fletcher-Hilderbrand, et al., 2022; McQuillan et al., 2015), plans to adopt (Park & Hill, 2014), distress about childlessness (McKennon Brody & Frey, 2017; Inhorn et al. 2017; McQuillan et al., 2012) and distress about pregnancy loss (Erato et al. 2021; Shreffler et al., 2011). There is wide variation in how important women rate motherhood to be (McQuillan et al., 2008; Tichenor et al., 2017), and not all women have positive expectations for motherhood (Copeland and Harbough 2019). When mothers are unable to form positive expectations about motherhood during pregnancy, they are at risk of bonding disturbance (Rusanen et al., 2021), but it remains unclear how perceiving motherhood as important is associated with the early maternal-infant bonding relationship or caregiving behaviors. Because the early bonding relationship and caregiving engagement is critical for infant development (e.g., Alhusen et al., 2013; Le Bas et al., 2020; Rocha et al., 2020), it is critical to identify modifiable targets for early intervention. Attitudes are a common precursor to relevant behaviors (Ajzen et al., 2018) and are more easily modified through educational and behavioral interventions than other factors such as personality (Conner & Norman, 2005). Perceived importance of motherhood refers to attitudes about the meaning and value of being a mother and is not necessarily a stable characteristic of women; perceptions of the importance of motherhood differ by life course circumstances including having children and experiencing infertility (McQuillan et al., 2008), and they can change over time following experiences such as pregnancy loss (Erato et al. 2021). Additionally, maternal awareness of the role and motherhood expectations have been shown to be modifiable through mindfulness-based intervention (Passaquindici et al., 2024; Sajadian et al. 2022). In this study, we used longitudinal data to examine how women’s perceptions of the importance of motherhood in early pregnancy were associated with maternal-fetal bonding during the second trimester, daily infant engagement at two months postpartum, and bonding at six months postpartum. Sample Data for the current study came from a longitudinal, urban, clinic-based cohort study involving 177 pregnant women (age range = 16–38; 89% receiving public insurance) recruited in 2017–2018 from their first prenatal appointment. The university-affiliated participating clinics serve a racially diverse and economically under-resourced patient population. The sample for the current study was restricted to the 116 participants who responded to survey assessments from the first trimester of pregnancy through six months postpartum. Most attrition occurred between the first and second waves of the study, coinciding with the first and second trimesters of pregnancy, with the primary known reason for attrition due to pregnancy loss. Response rates are comparable to other longitudinal clinical studies with a diverse, economically disadvantaged sample (Nicholson et al., 2015). The study was approved by the [university masked for review] Institutional Review Board. Procedures This study includes four time points, with recruitment occurring at the first prenatal visit (average gestation age of 10 weeks) and spanning into the sixth month postpartum. Informed consent/assent with parental consent for participants under 18 was performed at the time of enrollment. Participants received $50 for participation i (...truncated)