A Couple-Based Bonding Program During Pregnancy: Testing the Maternal-Fetal Attachment Kit (MaKit) to Strengthen Emotional Connection Between Expectant Mothers and Their Unborn Babies in Antenatal Care

Understanding the Maternal-Fetal Attachment Kit (MaKit) Study What is this study about? This study looked at whether a special program called the Maternal-Fetal Attachment Kit (MaKit) could help pregnant women feel more emotionally connected to their unborn babies. The program was designed to involve both the mother and her partner, making it a couple-based experience during pregnancy.

Why was this study done? Feeling emotionally bonded to an unborn baby during pregnancy is very important. It supports the mother's well-being and helps parents feel more ready for parenthood. However, most routine pregnancy check-ups (antenatal care) focus mainly on the physical health of the mother and baby, with little attention given to emotional bonding or involving the partner. This study aimed to fill that gap.

Who took part in this study?

Thirty pregnant women and their partners attending a primary antenatal care clinic in Indonesia took part in this study. They were divided into two groups:

Intervention group (15 couples): Received standard antenatal care plus the MaKit program.

Control group (15 couples): Received standard antenatal care only.

The study was conducted between March and May 2024. What is MaKit? MaKit is a psychosocial intervention kit designed to be used at home by expectant couples. It provides structured activities that encourage both parents to reflect on and strengthen their emotional bond with their unborn baby. It is designed to complement - not replace - routine antenatal care provided by midwives.

What did the study find? After the intervention, mothers in the MaKit group showed significantly higher emotional bonding scores with their unborn babies compared to mothers in the control group (68.5 vs. 62.7 out of a possible score). This difference was meaningful and statistically significant, suggesting that MaKit genuinely helped improve the mother-baby emotional connection.

What does this mean for patients and families? If you are pregnant, emotional bonding with your baby during pregnancy matters - and it is something you and your partner can actively nurture together. Programs like MaKit offer simple, structured ways to do this at home, alongside your regular antenatal visits. Involving your partner in this process may also strengthen your relationship and your shared readiness for parenthood.

What does this mean for health care providers? MaKit shows promise as a practical, low-cost psychosocial tool that midwives and antenatal care providers can recommend to expectant couples. Integrating such interventions into standard antenatal care could support a more holistic, family-centered model of care - addressing not just the physical, but also the emotional dimensions of pregnancy. This is especially relevant in low- and middle-income settings where psychosocial support during pregnancy is often limited.

What are the limitations? This was a small study involving only 30 couples at a single clinic in Indonesia. While the results are promising, larger studies across different settings are needed to confirm these findings and explore the long-term effects of MaKit on parenting and child development outcomes.

Key Takeaway The Maternal-Fetal Attachment Kit (MaKit) is a promising, couple-focused program that can help expectant mothers feel more emotionally connected to their unborn babies when used alongside routine antenatal care. It is simple, home-based, and designed to involve both parents in the bonding journey.

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Key information

Conditions

Attachment Low Maternal-Fetal Attachment During Pregnancy Pregnant Women

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Klinik Aisyiyah Moyudan

Sleman, Special Region of Yogyakarta, 55292, Indonesia

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

pregnant women 16-36 weeks' gestation with a singleton pregnancy, i
in marital union,
attending the antenatal care visit with their husband,
willing partner to participate in the intervention, and
able to communicate in Indonesian

Exclusion criteria

women ≥37 weeks' gestation (as they would likely deliver before completing the four-week intervention and follow-up).

Treatment and study plan

Makit

Behavioral

makit

Primary outcomes

Change in Maternal-Fetal Attachment as Measured by the Prenatal Attachment Inventory (PAI)

Time frame: up to 4 weeks

Maternal-fetal attachment will be assessed using the Prenatal Attachment Inventory (PAI), a 21-item self-report questionnaire developed by Muller (1993) to measure the intensity of a pregnant woman's emotional attachment to her unborn child. Each item is rated on a 4-point Likert scale, yielding a total score ranging from 21 to 84, with higher scores indicating stronger prenatal attachment. The PAI assesses maternal thoughts, feelings, and behaviors directed toward the fetus, such as attributing characteristics to the unborn child and engaging in interactive behaviors (e.g., talking to or touching the abdomen). The instrument will be administered [before and after the intervention / at baseline and follow-up] to evaluate changes in attachment scores.

Sponsors and collaborators

Lead sponsor

Universitas Aisyiyah Yogyakarta

Other

Registry information

Official study title

Effectiveness of the Maternal-Fetal Attachment Kit (MaKit) on Maternal-Fetal Attachment Among Expectant Couples Attending Antenatal Care: A Quasi-Experimental Study

Acronym: (MaKit)

Important dates

Study start: 2025
Primary completion: 2025
Study completion: 2025
First posted: Jul 9, 2026
Registry last updated: Jul 9, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed