Mothers' experiences of early interaction in multiple pregnancies: A qualitative interview study

Background: Forming an equal attachment relationship with more than one child at a time can be challenging for parents. The risks associated with multiple pregnancies for the expecting parent and fetuses can adversely affect the entire pregnancy and influence the early interaction between the woman and the baby. The purpose of this empirical study was to describe from the perspective of women which factors promote and weaken early interaction in multiple pregnancies. Methods: Data collection was conducted remotely through semistructured individual interviews, in collaboration with a regional welfare agency and multiple birth family associations. A total of 11 women expecting twins voluntarily participated in the interviews. The qualitative data were analysed via inductive content analysis. Results Factors that strengthened early maternal-fetal interaction included considering the fetus and fetuses as part of the family during pregnancy, naming the fetuses individually, and using terms other than "fetus." Strong social support and parents' understanding of fetal awareness and reciprocity also significantly promoted early interaction. Conversely, early knowledge of expecting twins, insufficient guidance from healthcare professionals for the formation of early interactions, unequal attachment to fetuses, a lack of knowledge, and fears weakened early interactions. Conclusions: Our findings suggest that early interaction and guidance should be initiated as soon as parents learn that they expect more than one child. Throughout prenatal visits, there should be a focus on supporting the resources of pregnant women and their families to enhance maternal capabilities. Keywords: early interaction, maternal-fetal attachment, multiple pregnancy, twins, qualitative study