الفهرس 
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Abstract
Pregnancy is a unique, exciting and often joyous transitional period in women’s lives. Simultaneously, it is also a period of disequilibrium that involves profound endocrine and general somatic as well as psychologic changes. One important aspect of the woman’s psychological adaptation during pregnancy is related to the building process of the relationship between the mother and her fetus. This connection or relationship is referred to as maternal fetal attachment (MFA). While attachment refers to an affectionate tie begins in early pregnancy to be most intensive during the last trimester then last forever.
Maternal–fetal attachment plays a key role in both the maternal and fetal health. Higher levels of maternal–fetal attachment can be considered as a good motivation for the woman to adopt self-care practices and health behaviours which are the corner stone of antenatal care (ANC). The promotion of self-care may reduce mortality and morbidity, improve quality of life, reduce pregnancy-related health care costs and improve pregnancy outcome.
In pregnancy, universal self care practices refer to all practices that the pregnant women should perform in order to maintain and promote health and wellbeing of both herself and her expected child. It includes: nutritious food, regular exercise, adequate rest and sleep, safety measures and hazard avoidance, hygienic care, seeking prenatal care and learning about pregnancy. So, it is very essential to understand the most important predictors of self care practices. Maternal – fetal attachment can be suggested as one of these predictors. Therefore, prenatal care should focus on not only the prevention and treatment of gestational problems, but also on the formation and strengthening of the bond between the mother and the baby.
Aim of the study
The present study aimed to identify the relationship between maternal-fetal attachment and self care practices among pregnant women.
Materials and method:
Setting:
This study was conducted at the outpatient clinic of antenatal unit at El- Shatby Maternity University Hospital in Alexandria governorate.
Subjects:
A convenience sample of 375 pregnant women who attended the above-mentioned setting.
Data collection tools
Three tools were used for data collection:
Tool I: Basic data structured interview schedule: It entailed three parts:
• Firstly, socio-demographic characteristics such as: age, level of education….etc.
• Secondly, reproductive history such as: gravidity, parity….etc.
• Thirdly, history of current pregnancy such as whether it was planned or not, weeks of gestation….etc.
Tool II: Maternal fetal attachment (MFA) structured interview schedule:
This tool was adapted from two scales (cranley, 1981) and (Muller et al, 1993) and translated into Arabic language to measure the subjects’ MFA level
Tool III: prenatal self care practices questionnaire:
This tool was originally developed by Lindgren (2001), and then revised (2005) to measure self care practices of pregnant women. It was adapted and translated to Arabic language.
The main findings of the present study were:
A. Subjects’ demographic data:
• More than one half (56%) of the study subjects were in their twenties.
• About one-half (47.7%) of them were either illiterate or had secondary education.
• Approximately three-fifths (60.8%) of them were housewives.
B. Subjects’ reproductive history:
• Less than one-third (29.9%) of the study subjects were primigravida, compared to about one quarter (25.9%) of them who were primipara.
• Less than one-fifth (17.4%) of them had a history of prenatal loss either once or more.
• Most of them (94.1%) had no history of stillbirth
C. Subjects’ current pregnancy profile:
• The current pregnancy of 79.5% of the study subjects was planned.
• As much as 70.75% of them were in their third trimester of pregnancy, and 78.7% of them had started their antenatal visits during their first trimester.
• A substantial proportion (72.8%) of them had attended an adequate number of antenatal visits at the time of data collection.
D. Maternal fetal attachment level:
• Slightly more than one half (52.8%) of them were highly attached to their fetuses compared to 29.1% of them who were moderately attached. Only 18.1% of them were poorly attached to their fetuses.
E. Self care practices level:
• Slightly more than one half (53.3%) of them performed good self-care practices compared to about one-third (32.3 %) of them who performed fair self-care practices. Only 14.4% of them performed poor self-care practices during their pregnancies.
• safety measures and avoiding hazards and personal hygiene were the most practices performed by the studied pregnant women (72.96 %, 72.30 %), respectively. Unlike balance of rest and exercise and seeking health care and information that were the least practices performed by the study subjects (56.77 %, 59.01 %), respectively.
F. Correlation between overall maternal fetal attachment and overall prenatal self-care practices levels:
• Overall maternal fetal attachment level was statistically significantly positively correlated with overall self care practices level.
G. Correlation between overall maternal fetal attachment and prenatal self-care practices’ subscales:
• Overall maternal fetal attachment level was positively correlated with three self care practices namely: a) seeking health care and information b) safety measures and avoiding hazards c) nutrition.
• no statistically significant correlation was observed between the overall level of maternal fetal attachment and two self care practices namely: a) balance of rest and exercise b) personal hygiene.
Recommendations
Based on the findings of the present study, the following recommendations are suggested:
• The issues of maternal fetal attachment and self care practices are recommended to be included within maternity nursing curricula at different nursing educational institutions.
• Assessment of maternal fetal attachment and self care levels are recommended to be included in the routine assessment of the antenatal maternity nurses.
• Antenatal health education should consider the positive relation between maternal fetal attachment and self care practices which in turn improves the pregnancy outcome.
For further researches:
• Replication of the same study in different Egyptian cultures especially Upper Egypt or rural areas to compare and validate the present study findings.
• Replication of the same study on high risk pregnant women to include health deviation self care requisites in the study tool.
• Further studies to investigate the possible applicable strategies to strengthen the levels of maternal fetal attachment.