• maternal–fetal attachment;
  • attachment;
  • pregnancy;
  • depression;
  • health practices;
  • health behaviors


The purpose of this study was to investigate a conceptual model in which depression was proposed to have direct negative effects on positive health practices as well as indirect negative effects through maternal–fetal attachment (MFA). Participants were 252 adult pregnant women, between 20 and 40 weeks postgestation, who were recruited from five prenatal care sites. Data were collected using mailed self-report instruments measuring MFA, depression, health practices, and demographic and pregnancy information. Hierarchical regression was used to examine direct and indirect effects of depression, person characteristics (maternal age, pregnancy risk status, parity, ethnicity, education, income, marital status), and MFA on health practices. Results of the study supported the conceptual model. Higher education, lower parity, and being partnered predicted more positive health practices (p <05). After controlling for person characteristics, depression was found to be a significant predictor of MFA. Both depression and MFA were significant predictors of positive health practices but in opposite directions. Depression had a negative relationship and MFA a positive relationship with positive health practices. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24: 203–217, 2001