The Fantasmatic and Imaginary Child of the Pregnant Woman

BACKGROUND: Pregnancy is a period of transition, which makes women more vulnerable and in unfavorable conditions may lead to psychopathology in both mother and infant. It is essential to outline factors adversely affecting the resolution of this period. Early interventions and why they matter: Interventions during pregnancy can provide important improvement in the outcome for both maternal and infant mental health. AIM: The aim of the study is to evaluate the risk factors of antenatal anxiety and depression focusing particularly on maternal representations of the relationship towards the fetus and her own parents during pregnancy and the early postpartum period. METHODS: The study is outlined using a quantifiable interview during pregnancy to evaluate the woman’s ability to keep her child in mind, measured by reflective functioning. Reflective functioning provides information regarding the pregnant woman’s relationship quality to her fetus and important people in her life. Primiparae in Stockholm around gestation week 20 are asked about their experience with respect to pregnancy, their relationship to their family, partner, and their unborn child. The women selected to the study are an at risk population, with high levels of stress, childhood adversity, and/or history of mental health. These women are more vulnerable to develop perinatal anxiety and depression. RESULTS: The pregnancy interview provides valuable insight into the pregnant women’s psychic constitution. The quantifiable measure of their mental state, reflective functioning, serves as measure of quality of the mother’s parenting capacity. The countertransference and transference of the interviewer towards the women during the interview enables a more profound understanding of the underlying dynamics and constructs of repression, aggression, mourning, and narcissistic defenses. CONCLUSION: A better understanding of the underlying mechanisms of the pregnant women’s intrapsychic reorganization of motherhood and her relation to the unborn child shall facilitate specific early interventions. These interventions shall be targeted to specific risk groups and enable the prevention of adverse child outcomes.