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First Reactions in Mother-Baby Meeting – An Observational Study

Resmiye Ozdilek 1, Yasemin Dinçel 2

1 Department of Midwifery, Faculty of Health Sciences, Kocaeli University, Kocaeli, Turkey. ORCID: 0000-0002-8130-4123

2 Department of Midwifery, Kocaeli Provincial Directorate of Health Darica Farabi Training And Research Hospital, Gynecology and Obstetrics Midwifery, Kocaeli, Turkey. ORCID: 0000-0002-4025-078X

Received: 6 June 2024

Revised: 10 June 2024

Accepted: 10 June 2024

Published: 10 June 2024

Keywords:

Attachment, labor, mother-baby, skin-to-skin contact, observation.

Corresponding author:

MSc. Midwife Yasemin Dinçel

Department of Midwifery, Kocaeli Provincial Directorate of Health Darica Farabi Training And Research Hospital, Gynecology and Obstetrics Midwifery, Kocaeli, Turkey.

yasemindincel96@gmail.com

ORCID: 0000-0002-4025-078X

Cite as:

Ozdilek R, Dincel Y. First Reactions in Mother-Baby Meeting – An Observational Study. Med J Eur. 2024;2(3):51-57. doi: 10.5281/zenodo.11547219

ABSTRACT
Labor, which is a natural process, affects women’s health in a physical and emotional way. Hormones that increase during pregnancy are thought to play a role in initiating motherhood after the birth of the baby. This study was carried out to determine the reactions of the mothers, who deliver vaginally, at the first encounter with their baby. The research is a descriptive, observational study. The population of the study consisted of women who deliver vaginally between March 2019 and September 2020 in a Training and Research Hospital delivery unit. Women who met the research criteria constituted the study sample (n:206). An observation form prepared by the researchers was used to collect the data. Required ethics committee permission and written institutional permission were obtained. Ethnicity of 74.3% of the participants was Turkish and 25.7% of them were Syrian. In our study, statistical significance was determined between the reactions of mothers at the first encounter with their babies and their ethnic origin. It was determined that 72.3% (n:149) of the mothers’ reactions at the first encounter with their babies were towards the baby, 86.9% (n:179) were emotional, and 9.2% (n:19) were self-directed and against their relatives. The reactions of mothers at the first encounter with the baby were determined as follows: 37.4% (n:77) crying, 42.7% (n:88) trying to touch their baby, 31.6% (n:65) praying, 16% (n:33) asking if the baby is okay, 12.1% (n:25) not wanting/refusing to touch, 10.2% (n:21) wanting to see the gender, 5.3% (n:11) asking about own situation, 4.4% (n:9) thanking the midwife. In our study, the reactions of mothers in their first encounter with their babies were determined as reactions against their baby, emotional reactions, and reactions against themselves and their environment.

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INTRODUCTION

Labor is a natural process that affects the woman health both physically and emotionally. Delivery is not an event that is under the control of the woman and her supporters during the delivery. The effects of factors such as obstetric history, hormones, labor environment and health professionals are observed during delivery (1,2). Delivery is an action in which many different emotions are experienced, and the mother who transitions to a new role in the postpartum period may experience stress, anxiety and concern along with positive emotions (3).

During pregnancy, the woman develops a baby in her own body as well as getting prepared for the lactational process that is necessary to feed the baby after birth. The mother, who gains the ability to produce milk during pregnancy, has the adaptation to feed the baby immediately after delivery. Therefore, preparation for maternity care in mammals begins with the physiological changes during pregnancy (4).

It has been thought that the increased level of estrogen and progesterone during pregnancy play a role in preparing the woman for motherhood. Estrogen, prolactin and oxytocin hormones stimulate maternal behavior after birth. High levels of progesterone and estrogen during pregnancy are thought to initiate motherhood by increasing oxytocin and prolactin receptors in brain regions that are important in the formation of maternal behavior. Estrogen and progesterone levels drop soon after birth. It is sufficient to stimulate the maternal behavior once and after triggering, the change in hormone levels does not appear to have a negative effect on motherhood (4-6).

Although oxytocin has an effect on birth and milk secretion, it initiates maternal behavior by stimulating various receptors in the brain. The mother’s perception of her baby’s scent and recognizing it in this way also occurs with the effect of oxytocin. Oxytocin initiates motherhood soon after birth but is not important in its maintenance. Blocking oxytocin in multiparous mothers does not prevent maternal behavior. In brief the following statement seems valid: “Once you become a mother, you will be a mother forever” (4). It can be said that the behaviors such as touching, crying and laughing observed in the mother who meets with her baby after birth are behaviors related to the formation of the maternal bond. The mother tries to perceive, understand and supply with the needs of her baby in addition to self-care while trying to adapt to the postpartum changes. The early postpartum period is the time in which the mother, who has begun to perceive her baby, is most willing to establish intimacy with her baby. When most mothers meet their babies, they start talking to them by touching and fondling them (2).

The number of studies investigating the reactions of mothers at the first meeting with their babies is limited. The aim of this study was to determine the reactions in the first mother-baby meeting.

METHODS

This study is a descriptive, observational study. The population of the study consisted of women who gave vaginal birth between March 2019 and September 2020 in a Training and Research Hospital delivery unit. The number of pregnant women who applied to the relevant hospital between the specified dates is 1849. Since the number of individuals in the target population is known, the sample was selected by calculating the prevalence. In this direction, the prevalence in the study was calculated as 0.1438, and the sample calculation of the study was calculated as 176 pregnant women, using the formula below, according to the sample calculation of the known universe. It was planned to include a total of 250 women by predicting losses between the specified dates, and the research was completed with 206 women.

Sample Selection

Inclusion criteria for the study are as follows; having a vaginal delivery, having a healthy newborn, not being used an instrument during the delivery, not having epidural or spinal anesthesia, and being volunteered to participate in the study.

On the other hand, exclusion criteria include; newborns who are depressed or in need of resuscitation, using an instrument during delivery, having epidural or spinal anesthesia, and not participating in the study voluntarily.

Data Collection Process

The purpose and method of the research were explained to the pregnant women who were hospitalized for vaginal delivery. The consent of the volunteer participants was obtained, and the pregnant women included in the study were allowed to fill out the Introductory Information Form. At the same time, it was announced that the researcher would accompany the pregnant woman in labor and her reactions when she first met her baby would be recorded in the observation form.

Data Collection Tools

Observational Data Form

An observational data form, which was structured by using the category system, was used. The observational data form was created by the researchers based on literature review and clinical experience (4, 7). The reactions of mothers when they meet their babies for the first time; were divided into three categories as reactions against the baby, emotional reactions, and reactions against herself and her environment. Mother’s reactions that were not included in the observation form were noted by the researcher.

Introductory Information Form

There are 8 questions questioning the socio-demographic characteristics and obstetric characteristics of pregnant women.

Statistical Analysis

In order to analyze the data, the data were evaluated by transferring the data to the computer using the IBM SPSS Statistics for Windows, Version 22.0 package program. The conformity of the data to the normal distribution was tested with the Shapiro-Wilk-W test. Since the research design was descriptive, descriptive statistical methods were used. Mean, mode, frequency and standard deviation values were calculated. Chi-square test, which is one of the non-parametric tests, was used to compare the ethnicity variable with maternal responses. P≤0.05 was considered statistically significant.

RESULTS

Findings Regarding the Socio-Demographical Characteristics of the Participants

The mean age of the participants was 26.34±5.72 years, with a minimum of 16 and a maximum of 45. While the average number of pregnancies of the participants was 2.70±1.57, the average number of births was 2.40±1.15, and the average number of living children was calculated as 2.34±1.08. In terms of ethnicity, 74.3% of the participants were Turkish and 25.7% Syrian. It was determined that 87.4% of the participants received childbirth preparation training and 95.6% of them had a desired pregnancy. While 77.2% of the participants gave Yes answer to the following question: “Is it the desired gender?”, 21.4% of the participants did not know the gender of their baby (Table 1).

Table 1. Socio-demographic characteristics.

 Min-Max.Mean±SD
Number of pregnancies1-122.70±1.57
Number of births1-82.40±1.15
Number of living children1-62.34±1.08
Age16-4526.34±5.72
 n%
Ethnicity  
Turkish15374.3
Syrian5325.7
Did you attend an antenatal class?  
Yes2612.6
No18087.4
Is this a desired pregnancy?  
Yes19795.6
No94.4
Is this a desired gender?  
Yes15977.2
No31.5
Not known4421.4

SD: Standard deviation.

First Reactions During the Mother-Baby Meeting

The reactions of mothers when they first met their babies were analyzed in three categories. It was determined that 72.3% (n:149) of the reactions were directed towards the baby, 86.9% (n:179) were emotional and 9.2% (n:19) were directed towards themselves and their environment (Table 2).

Reactions toward Baby

It was observed that the participants talked to their baby, tried to love their baby by touching them, and questioned the baby’s well-being and gender under the heading of reactions to the baby. Nearly half of the mothers (42.7% (n:88)) tried to love their baby by touching. While 28.2% (n:58) of the participants were talking to their baby, 16.0% (n:33) asked the health personnel the following question: “Is my baby okay?”. It was observed that 10.2% (n:21) questioned the gender of the baby. (Table 2).

Emotional Reactions

Crying, praying, being thankful, being surprised, trying to believe that the birth has occurred, and not wanting to touch the baby were grouped as emotional reactions. Crying when seeing the baby, praying, being thankful, being surprised, trying to believe that the birth occurred, and not wanting to touch the baby were grouped as emotional reactions. Among these emotional reactions; it was observed that 37,4% (n:77) cried when first saw her baby, 31,6% (n:65) prayed and be grateful, 36,4% (n:75) be surprised and tried to believe that the delivery occurred and 12,1% (n:25) didn’t want to touch her baby (Table 2).

Reactions toward Herself and Her Environment

When the reactions of the participants towards themselves and their environment were evaluated, it was determined that 5.3% (n:11) asked questions about themselves, while 4.4% (n:9) thanked the midwife (Table 2).

Table 2. First reactions during the mother-baby encounter.

 n%
Reactions to the baby  
Talks to her baby5828.2
Tries to love her baby by touching8842.7
Is my baby OK?3316.0
Questions the gender2110.2
Total14972.3
Emotional reactions  
She cries when she sees her baby7737.4
Prays and gives thanks6531.6
She is surprised, tries to believe that the baby was born7536.4
Does not want to touch her baby2512.1
Total17986.9
Reactions to herself and her environment  
Asks questions about herself115.3
Thanks to the midwife94.4
Total199.2

The reactions of the mothers at the first encounter with their babies were compared with the ethnicity (Table 3). A statistically significant difference was determined between ethnicity and mothers’ first reactions (p<0,05). It was found that 94.8% (n:55) of Turkish women and 5.2% (n:3) of Syrian women showed the “talking to the baby” reaction and this difference between ethnicities was statistically significant (p<0,05). It was determined that the first postpartum question, namely “Is my baby okay?”, was asked in 93.9% (n:31) of Turkish women and 6% (n:2) of Syrian women. There was a statistically significant difference between the two groups (p<0,05). It was determined that 19.0% (n:4) of Turkish mothers and 81.0% (n:17) of Syrian mothers questioned gender as a first reaction after delivery. The difference between ethnic origin and gender questioning variable was found to be statistically significant (p<0,05). “Crying when seeing the baby”, which is one of the emotional reactions, was observed in 74.0% (n:57) of Turkish mothers and 26.0% (n:20) of Syrian mothers. This response was found to be statistically significant (p<0,05). It was determined that more than half of the women (n:65) who prayed and be thankful when they met their baby for the first time were Syrian (52.3% (n:34)). The difference between the Turkish and Syrian women in terms of praying and being thankful was statistically significant (p<0,05). It was determined that the ratio of Turkish and Syrian women who looked at their baby with disgust at the first encounter were 92% and 8.0%, respectively. The difference between the reaction to look at the baby with disgust in terms of ethnicity was statistically significant (p<0,05). It was determined that all of the women (100.0% (n:11)) who asked questions about themselves and their surroundings were Turkish, and this difference was statistically significant (p<0,05). During the first encounter of mothers with their babies; it was determined that there was no statistically significant difference between the reactions of “loving baby by touching”, “not believing or getting surprised about the occurrence of birth”, “thanking the midwife” with ethnicity (p>0,05).

Table 3. Comparison of the reactions of mother and baby to their first encounter according to ethnicity

ReactionsEthnicityn%Value 
Talks to her baby  Turkish5594.8  p=0.000 X2=17.85
Syrian35.2
Total58100
She cries when she sees her baby  Turkish5774.0p=0.004 X2=0.950  
Syrian2026.0
Total77100
Tries to love her baby by touching  Turkish6675.0  p=0.836 X2=0.043  
Syrian2225.0
Total88100
Is my baby ok?Turkish3193.9  p=0.005 X2=7.95  
Syrian26.1
Total33100
Questions the genderTurkish419.0  p=0.000 X2=37.32  
Syrian1781.0
Total21100
Prays and gives thanksTurkish3147.7  p=0.635 X2=5.103  
Syrian3452.3
Total65100
Does not want to touch her babyTurkish2392.0  p=0.031 X2=4.68  
Syrian28.0
Total77100

DISCUSSION

Genetic, environmental and hormonal factors improve maternal behavior in humans and animals together (4). Maternal attachment, which begins with the effect of hormones during pregnancy, is an important factor in the formation of maternal postpartum behaviors. Physiologically, mothers and babies should be together in the first hours after delivery. It is obvious that this togetherness and close encounter are related with the mother-baby interaction in the first period of life and are important for developing a strong bond between mother and baby (8).

The mother tries to perceive, understand and supply with the needs of her baby in addition to self-care while trying to adapt to the postpartum changes. The early postpartum period is the time in which the mother, who has begun to perceive her baby, is most willing to establish intimacy with her baby. When most mothers meet their babies, they start talking to them by touching and fondling them (9, 10).

In our study, it was determined that about half of the mothers tried to love their babies by touching them when they first met with their babies. Other reactions to the baby were to talk to the baby and ask if the baby is okay.

It is known that mammals show reactions related to touching their offspring after birth. The mother’s touch to her baby can be in the form of light fingertips, as well as in the form of a poke or a bear hug (4, 11, 12). In a study of Lucci et al., in which video recording was used in order to observe the behaviors of 60 mothers when baby is placed on their breast at the time of birth, it was reported that mothers tried to calm their crying baby by touching. In that study, it was also determined that half of the mothers touched their babies and some of them talked to their babies. The researchers explained these findings as mothers looking at their babies and making contact to recognize, feel, or calm them down (13). In a study of Trevathan, in which the first hour of mothers was observed during 100 births, It has been reported that mothers have similar reactions following delivery and have a natural tendency to hold their babies on the left side of their bodies (14). It can be said that this findings in the literature and in our study are similar.

While the maternity and love develop, the activity of brain structures related to negative emotions, social judgments and critical thoughts decreases. In brief, maternal love reduces the possibility of critical evaluation towards the baby. According to the study by Leckman et al., It was found that 73% of mothers and 66% of fathers thought that their child is “perfect” in the first trimester after birth (15). This positive view is necessary for a positive relationship and interaction between mother and baby (4).

Placing the naked baby on the mother’s bare chest in the early postnatal period and providing a skin-to-skin contact is considered as the most sensitive period for both the mother and the newborn. Ensuring skin-to-skin contact causes an increase in the level of oxytocin in the mother and improves maternal feelings. Skin-to-skin contact helps to establish a biological bond between the mother and the baby, to develop the sense of motherhood and to ensure the adaptation between the mother and the baby. It is possible to say that behaviors such as touching, crying and laughing might form the maternal bond (2).

It was determined that one third of our study group showed the praying response when they first met their babies during birth. In the study of Karahan et al., in which they examined the traditional practices of mothers during childbirth, it has been reported that 30.9% of mothers pray (16). In the study of Aziato et al., with Christian women in Ghana, it has been reported that women resort to spiritual practices such as praying and giving thanks during childbirth. While women pray for a safe delivery during pregnancy, it has been reported that women pray to express their gratitude to God with the feelings of getting rid of postpartum pain and reuniting with their baby (17). It has been shown in studies that gratitude reactions may occur in different religious or ethnic groups because of getting rid of a painful situation after giving birth or receiving a gift (18). It can be said that our finding is in parallel with the literature.

It was determined that 12.1% of the mothers in our study did not want to touch their baby. Studies investigating the reactions of the mother and newborn after birth show that many factors belonging to the mother and the baby can affect these reactions negatively. It was observed that women who stated that they experienced perineal pain due to episiotomy, uncontrolled lacerations, and perineal trauma in the early postpartum period did not want to hold their babies (2). In addition, it has been reported that mothers who have depression during pregnancy may also show reactions such as not wanting to touch their baby during delivery, rejecting their baby, and hugging their baby less. It is observed that the mother’s low socio-economic status and lack of social support, especially during pregnancy, decrease the mother’s participation in the care of the baby and the interest against her baby. This behavior of the mother leads to differences in the behavior of the baby in the future life. In a study conducted on mice, mothers, who experienced stress during pregnancy, had decreased licking and grooming of their babies, and this situation affected oxytocin receptors and prevented them from being a good parent in the future (13).

Hwang observed that mothers behave differently according to certain variables of infants when they first meet with them. Mothers showed more reactions, such as smiling, looking, making sounds, and touching, to boys than girls (19). Another reason for the difference is being preterm or term babies. This difference seen in mothers with preterm and term babies is thought to be related to the traumatic situation experienced by the mother, the fear of her baby’s life and the low level of acceptance. Studies have shown that mothers with preterm babies touch their babies later, delay seeing holding them, have difficulty in perceiving that their babies are their own and perceive their baby negatively compared to the term babies. In a systematic review in which early mother-baby relations were evaluated; it was stated that mothers with premature babies touch and interact with their babies less often and also treat term babies with a loving approach (9, 13, 20). Low prenatal attachment in the third trimester of pregnancy also negatively affects the postpartum mother-baby interaction (13).

Another factor that influences the first encounter between mothers and babies is the type of delivery. It has been reported that mothers, who delivered vaginally, approach their babies with a higher positive response and have more interaction with them compared to mothers who delivered by C-section (13).

It was determined that the first postpartum reactions of mothers were emotional reactions towards the baby, and very few of them gave reactions to themselves and their environment.

Labor is a process and the mother focuses on the birth of the baby, herself, and her environment. Therefore, At the end of the birth, reactions about the baby are expected. Labor is not a completely controllable process. Along with physical changes, there are also psychological changes during pregnancy (21). Research shows that mothers’ reactions are directed towards their babies, regardless of how they feel emotionally in the postpartum period (13). The fact that, a very few number of mothers in our study gave reactions against themselves and their environment, is in line with the literature.

It was observed that the Syrian mothers in our sample group showed less reactions that required communication when they first met their babies such as “asking questions about the baby’s well-being”, “asking questions about herself” and “thanking the midwife”. It is thought that one of the reasons for this may be the language barrier in communicating with health personnel.

In our study, a statistically significant relationship was determined between the reactions of mothers at the first encounter with their babies and their ethnic origin. Talking to their baby and questioning their baby’s well-being were less common in Syrian mothers. It can be thought that this finding is due to the language problem. It has been reported in many studies in the literature that one of the biggest barriers that refugees experience while receiving health care is the language problem (22-24). In a qualitative study conducted by Karakaya et al., by interviewing 50 Syrian women, It has been determined that the Syrians who came to Turkey have language problems and these people stated that they have difficulty in going to the hospital because they do not know the language (25). Kelaher and Manderson state that there are problems in the health services provided to women who immigrated to Australia due to language barriers and cultural differences (26). When women with language barrier want to benefit from health services, they cannot receive adequate health care for many reasons such as difficulties in expressing themselves, unaccountability, misunderstanding, and insecurity (27).

It was determined that almost all of the Syrian mothers in our study questioned gender as the first reaction as soon as the baby was born. It is reported that the vast majority of Syrian immigrants have difficulties in accessing health services during pregnancy. In a study conducted in Turkey, the rate of never going to the hospital during pregnancy for migrant Syrian women was 22%, and this ratio was reported to be 7 times more than Turkish women (28). In a study examining the prenatal care status of Syrian migrant women in Lebanon, it was determined that 17% of women did not receive any prenatal care (29). The gender of the baby can be shared with the parents in prenatal follow-up period.

It is thought that a response such as asking about the gender of baby at birth is due to the fact that the baby’s gender is not known during pregnancy in women with a low rate of receiving antenatal care.

Although there is a large literature about the mother-infant interaction in the early postpartum period, there are few studies examining the mother-infant behavior. In our study, it can be said that the reactions of the mothers in their first encounter with their babies were determined as reactions to the baby, emotional reactions, and reactions to themselves and their environment. Skin-to-skin contact should be ensured in the early postpartum period and the interaction between mother and baby should be initiated. Women’s access to prenatal care should be facilitated and midwives/nurses should be trained to increase the quality of care, and women should be supported physically and emotionally. In addition, it is recommended to conduct studies with larger sample groups examining mother-infant interaction and behaviors in the early postpartum period.

Conflict of Interest

The authors have no conflict of interest about the research, writing and publication of this article.

Ethics

•              Approval was obtained from Kocaeli University Non-Interventional Ethics Committee (GOKAEK-2020/3.23 2020/65)

•              Written permission was obtained from the chief physician of Kocaeli Darıca Farabi Training and Research Hospital and the responsible physician of the delivery unit.

•              Written informed consent was obtained from the women who agreed to participate in the study. It was stated that participation in the research was on a voluntary basis, the information of the research and its participants was kept confidential and the data obtained were not used for any purpose other than scientific study.

Author Contributions

Idea/Concept: Y.D., R.Ö.; Design: Y.D., R.Ö.; Supervision/Consulting: Y.D., R.Ö.; Analysis and/or Interpretation: Y.D., R.Ö.; Literature search: Y.D., R.Ö.; Writing the Article: Y.D , R.Ö.; Critical Review: Y.D , R.Ö.

Acknowledgement

We thank all mothers who agreed to participate in this study.

CC BY Licence

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

REFERENCES

  1. Olza I, Leahy-Warren P, Benyamini Y, et al. Women’s psychological experiences of physiological childbirth: a meta-synthesis. BMJ Open. 2018;8(10):e020347. doi:10.1136/bmjopen-2017-020347
  2. Mete S. Stres, The Relationship Between Hormones and Birth. Dokuz Eylül University School of Nursing Electronic Journal. 2013;6(2):93–98.
  3. Anık Y, Altuntuğ K. The Effect of Solution-Focused Approach to Primigravidas on Psychosocial Health, Fear of Birth and Postpartum Safety Feelings: Randomized Controlled Study Protocol. Journal of Current Nursing Research. 2021;1(2):80–95.
  4. Eşel E. Neurobiology of Motherhood. Turkish Journal of Psychiatry. 2010;b21(1):68–78.
  5. Brunton PJ, Russell JA. The Expectant Brain: Adapting for Motherhood. Nature Reviews Neuroscience. 2008;9(1):11–25.  doi: 10.1038/nrn2280
  6. Russell J, Douglas A, Ingram C. Brain Preparations for Maternity- Adaptive Changes in Behavioral and Neuroendocrine Systems During Pregnancy and Lactotion. An Overview. The Maternal Brain. 2001133, 1–38.
  7. Esin MN. Research Process Application and Criticism in Nursing. Nobel Medicine Publishing. 2014.
  8. Crenshaw JT. Healthy Birth Practice #6: Keep Mother and Baby Together— It’s Best for Mother, Baby, and Breastfeeding. The Journal of Perinatal Education. 2014;23(4):211–217.  doi: 10.1891/1058-1243.23.4.211
  9. Manav G, Yıldırım F. Perception of Mothers of Term and Preterm Babies about their Babies. Cumhuriyet Medical Journal. 2009;32, 149–157.  doi: 10.7197/cmj.v32i2.1008000180
  10. Mermer G, Bilge A, Yücel U, Çeber E. Examination of Social Support Perception Levels during Pregnancy and Postpartum Period. Journal of Psychiatric Nursing. 2010;1(2):71–76.
  11. Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016;11(11):CD003519. doi:10.1002/14651858.CD003519.pub4
  12. Trevathan WR. Maternal Touch at Ist Contact With the Newborn Infant. Developmental Psychobiology. 1981;14(6):549–558.  doi: 10.1002/dev.420140608
  13. Lucci TK, Defelipe RP, Andrade NC, David VF, Otta E. Early Mother-Infant Interaction After Delivery: A Naturalistic Study. Human Ethology. 2019;34(1):130–143.  doi: 10.22330/he/34/130-143
  14. Trevathan WR. Maternal Lateral Preference at First Contact with Her Newborn Infant. Birth, 1982;9(2):85–89.  doi: 10.1111/j.1523-536X.1982.tb01628.x
  15. Leckman JF, Feldman R, Swain JE, Eicher V, Thompson N, Mayes LC. Primary Parental Preoccupation: Circuits, Genes and the Crucial Role of the Environment. Journal of Neural Transmission. 2004;111, 753–771.  doi: 10.1007/s00702-003-0067-x
  16. Karahan N, Aydın R, Yılmaz GD, Benli AR, Kalkan NB. Traditional Health Practices Concerning Pregnancy, Bırth, and the Postpartum Period of Women Giving Birth in the Hospital. South. Clin. Ist. Euras. 2017;28(3):190-198.
  17. Aziato L, Odai PNA, Omenyo CN. Religious Beliefs and Practices in Pregnancy and Labour: An Inductive Qualitative Study Among Post-Partum Women in Ghana. BMC Pregnancy and Childbirth. 2016;16(1):1–10.  doi: 10.1186/s12884-016-0920-1
  18. Kaphle S, Hancock H, Newman LA. Childbirth Traditions and Cultural Perceptions of Safety in Nepal: Critical Spaces to Ensure the Survival of Mothers and Newborns in Remote Mountain Villages. Midwifery. 2013;29(10):1173–1181.  doi: 10.1016/j.midw.2013.06.002
  19. Hwang CP. Mother-infant InteractionEffects of Sex of Infant on Feeding Behaviour. Early Human Development. 1978;2(4):341–349.  doi: 10.1016/0378-3782(78)90061-0
  20. Korja R, Latva R, Lehtonen L. The Effects of Preterm Birth on Mother-Infant Interaction and Attachment During the Infant’s First Two Years. Acta Obstetricia et Gynecologica Scandinavica. 2012;91(2):164–173.  doi: 10. /j.1600-0412.2011.01304.x
  21. Coşar F, Demirci N. Effect of Birth Preparation Education Based on Lamaze Philosophy on Birth Perception and Birth Adaptation Process. SDU Journal of Health Sciences. 20123(1):18–30.  doi: 10.22312/sbed.95266
  22. Cantürk KF, Dağlı SS, Cantürk M. Evaluation of Perinatal Outcomes of Syrian Refugees in Kirsehir Province. Ahi Evran Medical Journal. 2017;1(3):6–11.
  23. McKeary M, Newbold B. Barriers to Care: The Challenges for Canadian Refugees and Their Health Care Providers. Journal of Refugee Studies. 2010;23(4):523–545.  doi: 10.1093/jrs/feq038
  24. Shah RR, Ray JG, Taback N, Meffe F, Glazier RH. Adverse Pregnancy Outcomes Among Foreign-Born Canadians. Journal of Obstetrics and Gynaecology Canada. 2011;33(3):207–215.  doi: 10.1016/S1701-2163(16)34821-6
  25. Karakaya E, Coşkun AM, Özerdoğan N, Yakıt E. Characteristics of Syrian Refugee Women and Affecting Factors: A Qualitative Study. International Journal of Social Research. 2017;10(48):417–428.
  26. Kelaher M, Manderson L. Migration and Mainstreaming: Matching Health Services to Immigrants’ Needs in Australia. Health Policy. 2000;54(1):1–11.  doi: 10.1016/S0168-8510(00)00098-1
  27. Çalım Sİ, Kavlak O, Sevil Ü. A Universal Problem: Migrant Women’s Health and the Language Barrier in Health Services. Health and Society. 2012;22(2):11–19.
  28. Şirin B, Ersoy S, Pala E. Comparison of Pregnancy and Birth Outcomes of Syrian Temporary Refugees and Citizens of the Republic of Turkey: 3. Case Control Study Conducted in a Primary Hospital. Smyrna Medical Journal. 2018;2:25–32.
  29. Benage M, Gregg Greenough P, Vinck P, Omeira N, Pham P. An Assessment of Antenatal Care Among Syrian Refugees in Lebanon. Conflict and Health. 2015;9(8): 1–11.  doi: 10.1186/s13031-015-0035-8

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