Intimate Partner Communication and Early Stimulation during Pregnancy in Northern Ghana

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Background: Global research on early childhood development is growing; however, there is still an evidence gap regarding how caregiver characteristics can affect a child’s development. Early childhood development begins at conception and family environment can influence the development of a child in utero. This study focused on the maternal-fetal relationship during pregnancy and how it is influenced by caregiver characteristics, specifically intimate partner communication. The aim of this study was to describe the maternal-fetal relationship through a series of bonding activities called early stimulation behaviors and to examine the relationship between early stimulation behaviors during pregnancy and intimate partner communication.

Methods: Study data are from a pre-intervention survey of a cluster randomized trial in two districts of Northern Ghana. A total of 376 pregnant women were enrolled at baseline with informed consent. Intimate partner communication was assessed using the Constructive Communication Subscale, derived from the Relationship Quality Index. Early stimulation behaviors were the primary outcome and was evaluated using four maternal-fetal bonding activities. A generalized linear mixed model with random effects was used for bivariate and multivariable analyses.

Results: Touching and talking was the most frequently performed early stimulation behavior by expectant mothers. Experiences of higher levels of intimate partner communication, physical intimate partner violence, and moderate to severe depression were positively correlated with an increase in stimulation behaviors performed by the expectant mother. Exploratory analysis showed that higher levels of emotional intimate partner violence and more frequently performed early stimulation behaviors had a positive association with intimate partner communication, while higher levels of Hope Score has a negative association. Development and evaluation of strategies to promote early stimulation behaviors during pregnancy are important for ensuring that all children research their developmental potential.






Mackness, Jessica (2020). Intimate Partner Communication and Early Stimulation during Pregnancy in Northern Ghana. Master's thesis, Duke University. Retrieved from


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