The relationship between maternal experiences of abuse and maternal sensitivity in early mother-infant interactions

Background: Sensitive parenting in early parent-child relationships predicts positive developmental outcomes for children. Maternal experiences of abuse may negatively impact on their ability to have sensitive interactions with their infant. Few studies have used observational measures of sensitivity, investigated maternal abuse across the lifespan, and included contextual explanatory variables such as socioeconomic status. This study aimed to address these gaps in the literature through a secondary data analysis of rich quantitative data from a diverse inner-London maternity service. Research question: Is there an association between maternal experiences of lifetime abuse and maternal sensitivity in early mother-infant interactions, and what happens to this association when key contextual factors (social support, maternal mental health, socioeconomic and demographic factors) are accounted for? Methods: 197 mother-infant dyads were recruited in early pregnancy at their antenatal booking appointment and followed up at 28-weeks gestation and 3-months postpartum as part of a cohort study. At baseline, detailed sociodemographic and mental health information was collected and history of childhood and lifetime abuse experiences. At 3-months postpartum, motherinfant interactions were filmed, and subsequently coded using the CARE-Index to measure maternal sensitivity. Results: There was insufficient evidence to support the primary hypothesis that maternal experiences of abuse would be associated with decreased sensitivity in interactions with their 3-month-old infants. Trauma symptoms, social support, ethnicity and socioeconomic factors predicted maternal sensitivity. Conclusion: Although abuse is unlikely to independently predict sensitivity, abuse is associated with socioeconomic disadvantage, poorer social support, trauma and mental health problems, all of which can impact on sensitive parenting. Interventions to support parent-infant relationships are important tools for tackling health inequalities and need to be trauma focused.