International Journal of Health Sciences & Research (www.ijhsr.org) 346 Vol.7; Issue: 4; April 2017 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Mothers’ Social Perceived Support, Anxiety and Prenatal Attachment to Child: Which Direct and Indirect Influences on Delivery Clinical Indices? Franca Tani 1 , Valeria Castagna 2 , Lucia Ponti 1 1 Department of Health Sciences, University of Florence, Via San Salvi, 12, Pad. 26 – 50135, Florence, Italy. 2 Maternal and Child Health, Obstetrics and Gynecology Unit, Local Health Unit 4 (USL 4) Prato, Piazza dell'Ospedale 5 - 59100 Prato; Corresponding Author: Franca Tani ABSTRACT This study investigates the reciprocal, direct and indirect influences that the social support mothers perceive during pregnancy, their states of anxiety, and prenatal attachment to the child have on the quality of the mother’s delivery experience. In particular, we tested a complex theoretical model hypothesizing that maternal social perceived support could influence clinical delivery indices, both directly and indirectly, through the mediate effects of a mother’s anxiety state and her prenatal attachment to her child. A longitudinal design at two different times was carried out on 167 nulliparous no risk pregnant women. The women completed the Maternal Social Support Questionnaire, Prenatal Attachment Inventory, and State-Trait Anxiety Inventory- Y during the third trimester of pregnancy. Then, the first day after childbirth, clinical data on delivery (duration of labor, administration of oxytocin and epidural analgesia) were collected. Structural Equation Modeling (SEM) was employed to investigate the theoretical hypothesized model, using robust procedures. SEM analyses showed that the tested model has a good fit to the data. Social support perceived by mothers during pregnancy plays an important role as a significant protection factor to reduce the negative clinical aspects of their childbirth experience, both directly and indirectly, through the promotion of maternal prenatal attachment to child, mediated by a reduction of the mother’s anxiety states connected to pregnancy and delivery experiences. Keywords: birth, social support, anxiety, prenatal attachment. INTRODUCTION The network of social relationships plays a significant role in shaping the quality of people’s lives, and numerous studies have shown that being loved and emotionally supported protects against physical illness and premature death. [1,2] In addition, good social relationships are found to improve mental health through their influence on reducing individual stress levels, depression, anxiety, and promoting psychological wellbeing. [3] In recent decades, the influence of social relationships on health status has become increasingly recognized within assistance procedures and epidemiological research in obstetric, nursing, and neonatal medicine. In particular, studies on pregnancy and neonatal health have verified that having supportive relationships may significantly enhance feelings of well-being and personal control, and have a positive effect on mothers: pregnant women who perceive high levels of social support feel