Self-objectification during the perinatal period: The role of body surveillance in maternal and infant wellbeing

Self-objectification during the perinatal period: The role of body surveillance in maternal and infant wellbeing | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Self-objectification during the perinatal period: The role of body surveillance in maternal and infant wellbeing Lauren M. Laifer, Olivia R. Maras, Gemma Sáez, Sarah J. Gervais, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2714781/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 02 May, 2023 Read the published version in Sex Roles → Version 1 posted You are reading this latest preprint version Abstract Pregnancy represents a unique time during which women’s bodies undergo significant physical changes (e.g., expanding belly, larger breasts, weight gain) that can elicit increased objectification. Experiences of objectification set the stage for women to view themselves as sexual objects (i.e., self-objectification) and is associated with adverse mental health outcomes. Although women may experience heightened self-objectification and behavioral consequences (such as body surveillance) due to the objectification of pregnant bodies in Western cultures, there are remarkably few studies examining objectification theory among women during the perinatal period. The present study investigated the impact of body surveillance, a consequence of self-objectification, on maternal mental health, mother-infant bonding, and infant socioemotional outcomes in a sample of 159 women navigating pregnancy and postpartum. Utilizing a serial mediation model, we found that mothers who endorsed higher levels of body surveillance during pregnancy reported more depressive symptoms and body dissatisfaction, which were associated with greater impairments in mother-infant bonding following childbirth and more infant socioemotional dysfunction at 1-year postpartum. Maternal prenatal depressive symptoms emerged as a unique mechanism through which body surveillance predicted bonding impairments and subsequent infant outcomes. Results highlight the critical need for early intervention efforts that not only target general depression, but also promote body functionality and acceptance over the Western “thin ideal” of attractiveness among expecting mothers. self-objectification pregnancy perinatal period objectification theory body surveillance body image depression mother-infant bonding infant socioemotional functioning Figures Figure 1 Figure 2 Introduction Self-objectification—seeing the self as a sexual object—has been recognized as an important contributor to women’s mental health since the phenomenon was formally introduced to the psychological literature in the form of objectification theory two and a half decades ago (Fredrickson & Roberts, 1997 ; Roberts et al., 2018 ). According to this framework, by living in a culture in which women are commonly reduced to their bodily appearance, women learn to view their bodies from a third person’s perspective (i.e., self-objectify, Fredrickson & Roberts, 1997 ) and often engage in persistent body surveillance (McKinley & Hyde, 1996 ). Further, many women feel pressure to fit cultural ideals of attractiveness and may experience body shame and dissatisfaction if their bodies do not align with these often-unattainable standards (McKinley & Hyde, 1996 ; Tiggemann & Lynch, 2001 ). Self-objectification and its behavioral consequences, such as body surveillance, set the stage for adverse mental health outcomes that disproportionately affect women (e.g., anxiety, depression, eating disorders; Fitzsimmons-Craft & Bardone-Cone, 2012 ; Jones & Griffiths, 2015 ; Roberts et al., 2018 ; Rubin & Steinberg, 2011 ; Sun, 2018 ) and can interfere with parenting and child wellbeing (Chapman et al., 2021 ; Deave et al., 2008 ; Galbally & Lewis, 2017 ; Herba et al., 2016 ). The current study presents a novel conceptual framework in which self-objectification, as manifested by persistent body surveillance, is significantly linked to maternal mental health during pregnancy (i.e., body dissatisfaction, depression) and undermines infant socioemotional functioning through impaired mother-infant bonding following childbirth. Objectification Theory And The Consequences Of Self-objectification Objectification theory posits that “ women are most targeted for objectification during their years of reproductive potential ” (Fredrickson & Roberts, 1997 , p. 192). Indeed, objectification (reduction to appearance and sexual body parts; loss of autonomy; denial of subjectivity) is heightened during key stages in which girls and women undergo physical changes (e.g., puberty), and it may also be heightened during pregnancy. Specifically, pregnant bodies become “public property,” with people looking at, commenting on, and even touching the bodies of pregnant women (Kukla, 2005 ). Further, women may experience increased body surveillance and related body dissatisfaction across pregnancy and postpartum as their bodies become more removed from a potentially internalized “thin ideal” of attractiveness. These bodily changes may also be connected to other facets of self-objectification (Talmon & Ginzburg, 2016 ), such as feeling like their autonomy and freedoms are restricted (Sutton et al., 2011 ). Women may feel like their pregnant bodies have become hyper-visible, while other aspects of their personhood have been rendered invisible. Indeed, a systematic review of research on self-objectification and motherhood by Beech and colleagues ( 2020 ) revealed that self-objectification among mothers is associated with a range of negative outcomes, such as difficulties breastfeeding, fear of childbirth, depression, and disordered eating. Despite these possibilities, remarkably few studies have examined whether the tenets of objectification theory apply to the perinatal period (Beech et al., 2020 ; Brock et al., 2021 ; Rubin & Steinberg, 2011 ). Because of the significant changes that women’s bodies undergo during pregnancy and postpartum (e.g., expanding belly, larger breasts, weight gain), the present investigation focused on body surveillance (see Talmon & Ginzburg, 2016 , for other important facets of self-objectification). We posit that bodily changes during pregnancy and concomitant increases in objectification from others may cause women to engage in more persistent body surveillance and experience associated mental health problems (e.g., body dissatisfaction, depression). These decrements in mental health may, in turn, undermine the quality of mother-infant interactions (see McNamara et al., 2019 for a review). Increasingly, researchers have examined whether markers of self-objectification among mothers, such as body surveillance, and associated mental health consequences spill over into parenting and child development. Although much of this research has focused on women with adolescent children (e.g., Arroyo & Andersen, 2016 ; Katz-Wise et al., 2013 ), research also provides evidence for the intergenerational transmission of body dissatisfaction and disordered eating behaviors in younger children (Rodgers et al., 2013 ; Spiel et al., 2012 ). For example, maternal body dissatisfaction is prospectively associated with lower child body esteem in middle childhood (Rodgers et al., 2020 ). Maternal body dissatisfaction has also been linked to the use of more controlling feeding practices (e.g., food restriction, pressure to eat) with preschool-age children (Blissett & Haycraft, 2011 ; Duke et al., 2004 ; Rodgers et al., 2013 ; Webb & Haycraft, 2019 ), which may interfere with children’s regulatory capacities by teaching them to view eating as a primary strategy for emotion regulation (Farrow et al., 2015 ). Despite growing evidence that body surveillance in mothers and associated mental health consequences (e.g., depression, body dissatisfaction) may negatively impact children, comparatively less is known about the impact of body surveillance on infant socioemotional functioning. Thus, we extend these considerations to examine whether body surveillance impacts not only maternal mental health, but also infants by undermining mother-infant bonding following childbirth. We posit that increased body surveillance, resulting from a culture that persistently objectifies women’s bodies, is linked to maternal mental health concerns and the likelihood that mothers experience difficulties bonding with their infants. Body Surveillance and Body Dissatisfaction During Pregnancy Research on body dissatisfaction during pregnancy has demonstrated mixed findings (Coker & Abraham, 2015 ; Fuller-Tyszkiewicz et al., 2020 ; Loth et al., 2011 ; Skouteris et al., 2005 ). Presumably, there are important individual differences in how women experience their body transformation across pregnancy. Some women may embrace this transformation and become more appreciative of what their bodies are physically capable of – nurturing and supporting a developing fetus (Rubin & Steinberg, 2011 ). This appreciation of body functionality, in turn, may buffer against distress related to the rapid physical changes that occur across pregnancy and postpartum (Clark et al., 2009 ). Alternatively, some pregnant women might be more susceptible to societal pressures around their bodies and continue to hold their bodies to unrealistic beauty standards, focusing more on body image than functionality (Johnson et al., 2004 ). For instance, some mothers may aspire to gain minimal gestational weight and to return to their pre-pregnancy figure, or “bounce back,” quickly after childbirth (Watson et al., 2015 ). Perceived sociocultural pressure to remain thin is associated with maternal distress and body dissatisfaction during pregnancy and the postpartum (Dryer et al., 2020 ; Fuller-Tyszkiewicz et al., 2013 ; Kamysheva et al., 2008 ; Lovering et al., 2018 ). Further, gaining less than the recommended amount of weight during pregnancy is associated with higher risk of preterm birth and low birthweight (Han et al., 2011 ), which predict self-regulatory difficulties as early as infancy (Arpi & Ferrari, 2013 ). Body Surveillance and Depression During Pregnancy Body surveillance is associated with higher levels of depressive symptoms during the perinatal period (Rodgers et al., 2018 ; Rubin & Steinberg, 2011 ). These associations are alarming given that pregnant women are already at increased risk for depression during the perinatal period, with one in five women endorsing depressive symptoms across pregnancy and postpartum (Underwood et al., 2016 ; Woolhouse et al., 2015 ). In the United States, over half of women with perinatal depression go undetected, undiagnosed, and untreated for this condition (Cox et al., 2016 ). This represents a significant public health burden given that antenatal depression contributes to the proliferation of a range of mental health concerns in both parents and children (Hentges et al., 2019 ; Waters et al., 2014 ). Maternal Mental Health And Infant Development Maternal psychopathology during pregnancy, particularly depression, is a robust predictor of poor child outcomes, including increased risk for child psychopathology (Barker et al., 2011 ; Goodman et al., 2011 ; Goodman & Gotlib, 1999 ; Szekely et al., 2021 ). Indeed, perinatal depression predicts socioemotional difficulties (e.g., crying for long periods of time) as early as infancy (Field, 2017 ; Porter et al., 2019 ). Mother-infant bonding (i.e., the emotional tie between mother and infant; Bicking Kinsey & Hupcey, 2013 ), is a salient mechanism through which depression can undermine child functioning (Lefkovics et al., 2014 ; Slomian et al., 2019 ). In particular, bonding during the first 6 months postpartum is critical to infant socioemotional development, as infants largely depend on their caregivers to regulate their emotions (Rosenblum et al., 2009 ), and early mother-infant bonding impairments predict infant socioemotional difficulties as early as 6-months postpartum (Ramsdell & Brock, 2021 ). Women who report higher levels of depression during and after pregnancy tend to demonstrate greater impairments in mother-infant bonding (Moehler et al., 2006 ; Nonnenmacher et al., 2016 ; O’Higgins et al., 2013 ), and research suggests that negative cognitions associated with perinatal depression may undermine maternal motivation to bond with the infant following childbirth (Muzik & Borovska, 2011 ). Although maternal depression is a robust predictor of bonding impairments and associated infant maladjustment, researchers also posit that body dissatisfaction during pregnancy impacts mothers’ developing bonds with their infants and, subsequently, child socioemotional functioning (Bergmeier et al., 2020 ). Indeed, the physical changes that occur over the course of pregnancy–and how these changes are perceived and experienced–represent one of the first ways in which mothers interact with their babies. Women who embrace the bodily changes associated with pregnancy may be more likely to engage emotionally with their babies prior to childbirth, whereas women who feel negatively about these changes and experience greater body dissatisfaction may face more bonding difficulties (Kirk & Preston, 2019 ). Further, some women may experience a loss of agency and control over their own bodies during pregnancy (Kinloch & Jaworska, 2021 ). This perceived loss of control, which is associated with maternal distress (Hodgkinson et al., 2014 ), might also interfere with antenatal attachment. The Present Study Objectification theory would suggest that women may be at heightened risk for self-objectification during pregnancy, which can compromise their mental health, and past research suggests a robust link between maternal mental health and bonding difficulties. Taken together, this work suggests that elevations in self-objectification and its correlates (e.g., body surveillance, body dissatisfaction, depression) during pregnancy might ultimately undermine healthy infant socioemotional development. Building on recent work applying objectification theory to motherhood (e.g., Beech et al., 2020 ), we present a novel conceptual framework (see Fig. 1 ) in which mothers who report greater body surveillance during pregnancy–a marker of self-objectification–experience higher levels of prenatal depressive symptoms and body dissatisfaction that, in turn, uniquely predict greater mother-infant bonding impairments following childbirth, thereby undermining infant socioemotional functioning at age 1. An integration of research and theory in the areas of objectification and maternal-infant health has the potential to impact both maternal and infant wellbeing by identifying largely overlooked intervention targets during pregnancy (i.e., body surveillance and body dissatisfaction) that arise as a consequence of living in a culture of persistent objectification. Method Participants and Procedures The present study is part of a multi-method, longitudinal study examining how couples navigate the transition from pregnancy to postpartum; thus, participants also completed other procedures beyond the scope of the present study. All participants identified as cisgender upon study entry. Most women were in the second (38.4%) or third (58.5%) trimester of pregnancy. On average, there was one child living at home during pregnancy ( SD = 1.18); more than half of women (57.9%) had no children and were experiencing the transition into parenthood for the first time. The majority of women were married (84.9%). Annual household income ranged from less than $9,999 to more than $90,000, with a median household income of $60,000 to $69,999. Nearly half (47.8%) reported earning $50,000 to 59,999 or less which converges with federal guidelines for defining low-income status (Roberts et al., 2012 ). Reflecting the Midwestern region where the study was conducted, women were primarily White (89.3%), and 9.4% identified as Hispanic or Latina. On average, women were 28.67 years of age ( SD = 4.27), and most women were employed at least 16 hours per week (74.2%). Modal education was a bachelor’s degree (46.5%). During follow-up assessments, it was determined that one infant was diagnosed with trisomy 21, and one mother experienced a miscarriage. As such, those families were excluded from analyses to focus on women with typically developing infants (50% male) for a final sample of 157 perinatal women. There were four waves of data collection spanning February 2016 to April 2019. To address the aims of the present study, we assessed body surveillance, body dissatisfaction, and depressive symptoms using self-report questionnaires administered to mothers during the appointment. We assessed mother-infant bonding at 1-month postpartum ( M = 1.12 months, SD = 0.29) and 6-months postpartum ( M = 6.32 months, SD = 0.36) using a self-report questionnaire. Additionally, when the infant turned 1year of age ( M = 12.80 months, SD = 0.76), both parents reported on infant socioemotional dysfunction. All procedures were approved by the University of Nebraska-Lincoln Institutional Review Board. Measures During Pregnancy Body Surveillance. The Body Surveillance subscale of the Objectified Body Consciousness Scale (OBCS, (McKinley & Hyde, 1996 ) was used to assess body surveillance, an important manifestation of self-objectification. During pregnancy, mothers rated the degree to which they persistently monitored their bodily appearance on a scale from one ( strongly disagree ) to six ( strongly agree ), with a not applicable option (coded as missing) for items that did not apply. The Body Surveillance subscale contains 8 items, including “During the day, I think about how I look many times” and “I rarely worry about how I look to other people” (reverse coded). Items were averaged with higher scores indicating more body surveillance (Cronbach’s α = .85). Depression . Maternal depressive symptoms were assessed using the General Depression subscale of the Inventory of Depression and Anxiety Symptoms (IDAS-II; Watson et al., 2012 ). The IDAS-II is a 99-item self-report questionnaire designed to assess general and specific symptom dimensions of depression and related anxiety disorders. Participants rated their feelings and experiences during the past two weeks on a scale from 1 ( not at all ) to 5 ( extremely ). The general depression subscale consists of 20 items (e.g., “I felt inadequate,” “I felt discouraged about things”), with possible scores ranging from 20 to 100 (Cronbach’s α = 0.84). Body Dissatisfaction. The Eating Pathology Symptoms Inventory (EPSI; Forbush et al., 2013 , 2014 ) was used to assess body dissatisfaction reported by mothers during pregnancy. The EPSI is a factor analytically derived scale of eating disorder (ED) symptoms. The Body Dissatisfaction subscale consists of 7 items (e.g., “I did not like how clothes fit the shape of my body,” “I wished the shape of my body was different”) and captures the higher-order, shared dimension among ED symptoms. Participants rated how frequently each statement applied to them during the past month on a scale from 0 ( never ) to 4 ( very often ). Items responses were summed, with possible scores ranging from 0 to 28 (Cronbach’s α = 0.88). Measures At 1- And 6-months Postpartum Impaired Mother-Infant Bonding. Postpartum mother-infant bonding was assessed using the Postpartum Bonding Questionnaire (PBQ; Brockington et al. 2001 ). The PBQ is a 25-item, factor-analytically derived, parent-report measure of a parent’s feelings or attitudes toward their baby. The PBQ assesses impaired bonding, rejection and anger, anxiety about care, and risk of abuse, represented as four subscales that can be summed for a total score. Participants rated their agreement with a series of statements on a 6-point Likert scale. Positive responses (e.g., “I feel close to my baby”) were scored from 0 ( always ) to 5 ( never ), while negative responses (e.g., “My baby irritates me”) were scored from 0 ( never ) to 5 ( always ). Items were summed to generate a total score, with low scores denoting good bonding and high scores indicating impaired bonding. Scores at 1- and 6-months postpartum were internally consistent (Cronbach’s α = 0.88 at 1 month and Cronbach’s α = 0.86 at 6 months). Scores at each time point were highly correlated ( r = .76, p < .001) and were thus aggregated to provide a robust measure of mother-infant impaired bonding during the first 6 months postpartum. Measures At 1-year Postpartum Infant Socioemotional Dysfunction. The Ages and Stages Questionnaire: Social-Emotional, Second Edition (ASQ:SE-2; (Squires et al., 2015 ) was used to assess socioemotional dysfunction when the infant turned one year of age. Participants reported how frequently their infant had engaged in a series of behaviors (e.g., “Smiles at you and family members?”, “Cries for long periods of time?”) using the following scale: often or always (score = 1), sometimes (score = 5), and rarely or never (score = 10). They were also asked to indicate if this is a concern (score = 5). Items were aggregated to obtain an overall score ranging from 0 to 345 (reverse coding items that represent competencies), with higher scores indicating greater infant socioemotional dysfunction. The correlation between maternal and paternal reports was significant ( r = .33, p < .001). Therefore, scores were aggregated to obtain a score of infant socioemotional dysfunction based on multiple parental reports to produce a less biased and more reliable estimate (Lengua et al., 2008 ). The ASQ:SE-2 has demonstrated good reliability and validity, and there was adequate internal consistency in the present sample (Cronbach’s α = . 71). Data Analytic Plan We tested a series of mediation models in Mplus 8.0. (Muthén & Muthén, 2010 ). Missing data were addressed with full information maximum likelihood estimation (covariance coverage ranged from .74 to 1.00), which retains all participants and is preferred over more traditional approaches for handling missing data that introduce bias (e.g., pairwise deletion; Enders, 2010 ). A series of demographic characteristics (e.g., maternal age, relationship duration, first-time parenthood status, minority racial/ethnic identity, and low-income status) were screened for potential inclusion as control variables. First-time parenthood status was associated with mother-infant bonding and was therefore included as a control. We also controlled for week of pregnancy when the initial assessment occurred to account for differing time intervals between the pregnancy and follow-up assessments across participants. Mediation models were just-identified. To test for mediation, a nonparametric resampling method (bias-corrected bootstrap) with 10,000 resamples was performed to derive the 95% confidence intervals for indirect effects (Preacher et al., 2007 ). Bias-corrected bootstrapped confidence intervals were used to determine significance of effects given they are robust to violations of univariate and multivariate normality. Data management and analysis procedures for this project were registered ( https://osf.io/hprk8 ), and we made no deviations from that plan. Because we had prior knowledge of data from this longitudinal study, we did not preregister study hypotheses. Results Descriptive statistics and correlations are reported in Table 1 . As expected for a community sample, levels of body surveillance, general depression, and body dissatisfaction in mothers during pregnancy were relatively low, as were impairments in bonding during the first 6 months postpartum and infant socioemotional dysfunction at 1-year postpartum. There was a large correlation between body surveillance and body dissatisfaction during pregnancy ( r = .54, p < .001), as well as a moderate correlation between body surveillance and general depression ( r = .30, p < .001). Body surveillance in mothers was significantly correlated with impaired bonding during the first 6 months postpartum ( r = .16, p < .05). There was a moderate correlation between general depression and body dissatisfaction during pregnancy ( r = .34, p < .001). Small but significant correlations between general depression and impaired bonding ( r = .26, p < .001) and between body dissatisfaction and impaired bonding ( r = .23, p < .01) emerged. Last, impaired bonding was associated with greater infant socioemotional difficulties ( r = .21, p < .01). Table 1 Descriptive Statistics and Correlations 1 2 3 4 5 1. Body Surveillance 1.00 2. General Depression 0.30 *** 1.00 3. Body Dissatisfaction 0.54 *** 0.34 *** 1.00 4. Impaired Bonding 0.16 * 0.26 *** 0.23 ** 1.00 5. Infant Socioemotional Dysfunction 0.10 0.13 0.09 0.21 ** 1.00 Mean 3.67 37.90 9.34 8.75 29.41 SD 0.97 8.54 5.91 7.06 15.07 N 156 157 157 142 121 Note. Significant correlations are bolded. * p < .05. ** p < .01. *** p < .001. Mediation Model With General Depression As Critical Mediator First, we tested a serial mediation model with body surveillance → general depression → impaired mother-infant bonding → infant socioemotional dysfunction. Full model results are reported in Table 2 and Fig. 2 a. Greater body surveillance was associated with greater general depression during pregnancy, 95% CI [1.29, 4.12]. Further, greater maternal depression predicted higher levels of impaired mother-infant bonding over the first 6 months postpartum, 95% CI [.05, .32]. In turn, bonding difficulties predicted greater socioemotional dysfunction for infants at 1 year of age, 95% CI [.04, .77]. The overall indirect effect of body surveillance on infant socioemotional dysfunction through maternal general depression and impaired mother-infant bonding was significant, 95% CI [.04, .59]. Table 2 Path Analyses Examining the Impact of Body Surveillance, General Depression, and Body Dissatisfaction During Pregnancy on Infant Socioemotional Dysfunction via Impaired Bonding Unstandardized Estimate 95% CI a Standardized Estimate Model 1: General depression Outcome : Infant socioemotional dysfunction (ASQ), R 2 = 0.06 Impaired bonding (BOND) 0.40 [.04, .77] 0.19 General depression (DEP) 0.11 [-.24, .43] 0.06 Body surveillance (OBJ) 0.87 [-2.34, 3.87] 0.06 Outcome : Impaired bonding (BOND), R 2 = 0.11 General depression (DEP) 0.18 [.05, .32] 0.22 Body surveillance (OBJ) 0.80 [-.35, 2.00] 0.11 Outcome : General depression (DEP), R 2 = 0.11 Body surveillance (OBJ) 2.70 [1.29, 4.12] 0.31 Indirect effects OBJ → DEP → ASQ 0.30 [-.64, 1.26] OBJ → BOND → ASQ 0.32 [-.07, 1.09] OBJ → DEP → BOND → ASQ 0.19 [.04, .59] Model 2: Body dissatisfaction Outcome : Infant socioemotional dysfunction (ASQ), R 2 = 0.05 Impaired bonding (BOND) 0.42 [.08, .79] 0.20 Body dissatisfaction (BODY) 0.06 [-.51, .65] 0.03 Body surveillance (OBJ) 0.76 [-3.08, 4.16] 0.05 Outcome : Impaired bonding (BOND), R 2 = 0.10 Body dissatisfaction (BODY) 0.24 [.01, .48] 0.20 Body surveillance (OBJ) 0.47 [-.81, 1.82] 0.06 Outcome : Body dissatisfaction (BODY), R 2 = 0.30 Body surveillance (OBJ) 3.30 [2.45, 4.15] 0.54 Indirect effects OBJ → BODY → ASQ 0.21 [-1.69, 2.24] OBJ → BOND → ASQ 0.20 [-.29, 1.02] OBJ → BODY → BOND → ASQ 0.34 [.03, 1.00] Model 3: Integrated model Outcome : Infant socioemotional dysfunction (ASQ), R 2 = 0.05 Impaired bonding (BOND) 0.40 [.04, .76] 0.19 General depression (DEP) 0.12 [-.25, .46] 0.07 Body dissatisfaction (BODY) 0.02 [-.62, .64] 0.01 Body surveillance (OBJ) 0.65 [-3.28, 3.97] 0.04 Outcome : Impaired bonding (BOND), R 2 = 0.13 General depression (DEP) 0.15 [.02, .30] 0.18 Body dissatisfaction (BODY) 0.18 [-.07, .42] 0.15 Body surveillance (OBJ) 0.30 [-.97, 1.67] 0.04 Outcome : General depression (DEP), R 2 = 0.11 Body surveillance (OBJ) 2.68 [1.26, 4.11] 0.31 Outcome : Body dissatisfaction (BODY), R 2 = 0.30 Body surveillance (OBJ) 3.30 [2.44, 4.15] 0.54 Indirect effects OBJ → DEP → ASQ 0.31 [-.68, 1.33] OBJ → BODY → ASQ 0.05 [-2.01, 2.16] OBJ → BOND → ASQ 0.12 [-.37, .89] OBJ → DEP → BOND → ASQ 0.16 [.03, .55] OBJ → BODY → BOND → ASQ 0.24 [-.03, .83] Note. Significant parameters are bolded. a 95% confidence intervals based on 10,000 bootstrapped samples. Mediation Model With Body Dissatisfaction As Critical Mediator Next, we tested a serial mediation model with body surveillance → body dissatisfaction → impaired mother-infant bonding → infant socioemotional dysfunction. Full model results are reported in Table 2 and Fig. 2 b. Greater body surveillance was associated with greater body dissatisfaction during pregnancy, 95% CI [2.45, 4.15]. Further, greater body dissatisfaction predicted higher levels of impaired mother-infant bonding over the first 6 months postpartum, 95% CI [.01, .48]. In turn, bonding difficulties predicted greater socioemotional dysfunction for infants at 1 year of age, 95% CI [.08, .79]. The overall indirect effect of body surveillance on infant socioemotional dysfunction through maternal body dissatisfaction and impaired mother-infant bonding was significant, 95% CI [.03, 1.00]. Integrated Model With Depression And Body Dissatisfaction As Parallel Mediators Finally, we tested an integrated model with general depression and body dissatisfaction as parallel mediators in a larger serial mediation model. We covaried the residuals of general depression and body dissatisfaction as they are both dimensions of maternal mental health. Full model results are reported in Table 2 and Fig. 2 c. Greater body surveillance was associated with greater maternal depression, 95% CI [1.26, 4.11], and body dissatisfaction during pregnancy, 95% CI [2.44, 4.15]. Further, greater maternal depression associated with body surveillance predicted higher levels of impaired mother-infant bonding over the first 6 months postpartum, controlling for body dissatisfaction, 95% CI [.02, .30]. In turn, bonding difficulties predicted socioemotional dysfunction for infants at 1 year of age, 95% CI [.04, .76]. The overall indirect effect of body surveillance on infant socioemotional dysfunction at 1-year postpartum through maternal general depression and impaired mother-infant bonding was significant, 95% CI [.03, .55]. Notably, when controlling for depression, body dissatisfaction was no longer a significant mechanism through which body surveillance impacted mother-infant bonding and infant socioemotional dysfunction. Discussion Living in a culture of persistent objectification, women may self-objectify and experience societal pressure to modify their bodies to achieve the thin ideal. During pregnancy, a period in which the body undergoes rapid changes to support fetal development, women who have internalized these messages and engage in more body surveillance may be at increased risk for negative mental health consequences, including body dissatisfaction and depression (Beech et al., 2020 ; Brock et al., 2021 ; Rubin & Steinberg, 2011 ). Maternal mental health, in turn, can undermine the mother-infant relationship and infant socioemotional functioning (McNamara et al., 2019 ; Slomian et al., 2019 ). By integrating research and theory in the areas of objectification and maternal-infant health, we found support for a novel conceptual framework in which self-objectification during pregnancy, as manifested by body surveillance, contributes to impaired mother-infant bonding and infant socioemotional functioning at 1-year postpartum through maternal mental health difficulties during pregnancy (i.e., body dissatisfaction and depression). Specifically, we found that mothers who endorsed higher levels of body surveillance also reported higher levels of depressive symptoms and body dissatisfaction during pregnancy. In turn, depressive symptoms and body dissatisfaction were associated with greater mother-infant bonding impairments during the 6 months following childbirth, which contributed to subsequent infant socioemotional dysfunction at 1-year postpartum (i.e., difficulties self-soothing, feeding, and sleeping). When examining maternal depressive symptoms and body dissatisfaction during pregnancy as parallel mechanisms, results suggested that maternal depressive symptoms uniquely contribute to bonding impairments and subsequent maladjustment. Thus, maternal prenatal depression, which was moderately correlated with body dissatisfaction, might be a particularly salient pathway through which body surveillance undermines bonding and infant development. A potential explanation for this finding is that body dissatisfaction during pregnancy could be a prodromal symptom of an underlying mood disorder (Chan et al., 2020 ; Roomruangwong et al., 2017 ) or a risk factor for elevations in prenatal depression (Riquin et al., 2019 ). Indeed, a recent study found that risk of perinatal depression was four times higher in women dissatisfied with their body image (Riquin et al., 2019 ). Ultimately, results from the present study suggest that persistent depressed mood might be more detrimental to mother-infant bonding (e.g., by undermining maternal motivation and leading to disengagement) than unique aspects of body dissatisfaction. Nonetheless, given that it might contribute to risk for depression, body dissatisfaction remains an important target for investigations of prenatal mental health, particularly in perinatal research pursued within an objectification framework. Theoretical Implications The present work makes several theoretical contributions to the literature on objectification. First, while pregnancy is a time when women may experience greater objectification and related consequences due to bodily changes, only a handful of studies (e.g., Rubin & Steinberg, 2011 ; Brock et al., 2021 ) have examined body surveillance, body dissatisfaction, and depression during this period. Thus, this study adds to limited research demonstrating that objectification theory, as originally posited by Fredrickson and Roberts ( 1997 ) and expanded over the years (Roberts et al., 2018 ) also applies to pregnant women. Second, to our knowledge, the present study is the first research to link body surveillance to the early mother-infant relationship and infant socioemotional functioning via prenatal depression and body dissatisfaction. While extant research has revealed an association between body surveillance and related mental health outcomes among mothers and children, no research to date has linked these variables during infancy. Further, results isolate a key developmental cascade in which maternal mental health during pregnancy, prior to the birth of the child , predicts early parenting behaviors and infant socioemotional functioning. Researchers increasingly recognize the pregnancy-postpartum transition as a critical window for intervention and assert that this “may be the most important way to ensure healthy child development” (Saxbe et al., 2018 ). Thus, prenatal maternal mental health represents a critical target for reducing risk for infant socioemotional difficulties, and results of the present study identify features of maternal mental health that have received limited attention in past research (i.e., body surveillance and body dissatisfaction) yet appear to have important implications for infant development. Limitations And Future Research Directions It is important to acknowledge that the sample was comprised of women in committed relationships with men; participants also primarily identified as White and were from middle-class backgrounds, thereby limiting the generalizability of the results. There is a need for research examining objectification theory among more diverse populations (e.g., among sexual, gender, and racial minorities). For example, people of color, as well as sexual and gender minorities, experience unique forms of objectification, such as racialized sexual objectification and body policing (Flores et al., 2018 ). These additional forms of objectification may place pregnant people at even greater risk for self-objectification and related adverse mental health outcomes. There is also increasing recognition that researchers and clinicians alike must broaden their conceptualizations of pregnancy to include the experiences of not only cisgender women, but also transgender and nonbinary individuals (Moseson et al., 2020 ; Roosevelt et al., 2021 ). There were also limitations to our measurement approach. First, while the present work examined body surveillance as a manifestation of self-objectification and downstream consequences identified by objectification theory (e.g., body dissatisfaction, depression, Roberts et al., 2018 ) as well as novel consequences (e.g., infant outcomes), some aspects of the objectification model remain untested in pregnant women. We did not measure specific types of objectification that pregnant women may experience, such as objectification directed at their size and shape (e.g., because their bodies no longer conform to feminine ideals of thinness) or involving denial of autonomy and subjectivity (e.g., because their bodies become public property). Relatedly, we only included one indicator of self-objectification. Thus, future research should examine how other indicators of self-objectification, such as internalized objectifying views (Noll & Fredrickson, 1998) and beliefs (Lindner et al., 2017), as well as non-bodily indicators of self-objectification (e.g., feeling invisible or lacking autonomy; Talmon & Ginzburg, 2016 ), might impact infant socioemotional functioning. To conduct this important work, measures that specifically assess objectification and self-objectification in pregnant women will need to be developed and validated. Second, our measure of body dissatisfaction was not specifically designed for pregnancy and therefore may not capture specific appearance-related concerns associated with pregnancy (e.g., stretch marks, having a prototypical “baby bump”). Future research should consider newly developed measures, such as the Body Understanding Measure for Pregnancy Scale (BUMPs; Kirk & Preston, 2019 ) or the Body Experience during Pregnancy Scale (BEPS; Talmon & Ginzburg, 2018 ), that measure other facets of the body experience during pregnancy (e.g., body agency, estrangement, and visibility; satisfaction with appearing pregnant; weight gain concerns; physical burdens of pregnancy). Third, all data were collected using self-report questionnaires, raising the possibility of shared method bias. Although most objectification research has relied on self-report measures, there is increasing evidence that innovative approaches, such as eye tracking technology, can be utilized to assess the objectifying gaze, which may contribute to self-objectification (Gervais et al., 2013 ; Karsay et al., 2018 ). Fourth, measures of body surveillance, body dissatisfaction, and depression were gathered at the same time point. Although objectification theory posits that body surveillance contributes to subsequent body dissatisfaction and depression (Fredrickson & Roberts, 1997 ), it is also possible that maternal depression contributes to increased body surveillance. Thus, future studies examining these constructs at different time points across pregnancy are necessary to establish causality. Finally, other factors of potential relevance to the study aims warrant attention in future research. For example, we did not examine the impact of objective measures of weight, such as pre-pregnancy and pregnancy body-mass index (BMI) and gestational weight gain, on body surveillance, general depression, and body dissatisfaction during pregnancy. Research on this topic is particularly important given that pregnant people with higher BMI are more likely to experience weight stigma (Mulherin et al., 2013 ; Parker & Pausé, 2018 ), which has the potential to exacerbate maternal prenatal mental health concerns and, in turn, infant outcomes. In addition, given that pregnancy and childbirth experiences may contribute to bonding impairments (e.g., Hanko et al., 2020 ; Sockol et al., 2014 ), research examining whether perinatal complications moderate the associations between prenatal body surveillance, body dissatisfaction, depression, and mother-infant bonding during the postpartum is warranted. Practice Implications The present study sheds light on the importance of early interventions targeting not only maternal prenatal depression, but also body surveillance and dissatisfaction, to promote healthy infant development. Because body surveillance is a consequence of living in a culture that persistently objectifies women’s bodies, prevention efforts must begin at the societal level, long before people become pregnant. For instance, media campaigns can raise awareness of the insidious nature of valuing the appearance of girls and women over their other attributes and can help change perceptions of beauty by promoting body positivity and acceptance (e.g., #AerieReal and Dove’s Real Beauty campaign). Specific efforts to target objectification during pregnancy and the postpartum period are also warranted, such as campaigns promoting real images of mothers and their infants. For example, Mothercare’s #BodyProudMums is aimed at normalizing and celebrating the diversity and beauty of post-baby bodies. Broader dissemination of campaigns of this nature has the potential to promote maternal well-being. Finally, emerging evidence suggests that social media can be leveraged for the delivery of brief interventions to improve maternal body image and wellbeing (Wallis et al., 2021 ). Unfortunately, societal change is slow, and objectification continues to manifest in ways that justify the patriarchy despite collective advances (Roberts et al., 2018 ). Therefore, beyond broad prevention efforts, there is also a need for targeted interventions informed by careful screening. Providers who interact regularly with pregnant women (e.g., obstetricians, nurses, midwives) could screen for elevations in body surveillance and associated body dissatisfaction and, when indicated, deliver brief interventions to disrupt self-objectification by promoting embodiment, which emphasizes positive self-talk, body functionality and agency, and experiencing the body from a subjective position rather than viewing themselves as sexual objects (Piran, 2017 ). It is critical that providers avoid protective paternalism and benevolent sexism discourses (e.g., restricting women’s behaviors during pregnancy to protect the fetus; Sutton et al., 2011 ). Instead, providers should counteract societal objectification and related self-objectification in ways that normalize the experience of body surveillance and body dissatisfaction during pregnancy and empower expectant mothers to prioritize their own mental health. Indeed, research suggests that pregnant women may be especially motivated to make behavioral changes that promote maternal and infant health (Ayyala et al., 2020 ); thus, pregnancy may be a promising developmental window for the delivery of interventions targeting self-objectification, body surveillance, and the cascade of negative mental health outcomes. Additionally, despite the prevalence and underdiagnosis of perinatal depression (Cox et al., 2016 ; Underwood et al., 2016 ), there continues to be a critical need for universal screening and multidisciplinary approaches to maternal mental health care from a range of providers (e.g., obstetrics and gynecology, family medicine, and pediatric care providers; Muzik & Borovska, 2011 ) assessing multiple indicators of risk. For example, results highlight the utility of screening for body surveillance and dissatisfaction as an early manifestation of depressive symptoms, which can be done briefly and as part of routine prenatal care (Riquin et al., 2019 ; Stunkard et al., 1983 ). Further, perinatal depression screening can be effectively implemented by health and social service professionals with limited background in mental health (Segre et al., 2011 ). Professionals who come in regular contact with pregnant women (e.g., physicians, social workers, nurses) but do not have formal training in the assessment of depression could facilitate discussions of how women are relating to their bodies as they change throughout pregnancy and the postpartum. This approach has the potential to identify women who would benefit from intervention but might otherwise be overlooked by current screening practices. More generally, our results suggest that doctors and clinicians might benefit from a broader conceptualization of maternal mental health during pregnancy including other dimensions of the perinatal experience, such as body shame and dissatisfaction. Women are routinely weighed throughout pregnancy for important medical reasons (e.g., to monitor fetal growth); however, routine weight assessments have the potential to increase body surveillance and adversely impact perinatal mental health. Thus, healthcare providers might consider approaching conversations about weight with sensitivity and with the goal of promoting a healthy pregnancy and baby. For instance, the National Institute of Child and Human Development’s Pregnancy for Every Body initiative aims to help people of all sizes achieve a healthy pregnancy (National Institute of Child and Human Development, 2019). In addition, providing psychoeducation on the natural bodily changes that occur across pregnancy may help mothers adjust to changing body ideals (Beech et al., 2020 ). By emphasizing body functionality, maternal healthcare providers may help women shift their focus away from their appearance-related concerns (Alleva & Tylka, 2021 ; Beech et al., 2020 ). Finally, interventions for pregnant couples that seek to increase partner support may be particularly beneficial given evidence that partners may play a unique role in enhancing maternal body satisfaction during pregnancy (Watson et al., 2016 ). Indeed, given evidence that intimate partner humanization during pregnancy is associated with less body surveillance in mothers (Brock et al., 2021 ), it is important for interventions targeting self-objectification and its related consequences to include not only pregnant women, but also their partners. Conclusion The present study demonstrated that body surveillance during pregnancy impacts infant socioemotional functioning at 1-year postpartum through increased prenatal depressive symptoms and body dissatisfaction and impaired mother-bonding during the 6 months following childbirth. Further, results suggested that maternal depressive symptoms may uniquely contribute to bonding impairments and subsequent child outcomes. This work expands on the limited body of research applying objectification theory to the experience of pregnancy and childbirth and supports a novel conceptual framework within which maternal self-objectification, manifested as body surveillance during pregnancy, impacts infant development as early as 1-year postpartum. Results highlight the potential utility of prenatal interventions guided by objectification theory to reduce the consequences of sexual objectification on mothers and their children. Declarations Funding: This research was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (F31HD107948). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also funded by several internal funding mechanisms awarded to PI Rebecca Brock from the UNL Department of Psychology, the Nebraska Tobacco Settlement Biomedical Research Development Fund, and the UNL Office of Research and Economic Development. Competing Interests: The authors have no competing interests to declare that are relevant to the content of this article. Ethics Approval: Research was approved by the UNL Institutional Review Board (IRB Approval #: 20151215700EP; Title: Family Development Project). Data Availability Statement: This study complied with Transparency and Openness Promotion (TOP) Guidelines. The study PI, Rebecca L. Brock ( [email protected] ), should be contacted to request access to research materials, analysis code, and data. Data management and analysis procedures for this project are registered at https://osf.io/hprk8, and we made no deviations from that plan. Author Note: We thank the families who participated in this research and the entire team of research assistants who contributed to various stages of the study. In particular, we thank Erin Ramsdell, Jennifer Blake, and Kailee Groshans for project coordination. Data from this sample have been published elsewhere (e.g., Brock et al., 2020; Ramsdell & Brock, 2020); however, this is the first article in which body surveilllane has been linked to mother-infant bonding and infant outcomes. Portions of this article were presented at the 2020 International Marcé Society for Perinatal Mental Health virtual conference. COMPLIANCE WITH ETHICAL STANDARDS Disclosure of potential conflicts of interest The authors do not have any conflicts of interest to disclose. This research was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (F31HD107948). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also funded by several internal funding mechanisms awarded to PI Rebecca Brock from the UNL Department of Psychology, the Nebraska Tobacco Settlement Biomedical Research Development Fund, and the UNL Office of Research and Economic Development. Research involving human participants and/or animals The present research involved human participants. Research was approved by the UNL Institutional Review Board (IRB Approval #: 20151215700EP; Title: Family Development Project). No animals were involved in the present research. Informed consent Participants completed written informed consent procedures upon study enrollment. References Alleva, J. M., & Tylka, T. L. (2021). Body functionality: A review of the literature. Body Image , 36, 149–171. https://doi.org/10.1016/j.bodyim.2020.11.006 Arpi, E., & Ferrari, F. (2013). Preterm birth and behaviour problems in infants and preschool-age children: A review of the recent literature. Developmental Medicine and Child Neurology , 55(9), 788–796. https://doi.org/10.1111/dmcn.12142 Arroyo, A., & Andersen, K. K. (2016). The relationship between mother-daughter self-objectification: Identifying direct, indirect, and conditional direct effects. Sex Roles , 74 (5–6), 231––241. https://doi.org/10.1007/s11199-015-0554-1 Ayyala, M. S., Coughlin, J. W., Martin, L., Henderson, J., Ezekwe, N., Clark, J. M., Appel, L. J., & Bennett, W. L. (2020). Perspectives of pregnant and postpartum women and obstetric providers to promote healthy lifestyle in pregnancy and after delivery: A qualitative in-depth interview study. BMC Women’s Health , 20 (1), 44. https://doi.org/10.1186/s12905-020-0896-x Barker, E. D., Jaffee, S. R., Uher, R., & Maughan, B. (2011). The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment. Depression and Anxiety , 28 (8), 696–702. https://doi.org/10.1002/da.20856 Beech, O. D., Kaufmann, L., & Anderson, J. (2020). A systematic literature review exploring objectification and motherhood. Psychology of Women Quarterly , 44 (4), 036168432094981. https://doi.org/10.1177/0361684320949810 Bergmeier, H., Hill, B., Haycraft, E., Blewitt, C., Lim, S., Meyer, C., & Skouteris, H. (2020). Maternal body dissatisfaction in pregnancy, postpartum and early parenting: An overlooked factor implicated in maternal and childhood obesity risk. Appetite , 147, 104525. https://doi.org/10.1016/j.appet.2019.104525 Bicking Kinsey, C., & Hupcey, J. E. (2013). State of the science of maternal–infant bonding: A principle-based concept analysis. Midwifery , 29 , 1314–1320. https://doi.org/10.1016/j.midw.2012.12.019 Blissett, J., & Haycraft, E. (2011). Parental eating disorder symptoms and observations of mealtime interactions with children. Journal of Psychosomatic Research , 70 (4), 368–371. https://doi.org/10.1016/j.jpsychores.2010.07.006 Brock, R. L., Ramsdell, E. L., Sáez, G., & Gervais, S. J. (2021). Perceived humanization by intimate partners during pregnancy is associated with fewer depressive symptoms, less body dissatisfaction, and greater sexual satisfaction through reduced self-objectification. Sex Roles , 84 (5–6), 285–298. https://doi.org/10.1007/s11199-020-01166-6 Brockington, I. F., Oates, J., George, S., Turner, D., Vostanis, P., Sullivan, M., Loh, C., & Murdoch, C. (2001). A screening questionnaire for mother-infant bonding disorders. Archives of Women’s Mental Health , 3 , 133–140. https://doi.org/10.1007/s007370170010 Chan, C. Y., Lee, A. M., Koh, Y. W., Lam, S. K., Lee, C. P., Leung, K. Y., & Tang, C. S. K. (2020). Associations of body dissatisfaction with anxiety and depression in the pregnancy and postpartum periods: A longitudinal study. Journal of Affective Disorders , 263, 582–592. https://doi.org/10.1016/j.jad.2019.11.032 Chapman, L., Cartwright-Hatton, S., Thomson, A., & Lester, K. J. (2021). Parental eating disorders: A systematic review of parenting attitudes, behaviours, and parent-child interactions. Clinical Psychology Review , 88 , 102031. https://doi.org/10.1016/j.cpr.2021.102031 Clark, A., Skouteris, H., Wertheim, E. H., Paxton, S. J., & Milgrom, J. (2009). The relationship between depression and body dissatisfaction across pregnancy and the postpartum. Journal of Health Psychology , 14 , 27–35. https://doi.org/10.1177/1359105308097940 Coker, E., & Abraham, S. (2015). Body weight dissatisfaction before, during and after pregnancy: A comparison of women with and without eating disorders. Eating and Weight Disorders , 20 (1), 71–79. https://doi.org/10.1007/s40519-014-0133-4 Cox, E. Q., Sowa, N. A., Meltzer-Brody, S. E., & Gaynes, B. N. (2016). The perinatal depression treatment cascade: Baby steps toward improving outcomes. Journal of Clinical Psychiatry, 77 (9), 1189–1200. https://doi.org/10.4088/JCP.15r10174 de Cock, E. S. A., Henrichs, J., Vreeswijk, C. M. J. M., Maas, A. J. B. M., Rijk, C. H. A. M., & van Bakel, H. J. A. (2016). Continuous feelings of love? The parental bond from pregnancy to toddlerhood. Journal of Family Psychology , 30 , 125–134. https://doi.org/10.1037/fam0000138 Deave, T., Heron, J., Evans, J., & Emond, A. (2008). The impact of maternal depression in pregnancy on early child development. BJOG: An International Journal of Obstetrics & Gynaecology , 115 (8), 1043–1051. https://doi.org/10.1111/j.1471-0528.2008.01752.x Dryer, R., Graefin von der Schulenburg, I., & Brunton, R. (2020). Body dissatisfaction and Fat Talk during pregnancy: Predictors of distress. Journal of Affective Disorders , 267, 289–296. https://doi.org/10.1016/j.jad.2020.02.031 Duke, R. E., Bryson, S., Hammer, L. D., & Agras, W. S. (2004). The relationship between parental factors at infancy and parent-reported control over children’s eating at age 7. Appetite , 43 (3), 247–252. https://doi.org/10.1016/j.appet.2004.05.006 Enders, C. K. (2010). Applied missing data analysis . Guilford Press. Farrow, C. V., Haycraft, E., & Blissett, J. M. (2015). Teaching our children when to eat: How parental feeding practices inform the development of emotional eating-a longitudinal experimental design. American Journal of Clinical Nutrition , 101 (5), 908–913. https://doi.org/10.3945/ajcn.114.103713 Field, T. (2017). Prenatal depression risk factors, developmental effects and interventions: A review. Journal of Pregnancy and Child Health , 4 (1), 301. https://doi.org/10.4172/2376-127x.1000301 Fitzsimmons-Craft, E. E., & Bardone-Cone, A. M. (2012). Examining prospective mediation models of body surveillance, trait anxiety, and body dissatisfaction in African American and Caucasian college women. Sex Roles , 67 (3–4), 187–200. https://doi.org/10.1007/s11199-012-0151-5 Flores, M. J., Watson, L. B., Allen, L. R., Ford, M., Serpe, C. R., & Choo, P. Y. (2018). Transgender people of color’s experiences of sexual objectification: Locating sexual objectification within a matrix of domination. Journal of Counseling Psychology , 65 (3), 308–323. https://doi.org/10.1037/cou0000279 Forbush, K. T., Wildes, J. E., & Hunt, T. K. (2014). Gender norms, psychometric properties, and validity for the Eating Pathology Symptoms Inventory. International Journal of Eating Disorders , 47 (1), 85–91. https://doi.org/10.1002/eat.22180 Forbush, K. T., Wildes, J. E., Pollack, L. O., Dunbar, D., Luo, J., Patterson, K., Petruzzi, L., Pollpeter, M., Miller, H., Stone, A., Bright, A., & Watson, D. D. (2013). Development and validation of the eating pathology symptoms inventory (EPSI). Psychological Assessment , 25 (3), 859–878. https://doi.org/10.1037/a0032639 Fredrickson, B. L., & Roberts, T. A. (1997). Toward understanding women’s lived experiences and mental health risks. Psychology of Women Quarterly , 21 (2), 173–206. https://doi.org/10.1111/j.1471-6402.1997.tb00108.x Fuller-Tyszkiewicz, M., Broadbent, J., Richardson, B., Watson, B., Klas, A., & Skouteris, H. (2020). A network analysis comparison of central determinants of body dissatisfaction among pregnant and non-pregnant women. Body Image , 32, 111–120. https://doi.org/10.1016/j.bodyim.2019.12.001 Fuller-Tyszkiewicz, M., Skouteris, H., Watson, B. E., & Hill, B. (2013). Body dissatisfaction during pregnancy: A systematic review of cross-sectional and prospective correlates. Journal of Health Psychology, 18 (11), 1411–1421. https://doi.org/10.1177/1359105312462437 Galbally, M., & Lewis, A. J. (2017). Depression and parenting: The need for improved intervention models. Current Opinion in Psychology , 15 , 61–65. https://doi.org/10.1016/j.copsyc.2017.02.008 Gervais, S. J., Holland, A. M., & Dodd, M. D. (2013). My eyes are up here: The nature of the objectifying gaze toward women. Sex Roles , 69 (11–12), 557–570. https://doi.org/10.1007/s11199-013-0316-x Goodman, S. H., & Gotlib, I. H. (1999). Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. Psychological Review , 106 (3), 458–490. https://doi.org/10.1037/0033-295X.106.3.458 Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review , 14 , 1–27. https://doi.org/10.1007/s10567-010-0080-1 Han, Z., Lutsiv, O., Mulla, S., Rosen, A., Beyene, J., & McDonald, S. D. (2011). Low gestational weight gain and the risk of preterm birth and low birthweight: A systematic review and meta-analyses. Acta Obstetricia et Gynecologica Scandinavica, 90 (9), 935–954. https://doi.org/10.1111/j.1600-0412.2011.01185.x Hanko, C., Bittner, A., Junge-Hoffmeister, J., Mogwitz, S., Nitzsche, K., & Weidner, K. (2020). Course of mental health and mother–infant bonding in hospitalized women with threatened preterm birth. Archives of Gynecology and Obstetrics , 301 (1), 119–128. https://doi.org/10.1007/s00404-019-05406-3 Hentges, R. F., Graham, S. A., Plamondon, A., Tough, S., & Madigan, S. (2019). A developmental cascade from prenatal stress to child internalizing and externalizing problems. Journal of Pediatric Psychology , 44 (9), 1057–1067. https://doi.org/10.1093/jpepsy/jsz044 Herba, C. M., Glover, V., Ramchandani, P. G., & Rondon, M. B. (2016). Maternal depression and mental health in early childhood: An examination of underlying mechanisms in low-income and middle-income countries. The Lancet Psychiatry , 3 (10), 983–992. https://doi.org/10.1016/S2215-0366(16)30148-1 Hodgkinson, E. L., Smith, D. M., & Wittkowski, A. (2014). Women’s experiences of their pregnancy and postpartum body image: A systematic review and meta-synthesis. BMC Pregnancy and Childbirth , 14 (1), 330. https://doi.org/10.1186/1471-2393-14-330 Johnson, S., Burrows, A., & Williamson, I. (2004). “Does my bump look big in this?” The meaning of bodily changes for first-time mothers-to-be. Journal of Health Psychology, 9 (3), 361–374. https://doi.org/10.1177/1359105304042346 Jones, B. A., & Griffiths, K. M. (2015). Self-objectification and depression: An integrative systematic review. Journal of Affective Disorders , 171 , 22–32. https://doi.org/10.1016/j.jad.2014.09.011 Kamysheva, E., Skouteris, H., Wertheim, E. H., Paxton, S. J., & Milgrom, J. (2008). Examination of a multi-factorial model of body-related experiences during pregnancy: The relationships among physical symptoms, sleep quality, depression, self-esteem, and negative body attitudes. Body Image , 5 (2), 152–163. https://doi.org/10.1016/j.bodyim.2007.12.005 Karsay, K., Matthes, J., Platzer, P., & Plinke, M. (2018). Adopting the objectifying gaze: Exposure to sexually objectifying music videos and subsequent gazing behavior. Media Psychology , 21 (1), 27–49. https://doi.org/10.1080/15213269.2017.1378110 Katz-Wise, S. L., Budge, S. L., Lindberg, S. M., & Hyde, J. S. (2013). Individuation or identification? Self-objectification and the mother-adolescent relationship. Psychology of Women Quarterly , 37 (3), 366–380. https://doi.org/10.1177/0361684312468425 Kinloch, K., & Jaworska, S. (2021). ‘Your mind is part of your body’: Negotiating the maternal body in online stories of postnatal depression on Mumsnet. Discourse, Context and Media , 39, 100456. https://doi.org/10.1016/j.dcm.2020.100456 Kirk, E., & Preston, C. (2019). Development and validation of the body understanding measure for pregnancy scale (BUMPs) and its role in antenatal attachment. Psychological Assessment , 31 (9), 1092–1106. https://doi.org/10.1037/pas0000736 Kukla, R. (2005). Pregnant bodies as public spaces. In H. S. & W. C. (Eds.), Motherhood and space . Palgrave Macmillan, New York. Lefkovics, E., Baji, I., & Rigó, J. (2014). Impact of maternal depression on pregnancies and on early attachment. Infant Mental Health Journal , 35 (4), 354–365. https://doi.org/10.1002/imhj.21450 Lengua, L. J., Bush, N. R., Long, A. C., Kovacs, E. A., & Trancik, A. M. (2008). Effortful control as a moderator of the relation between contextual risk factors and growth in adjustment problems. Dev Psychopathol , 20 , 509–528. https://doi.org/10.1017/S0954579408000254 Lindner, D., & Tantleff-Dunn, S. (2017). The development and psychometric evaluation of the Self-Objectification Beliefs and Behaviors Scale. Psychology of Women Quarterly, 41 (2), 254–272. https://doi.org/10.1177/0361684317692109 Loth, K. A., Bauer, K. W., Wall, M., Berge, J., & Neumark-Sztainer, D. (2011). Body satisfaction during pregnancy. Body Image , 8 (3), 297–300. https://doi.org/10.1016/j.bodyim.2011.03.002 Lovering, M. E., Rodgers, R. F., George, J. E., & Franko, D. L. (2018). Exploring the tripartite influence model of body dissatisfaction in postpartum women. Body Image , 24, 44–54. https://doi.org/10.1016/j.bodyim.2017.12.001 Mason, Z. S., Briggs, R. D., & Silver, E. J. (2011). Maternal attachment feelings mediate between maternal reports of depression, infant social–emotional development, and parenting stress. Journal of Reproductive and Infant Psychology , 29 , 382–394. https://doi.org/10.1080/02646838.2011.629994 McKinley, N. M., & Hyde, J. S. (1996). The Objectified Body Consciousness Scale: Development and validation. Psychology of Women Quarterly , 20 , 181–215. https://doi.org/10.1111/j.1471-6402.1996.tb00467.x McNamara, J., Townsend, M. L., & Herbert, J. S. (2019). A systemic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding. PLOS ONE , 14 (7), e0220032. https://doi.org/10.1371/journal.pone.0220032 Moehler, E., Brunner, R., Wiebel, A., Reck, C., & Resch, F. (2006). Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother-child bonding. Archives of Women’s Mental Health , 9 , 273–278. https://doi.org/10.1007/s00737-006-0149-5 Moseson, H., Zazanis, N., Goldberg, E., Fix, L., Durden, M., Stoeffler, A., Hastings, J., Cudlitz, L., Lesser-Lee, B., Letcher, L., Reyes, A., & Obedin-Maliver, J. (2020). The imperative for transgender and gender nonbinary inclusion: Beyond women’s health. Obstetrics and Gynecology , 135 (5), 1059–1068. https://doi.org/10.1097/AOG.0000000000003816 Mulherin, K., Miller, Y. D., Barlow, F. K., Diedrichs, P. C., & Thompson, R. (2013). Weight stigma in maternity care: Women’s experiences and care providers’ attitudes. BMC Pregnancy and Childbirth , 13 (1), 19. https://doi.org/10.1186/1471-2393-13-19 Muthén, L. K., & Muthén, B. O. (2010). Mplus user’s guide (6th ed.). Muthén & Muthén. Muzik, M., & Borovska, S. (2011). Perinatal depression: Implications for child mental health. Mental Health in Family Medicine , 7 (4), 239–247. National Institute of Child Health and Human Development (2019, December 18). Pregnancy for every body: Information for moms-to-be. https://www.nichd.nih.gov/ncmhep/initiatives/pregnancy-for-every-body/moms-to-be Noll‚ S. M.‚ & Fredrickson‚ B. L. (1998). A mediational model linking self-objectification‚ body shame‚ and disordered eating. Psychology of Women Quarterly‚ 22 (4)‚ 623-636. https://doi.org/10.1111/j.1471-6402.1998.tb00181.x Nonnenmacher, N., Noe, D., Ehrenthal, J. C., & Reck, C. (2016). Postpartum bonding: The impact of maternal depression and adult attachment style. Archives of Women’s Mental Health , 19 , 927–935. https://doi.org/10.1007/s00737-016-0648-y O’Higgins, M., Roberts, I. S. J., Glover, V., & Taylor, A. (2013). Mother-child bonding at 1 year; associations with symptoms of postnatal depression and bonding in the first few weeks. Archives of Women’s Mental Health , 16 (5), 381–389. https://doi.org/10.1007/s00737-013-0354-y Parker, G., & Pausé, C. (2018). “I’m just a woman having a baby”: Negotiating and resisting the problematization of pregnancy fatness. Frontiers in Sociology , 3, 5. https://www.frontiersin.org/articles/10.3389/fsoc.2018.00005 Piran, N. (2017). The developmental theory of embodiment: Discovering paths in the body journeys of girls and women. In Journeys of embodiment at the intersection of body and culture: The developmental theory of embodiment (pp. 1–42). Elsevier. https://doi.org/10.1016/B978-0-12-805410-9.00001-3 Porter, E., Lewis, A. J., Watson, S. J., & Galbally, M. (2019). Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort. Infant Behavior and Development , 57, 101336. https://doi.org/10.1016/j.infbeh.2019.101336 Preacher, K. J., Rucker, D. D., & Hayes, A. F. (2007). Addressing moderated mediation hypotheses: Theory, methods, and prescriptions. Multivariate Behavioral Research , 42 , 185–227. https://doi.org/10.1080/00273170701341316 Ramsdell, E. L., & Brock, R. L. (2021). Interparental relationship quality during pregnancy: Implications for early parent–infant bonding and infant socioemotional development. Family Process , 60 (3), 966–983. https://doi.org/10.1111/famp.12599 Riquin, E., Lamas, C., Nicolas, I., Lebigre, C. D., Curt, F., Cohen, H., Legendre, G., Corcos, M., & Godart, N. (2019). A key for perinatal depression early diagnosis: The body dissatisfaction. Journal of Affective Disorders , 245, 340–347. https://doi.org/10.1016/j.jad.2018.11.032 Roberts, B., Povich, D., & Mather, M. (2012). Low-income working families: The growing economic gap. The Working Poor Families Project Policy Brief. https://www.prb.org/resources/u-s-low-income-working-families-increasing/ Roberts, T.-A., Calogero, R. M., & Gervais, S. J. (2018). Objectification theory: Continuing contributions to feminist psychology. In APA handbook of the psychology of women: History, theory, and battlegrounds (Vol. 1, pp. 249–271). American Psychological Association. https://doi.org/10.1037/0000059-013 Rodgers, R. F., O’Flynn, J. L., Bourdeau, A., & Zimmerman, E. (2018). A biopsychosocial model of body image, disordered eating, and breastfeeding among postpartum women. Appetite , 126, 163–168. https://doi.org/10.1016/j.appet.2018.04.007 Rodgers, R. F., Paxton, S. J., McLean, S. A., Campbell, K. J., Wertheim, E. H., Skouteris, H., & Gibbons, K. (2013). Do maternal body dissatisfaction and dietary restraint predict weight gain in young pre-school children? A 1-year follow-up study. Appetite , 67, 30–36. https://doi.org/10.1016/j.appet.2013.03.009 Rodgers, R. F., Wertheim, E. H., Damiano, S. R., & Paxton, S. J. (2020). Maternal influences on body image and eating concerns among 7- and 8-year-old boys and girls: Cross-sectional and prospective relations. International Journal of Eating Disorders , 53 (1), 79–84. https://doi.org/10.1002/eat.23166 Roomruangwong, C., Kanchanatawan, B., Sirivichayakul, S., & Maes, M. (2017). High incidence of body image dissatisfaction in pregnancy and the postnatal period: Associations with depression, anxiety, body mass index and weight gain during pregnancy. Sexual and Reproductive Healthcare , 13, 103–109. https://doi.org/10.1016/j.srhc.2017.08.002 Roosevelt, L. K., Pietzmeier, S., & Reed, R. (2021). Clinically and culturally competent care for transgender and nonbinary people: A challenge to providers of perinatal care. Journal of Perinatal and Neonatal Nursing , 35 (2), 142–149. https://doi.org/10.1097/JPN.0000000000000560 Rosenblum, K. L., Dayton, C. J., & Muzik, M. (2009). Infant social and emotional development: The emergence of self in a relational context. In Handbook of infant mental health (3rd ed., pp. 95–119). Guilford Press. Rubin, L. R., & Steinberg, J. R. (2011). Self-objectification and pregnancy: Are body functionality dimensions protective? Sex Roles , 65 (7), 606–618. https://doi.org/10.1007/s11199-011-9955-y Saxbe, D., Rossin-Slater, M., & Goldenberg, D. (2018). The transition to parenthood as a critical window for adult health. American Psychologist , 73 (9), 1190–1200. https://doi.org/10.1037/amp0000376 Segre, L. S., Brock, R. L., O’Hara, M. W., Gorman, L. L., & Engeldinger, J. (2011). Disseminating perinatal depression screening as a public health initiative: A train-the-trainer approach. Maternal and Child Health Journal , 15 (6), 814–821. https://doi.org/10.1007/s10995-010-0644-1 Skouteris, H., Carr, R., Wertheim, E. H., Paxton, S. J., & Duncombe, D. (2005). A prospective study of factors that lead to body dissatisfaction during pregnancy. Body Image , 2 (4), 347–361. https://doi.org/10.1016/j.bodyim.2005.09.002 Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health, 15, 1–55. https://doi.org/10.1177/1745506519844044 Sockol, L. E., Battle, C. L., Howard, M., & Davis, T. (2014). Correlates of impaired mother-infant bonding in a partial hospital program for perinatal women. Archives of Women’s Mental Health , 17 (5), 465–469. https://doi.org/10.1007/s00737-014-0419-6 Spiel, E. C., Paxton, S. J., & Yager, Z. (2012). Weight attitudes in 3- to 5-year-old children: Age differences and cross-sectional predictors. Body Image , 9 (4), 524–527. https://doi.org/10.1016/j.bodyim.2012.07.006 Squires, J., Bricker, D., & Twombly, E. (2015). ASQ:SE-2 . Paul H. Brookes Publishing. Stunkard, A. J., Sørensen, T., & Schulsinger, F. (1983). Use of the Danish Adoption Register for the study of obesity and thinness. Research Publications - Association for Research in Nervous and Mental Disease , 60, 115–120. Sun, Q. (2018). Materialism, body surveillance, body shame, and body dissatisfaction: Testing a mediational model. Frontiers in Psychology , 9, 2088. https://doi.org/10.3389/fpsyg.2018.02088 Sutton, R. M., Douglas, K. M., & McClellan, L. M. (2011). Benevolent sexism, perceived health risks, and the inclination to restrict pregnant women’s freedoms. Sex Roles , 65 , 596–605. https://doi.org/10.1007/s11199-010-9869-0 Szekely, E., Neumann, A., Sallis, H., Jolicoeur-Martineau, A., Verhulst, F. C., Meaney, M. J., Pearson, R. M., Levitan, R. D., Kennedy, J. L., Lydon, J. E., Steiner, M., Greenwood, C. M. T., Tiemeier, H., Evans, J., & Wazana, A. (2021). Maternal prenatal mood, pregnancy-specific worries, and early child psychopathology: Findings from the DREAM BIG consortium. Journal of the American Academy of Child and Adolescent Psychiatry , 60 (1), 186–197. https://doi.org/10.1016/j.jaac.2020.02.017 Talmon, A., & Ginzburg, K. (2016). The nullifying experience of self-objectification: The development and psychometric evaluation of the Self-Objectification Scale. Child Abuse & Neglect , 60 , 46–57. https://doi.org/10.1016/j.chiabu.2016.09.007 Talmon, A., & Ginzburg, K. (2018). “Who does this body belong to?” The development and psychometric evaluation of the Body Experience during Pregnancy Scale. Body Image , 26 , 19–28. https://doi.org/10.1016/j.bodyim.2018.05.002 Tiggemann, M., & Lynch, J. E. (2001). Body image across the life span in adult women: The role of self-objectification. Developmental Psychology , 37 (2), 243–253. https://doi.org/10.1037//0012-1649.37.2.243 Underwood, L., Waldie, K., D’Souza, S., Peterson, E. R., & Morton, S. (2016). A review of longitudinal studies on antenatal and postnatal depression. Archives of Women’s Mental Health, 19 (5), 711–720. https://doi.org/10.1007/s00737-016-0629-1 Wallis, K., Prichard, I., Hart, L., & Yager, Z. (2021). The Body Confident Mums challenge: A feasibility trial and qualitative evaluation of a body acceptance program delivered to mothers using Facebook. BMC Public Health , 21 (1), 1052. https://doi.org/10.1186/s12889-021-11126-8 Waters, C. S., Hay, D. F., Simmonds, J. R., & van Goozen, S. H. M. (2014). Antenatal depression and children’s developmental outcomes: Potential mechanisms and treatment options. European Child and Adolescent Psychiatry, 23 (10), 957–971. https://doi.org/10.1007/s00787-014-0582-3 Watson, B., Broadbent, J., Skouteris, H., & Fuller-Tyszkiewicz, M. (2016). A qualitative exploration of body image experiences of women progressing through pregnancy. Women and Birth , 29 (1), 72–79. https://doi.org/10.1016/j.wombi.2015.08.007 Watson, B., Fuller-Tyszkiewicz, M., Broadbent, J., & Skouteris, H. (2015). The meaning of body image experiences during the perinatal period: A systematic review of the qualitative literature. Body Image , 14 , 102–113. https://doi.org/10.1016/j.bodyim.2015.04.005 Watson, D., O’Hara, M. W., Naragon-Gainey, K., Koffel, E., Chmielewski, M., Kotov, R., Stasik, S. M., & Ruggero, C. J. (2012). Development and validation of new anxiety and bipolar symptom scales for an expanded version of the IDAS (the IDAS-II). Assessment , 19 , 399–420. https://doi.org/10.1177/1073191112449857 Webb, H. J., & Haycraft, E. (2019). Parental body dissatisfaction and controlling child feeding practices: A prospective study of Australian parent-child dyads. Eating Behaviors , 32, 1–6. https://doi.org/10.1016/j.eatbeh.2018.10.002 Woolhouse, H., Gartland, D., Mensah, F., & Brown, S. J. (2015). Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: Implications for primary health care. BJOG: An International Journal of Obstetrics and Gynaecology , 122 (3), 312–321. https://doi.org/10.1111/1471-0528.12837 Cite Share Download PDF Status: Published Journal Publication published 02 May, 2023 Read the published version in Sex Roles → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2714781","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":185283775,"identity":"1658f85f-01da-41a9-9b27-c997bf3625e0","order_by":0,"name":"Lauren M. Laifer","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA90lEQVRIie3LsUrDUBTG8S9cSJZY17rUVzgloy9zQ4e7tCAIpYOE61KXPkAeI+AggsO5XNAldA4oogScHNKtg4qROgiaW7s53P9whsP3A3y+f1gvAngGDAgQXz+hgbCbhO2OSyD5RoLtBC1Jix2IeGKePajLvqppdZ2B7s40mql1kJCYy5PJVT5O0vzZgu6NDvKli4Dsai4nRTUWNmYGVakWe3MXiRo271JRpWr7ytmGvDlJTGy0lFTJZAQWGxK4yTHzjRwW5UsyXLCND1piFkvVSfaj84uGT+Uh3aq6v+Zs0KtG5nE9PeokP4o/D/997/P5fL7f+gCg31yLBkMWGAAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0001-5473-7882","institution":"University of Nebraska-Lincoln","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Lauren","middleName":"M.","lastName":"Laifer","suffix":""},{"id":185283776,"identity":"13fca444-c050-4dad-93c7-7c5d7e1f719b","order_by":1,"name":"Olivia R. Maras","email":"","orcid":"","institution":"Arizona State University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Olivia","middleName":"R.","lastName":"Maras","suffix":""},{"id":185283777,"identity":"3d8fa33c-19f1-46c3-8fb8-20469c5b9ae6","order_by":2,"name":"Gemma Sáez","email":"","orcid":"","institution":"Universidad de Extremadura","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Gemma","middleName":"","lastName":"Sáez","suffix":""},{"id":185283778,"identity":"f896601a-bf97-42de-9698-65774cdce9af","order_by":3,"name":"Sarah J. Gervais","email":"","orcid":"","institution":"University of Nebraska-Lincoln","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sarah","middleName":"J.","lastName":"Gervais","suffix":""},{"id":185283779,"identity":"ee7089f1-f8a4-4f47-b9e4-49e09920b937","order_by":4,"name":"Rebecca L. Brock","email":"","orcid":"","institution":"University of Nebraska-Lincoln","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Rebecca","middleName":"L.","lastName":"Brock","suffix":""}],"badges":[],"createdAt":"2023-03-20 15:30:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2714781/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2714781/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s11199-023-01360-2","type":"published","date":"2023-05-02T20:41:25+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":34595495,"identity":"1c00a8bc-59af-4de9-9cd3-47a792142b6e","added_by":"auto","created_at":"2023-03-21 15:27:22","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":130141,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eNovel Conceptual Model Linking Body Surveillance During Pregnancy to Infant Socioemotional Dysfunction at Age One\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2714781/v1/c341c5eb63ee5aca54cda56a.jpg"},{"id":34595496,"identity":"1ca1ba3f-9e02-4aca-af30-56331ff62bc5","added_by":"auto","created_at":"2023-03-21 15:27:22","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":456572,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eResults of Path Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e Standardized coefficients are reported. Significant coefficients are bolded and are depicted by solid lines\u003cem\u003e.\u003c/em\u003e Bias-corrected confidence intervals (CIs) based on 10,000 bootstrapped samples were calculated to determine significance of effects. If a CI did not contain zero, the effect was significant. Significant indirect effects are depicted by solid lines. In figure 2(a), the overall indirect effect of body surveillance on infant socioemotional dysfunction through maternal general depression and impaired mother-infant bonding was significant, 95% CI [.04, .59]. In figure 2(b), the overall indirect effect of body surveillance on infant socioemotional dysfunction through maternal body dissatisfaction and impaired mother-infant bonding was significant, 95% CI [.03, 1.00]. Finally, in figure 2(c), the overall indirect effect of body surveillance on infant socioemotional dysfunction at one year through maternal general depression and impaired mother-infant bonding was significant, 95% CI [.03, .55]. All direct paths were tested in the integrated model (i.e., body surveillance → impaired bonding; body surveillance → socioemotional dysfunction; body dissatisfaction → socioemotional dysfunction; depression → socioemotional dysfunction) but were not significant and are not depicted in the figure. Please refer to Table 2 for full model results.\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2714781/v1/0f4f3c0d46c6e78147fd452b.jpg"},{"id":44727893,"identity":"d099c996-944c-4ade-bbc4-5c81604abab7","added_by":"auto","created_at":"2023-10-16 20:56:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":745104,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2714781/v1/567656e5-911c-4599-b018-8503d5c09397.pdf"}],"financialInterests":"","formattedTitle":"Self-objectification during the perinatal period: The role of body surveillance in maternal and infant wellbeing","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSelf-objectification\u0026mdash;seeing the self as a sexual object\u0026mdash;has been recognized as an important contributor to women\u0026rsquo;s mental health since the phenomenon was formally introduced to the psychological literature in the form of objectification theory two and a half decades ago (Fredrickson \u0026amp; Roberts, \u003cspan class=\"CitationRef\"\u003e1997\u003c/span\u003e; Roberts et al., \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e). According to this framework, by living in a culture in which women are commonly reduced to their bodily appearance, women learn to view their bodies from a third person\u0026rsquo;s perspective (i.e., self-objectify, Fredrickson \u0026amp; Roberts, \u003cspan class=\"CitationRef\"\u003e1997\u003c/span\u003e) and often engage in persistent body surveillance (McKinley \u0026amp; Hyde, \u003cspan class=\"CitationRef\"\u003e1996\u003c/span\u003e). Further, many women feel pressure to fit cultural ideals of attractiveness and may experience body shame and dissatisfaction if their bodies do not align with these often-unattainable standards (McKinley \u0026amp; Hyde, \u003cspan class=\"CitationRef\"\u003e1996\u003c/span\u003e; Tiggemann \u0026amp; Lynch, \u003cspan class=\"CitationRef\"\u003e2001\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eSelf-objectification and its behavioral consequences, such as body surveillance, set the stage for adverse mental health outcomes that disproportionately affect women (e.g., anxiety, depression, eating disorders; Fitzsimmons-Craft \u0026amp; Bardone-Cone, \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e; Jones \u0026amp; Griffiths, \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e; Roberts et al., \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e; Rubin \u0026amp; Steinberg, \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e; Sun, \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e) and can interfere with parenting and child wellbeing (Chapman et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e; Deave et al., \u003cspan class=\"CitationRef\"\u003e2008\u003c/span\u003e; Galbally \u0026amp; Lewis, \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e; Herba et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e). The current study presents a novel conceptual framework in which self-objectification, as manifested by persistent body surveillance, is significantly linked to maternal mental health during pregnancy (i.e., body dissatisfaction, depression) and undermines infant socioemotional functioning through impaired mother-infant bonding following childbirth.\u003c/p\u003e\n\u003ch3\u003eObjectification Theory And The Consequences Of Self-objectification\u003c/h3\u003e\n\u003cp\u003eObjectification theory posits that \u0026ldquo;\u003cem\u003ewomen are most targeted for objectification during their years of reproductive potential\u003c/em\u003e\u0026rdquo; (Fredrickson \u0026amp; Roberts, \u003cspan class=\"CitationRef\"\u003e1997\u003c/span\u003e, p. 192). Indeed, objectification (reduction to appearance and sexual body parts; loss of autonomy; denial of subjectivity) is heightened during key stages in which girls and women undergo physical changes (e.g., puberty), and it may also be heightened during pregnancy. Specifically, pregnant bodies become \u0026ldquo;public property,\u0026rdquo; with people looking at, commenting on, and even touching the bodies of pregnant women (Kukla, \u003cspan class=\"CitationRef\"\u003e2005\u003c/span\u003e). Further, women may experience increased body surveillance and related body dissatisfaction across pregnancy and postpartum as their bodies become more removed from a potentially internalized \u0026ldquo;thin ideal\u0026rdquo; of attractiveness. These bodily changes may also be connected to other facets of self-objectification (Talmon \u0026amp; Ginzburg, \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e), such as feeling like their autonomy and freedoms are restricted (Sutton et al., \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e). Women may feel like their pregnant bodies have become hyper-visible, while other aspects of their personhood have been rendered invisible.\u003c/p\u003e\n\u003cp\u003eIndeed, a systematic review of research on self-objectification and motherhood by Beech and colleagues (\u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e) revealed that self-objectification among mothers is associated with a range of negative outcomes, such as difficulties breastfeeding, fear of childbirth, depression, and disordered eating. Despite these possibilities, remarkably few studies have examined whether the tenets of objectification theory apply to the perinatal period (Beech et al., \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e; Brock et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e; Rubin \u0026amp; Steinberg, \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e). Because of the significant changes that women\u0026rsquo;s bodies undergo during pregnancy and postpartum (e.g., expanding belly, larger breasts, weight gain), the present investigation focused on body surveillance (see Talmon \u0026amp; Ginzburg, \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e, for other important facets of self-objectification). We posit that bodily changes during pregnancy and concomitant increases in objectification from others may cause women to engage in more persistent body surveillance and experience associated mental health problems (e.g., body dissatisfaction, depression). These decrements in mental health may, in turn, undermine the quality of mother-infant interactions (see McNamara et al., \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e for a review).\u003c/p\u003e\n\u003cp\u003eIncreasingly, researchers have examined whether markers of self-objectification among mothers, such as body surveillance, and associated mental health consequences spill over into parenting and child development. Although much of this research has focused on women with adolescent children (e.g., Arroyo \u0026amp; Andersen, \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e; Katz-Wise et al., \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e), research also provides evidence for the intergenerational transmission of body dissatisfaction and disordered eating behaviors in younger children (Rodgers et al., \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e; Spiel et al., \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e). For example, maternal body dissatisfaction is prospectively associated with lower child body esteem in middle childhood (Rodgers et al., \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e). Maternal body dissatisfaction has also been linked to the use of more controlling feeding practices (e.g., food restriction, pressure to eat) with preschool-age children (Blissett \u0026amp; Haycraft, \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e; Duke et al., \u003cspan class=\"CitationRef\"\u003e2004\u003c/span\u003e; Rodgers et al., \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e; Webb \u0026amp; Haycraft, \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e), which may interfere with children\u0026rsquo;s regulatory capacities by teaching them to view eating as a primary strategy for emotion regulation (Farrow et al., \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eDespite growing evidence that body surveillance in mothers and associated mental health consequences (e.g., depression, body dissatisfaction) may negatively impact children, comparatively less is known about the impact of body surveillance on infant socioemotional functioning. Thus, we extend these considerations to examine whether body surveillance impacts not only maternal mental health, but also infants by undermining mother-infant bonding following childbirth. We posit that increased body surveillance, resulting from a culture that persistently objectifies women\u0026rsquo;s bodies, is linked to maternal mental health concerns and the likelihood that mothers experience difficulties bonding with their infants.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n\u003ch3\u003eBody Surveillance and Body Dissatisfaction During Pregnancy\u003c/h3\u003e\n\u003cp\u003eResearch on body dissatisfaction during pregnancy has demonstrated mixed findings (Coker \u0026amp; Abraham, \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e; Fuller-Tyszkiewicz et al., \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e; Loth et al., \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e; Skouteris et al., \u003cspan class=\"CitationRef\"\u003e2005\u003c/span\u003e). Presumably, there are important individual differences in how women experience their body transformation across pregnancy. Some women may embrace this transformation and become more appreciative of what their bodies are physically capable of \u0026ndash; nurturing and supporting a developing fetus (Rubin \u0026amp; Steinberg, \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e). This appreciation of body functionality, in turn, may buffer against distress related to the rapid physical changes that occur across pregnancy and postpartum (Clark et al., \u003cspan class=\"CitationRef\"\u003e2009\u003c/span\u003e). Alternatively, some pregnant women might be more susceptible to societal pressures around their bodies and continue to hold their bodies to unrealistic beauty standards, focusing more on body image than functionality (Johnson et al., \u003cspan class=\"CitationRef\"\u003e2004\u003c/span\u003e). For instance, some mothers may aspire to gain minimal gestational weight and to return to their pre-pregnancy figure, or \u0026ldquo;bounce back,\u0026rdquo; quickly after childbirth (Watson et al., \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e). Perceived sociocultural pressure to remain thin is associated with maternal distress and body dissatisfaction during pregnancy and the postpartum (Dryer et al., \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e; Fuller-Tyszkiewicz et al., \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e; Kamysheva et al., \u003cspan class=\"CitationRef\"\u003e2008\u003c/span\u003e; Lovering et al., \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e). Further, gaining less than the recommended amount of weight during pregnancy is associated with higher risk of preterm birth and low birthweight (Han et al., \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e), which predict self-regulatory difficulties as early as infancy (Arpi \u0026amp; Ferrari, \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n\u003ch3\u003eBody Surveillance and Depression During Pregnancy\u003c/h3\u003e\n\u003cp\u003eBody surveillance is associated with higher levels of depressive symptoms during the perinatal period (Rodgers et al., \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e; Rubin \u0026amp; Steinberg, \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e). These associations are alarming given that pregnant women are already at increased risk for depression during the perinatal period, with one in five women endorsing depressive symptoms across pregnancy and postpartum (Underwood et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e; Woolhouse et al., \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e). In the United States, over half of women with perinatal depression go undetected, undiagnosed, and untreated for this condition (Cox et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e). This represents a significant public health burden given that antenatal depression contributes to the proliferation of a range of mental health concerns in both parents and children (Hentges et al., \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e; Waters et al., \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eMaternal Mental Health And Infant Development\u003c/h3\u003e\n\u003cp\u003eMaternal psychopathology during pregnancy, particularly depression, is a robust predictor of poor child outcomes, including increased risk for child psychopathology (Barker et al., \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e; Goodman et al., \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e; Goodman \u0026amp; Gotlib, \u003cspan class=\"CitationRef\"\u003e1999\u003c/span\u003e; Szekely et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e). Indeed, perinatal depression predicts socioemotional difficulties (e.g., crying for long periods of time) as early as infancy (Field, \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e; Porter et al., \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e). Mother-infant bonding (i.e., the emotional tie between mother and infant; Bicking Kinsey \u0026amp; Hupcey, \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e), is a salient mechanism through which depression can undermine child functioning (Lefkovics et al., \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e; Slomian et al., \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e). In particular, bonding during the first 6 months postpartum is critical to infant socioemotional development, as infants largely depend on their caregivers to regulate their emotions (Rosenblum et al., \u003cspan class=\"CitationRef\"\u003e2009\u003c/span\u003e), and early mother-infant bonding impairments predict infant socioemotional difficulties as early as 6-months postpartum (Ramsdell \u0026amp; Brock, \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e). Women who report higher levels of depression during and after pregnancy tend to demonstrate greater impairments in mother-infant bonding (Moehler et al., \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e; Nonnenmacher et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e; O\u0026rsquo;Higgins et al., \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e), and research suggests that negative cognitions associated with perinatal depression may undermine maternal motivation to bond with the infant following childbirth (Muzik \u0026amp; Borovska, \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eAlthough maternal depression is a robust predictor of bonding impairments and associated infant maladjustment, researchers also posit that body dissatisfaction during pregnancy impacts mothers\u0026rsquo; developing bonds with their infants and, subsequently, child socioemotional functioning (Bergmeier et al., \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e). Indeed, the physical changes that occur over the course of pregnancy\u0026ndash;and how these changes are perceived and experienced\u0026ndash;represent one of the first ways in which mothers interact with their babies. Women who embrace the bodily changes associated with pregnancy may be more likely to engage emotionally with their babies prior to childbirth, whereas women who feel negatively about these changes and experience greater body dissatisfaction may face more bonding difficulties (Kirk \u0026amp; Preston, \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e). Further, some women may experience a loss of agency and control over their own bodies during pregnancy (Kinloch \u0026amp; Jaworska, \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e). This perceived loss of control, which is associated with maternal distress (Hodgkinson et al., \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e), might also interfere with antenatal attachment.\u003c/p\u003e\n\u003ch3\u003eThe Present Study\u003c/h3\u003e\n\u003cp\u003eObjectification theory would suggest that women may be at heightened risk for self-objectification during pregnancy, which can compromise their mental health, and past research suggests a robust link between maternal mental health and bonding difficulties. Taken together, this work suggests that elevations in self-objectification and its correlates (e.g., body surveillance, body dissatisfaction, depression) during pregnancy might ultimately undermine healthy infant socioemotional development. Building on recent work applying objectification theory to motherhood (e.g., Beech et al., \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e), we present a novel conceptual framework (see Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) in which mothers who report greater body surveillance during pregnancy\u0026ndash;a marker of self-objectification\u0026ndash;experience higher levels of prenatal depressive symptoms and body dissatisfaction that, in turn, uniquely predict greater mother-infant bonding impairments following childbirth, thereby undermining infant socioemotional functioning at age 1. An integration of research and theory in the areas of objectification and maternal-infant health has the potential to impact both maternal and infant wellbeing by identifying largely overlooked intervention targets during pregnancy (i.e., body surveillance and body dissatisfaction) that arise as a consequence of living in a culture of persistent objectification.\u003c/p\u003e"},{"header":"Method","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003ch3\u003eParticipants and Procedures\u003c/h3\u003e\n\u003cp\u003eThe present study is part of a multi-method, longitudinal study examining how couples navigate the transition from pregnancy to postpartum; thus, participants also completed other procedures beyond the scope of the present study. All participants identified as cisgender upon study entry. Most women were in the second (38.4%) or third (58.5%) trimester of pregnancy. On average, there was one child living at home during pregnancy (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.18); more than half of women (57.9%) had no children and were experiencing the transition into parenthood for the first time. The majority of women were married (84.9%). Annual household income ranged from less than $9,999 to more than $90,000, with a median household income of $60,000 to $69,999. Nearly half (47.8%) reported earning $50,000 to 59,999 or less which converges with federal guidelines for defining low-income status (Roberts et al., \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e). Reflecting the Midwestern region where the study was conducted, women were primarily White (89.3%), and 9.4% identified as Hispanic or Latina. On average, women were 28.67 years of age (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4.27), and most women were employed at least 16 hours per week (74.2%). Modal education was a bachelor\u0026rsquo;s degree (46.5%). During follow-up assessments, it was determined that one infant was diagnosed with trisomy 21, and one mother experienced a miscarriage. As such, those families were excluded from analyses to focus on women with typically developing infants (50% male) for a final sample of 157 perinatal women.\u003c/p\u003e\n\u003cp\u003eThere were four waves of data collection spanning February 2016 to April 2019. To address the aims of the present study, we assessed body surveillance, body dissatisfaction, and depressive symptoms using self-report questionnaires administered to mothers during the appointment. We assessed mother-infant bonding at 1-month postpartum (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.12 months, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.29) and 6-months postpartum (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;6.32 months, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.36) using a self-report questionnaire. Additionally, when the infant turned 1year of age (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12.80 months, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.76), both parents reported on infant socioemotional dysfunction. All procedures were approved by the University of Nebraska-Lincoln Institutional Review Board.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eMeasures During Pregnancy\u003c/h3\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eBody Surveillance.\u003c/span\u003e The Body Surveillance subscale of the Objectified Body Consciousness Scale (OBCS, (McKinley \u0026amp; Hyde, \u003cspan class=\"CitationRef\"\u003e1996\u003c/span\u003e) was used to assess body surveillance, an important manifestation of self-objectification. During pregnancy, mothers rated the degree to which they persistently monitored their bodily appearance on a scale from one (\u003cem\u003estrongly disagree\u003c/em\u003e) to six (\u003cem\u003estrongly agree\u003c/em\u003e), with a \u003cem\u003enot applicable\u003c/em\u003e option (coded as missing) for items that did not apply. The Body Surveillance subscale contains 8 items, including \u0026ldquo;During the day, I think about how I look many times\u0026rdquo; and \u0026ldquo;I rarely worry about how I look to other people\u0026rdquo; (reverse coded). Items were averaged with higher scores indicating more body surveillance (Cronbach\u0026rsquo;s \u0026alpha;\u0026thinsp;=\u0026thinsp;.85).\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eDepression\u003c/span\u003e. Maternal depressive symptoms were assessed using the General Depression subscale of the Inventory of Depression and Anxiety Symptoms (IDAS-II; Watson et al., \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e). The IDAS-II is a 99-item self-report questionnaire designed to assess general and specific symptom dimensions of depression and related anxiety disorders. Participants rated their feelings and experiences during the past two weeks on a scale from 1 (\u003cem\u003enot at all\u003c/em\u003e) to 5 (\u003cem\u003eextremely\u003c/em\u003e). The general depression subscale consists of 20 items (e.g., \u0026ldquo;I felt inadequate,\u0026rdquo; \u0026ldquo;I felt discouraged about things\u0026rdquo;), with possible scores ranging from 20 to 100 (Cronbach\u0026rsquo;s \u0026alpha;\u0026thinsp;=\u0026thinsp;0.84).\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eBody Dissatisfaction.\u003c/span\u003e The Eating Pathology Symptoms Inventory (EPSI; Forbush et al., \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e) was used to assess body dissatisfaction reported by mothers during pregnancy. The EPSI is a factor analytically derived scale of eating disorder (ED) symptoms. The Body Dissatisfaction subscale consists of 7 items (e.g., \u0026ldquo;I did not like how clothes fit the shape of my body,\u0026rdquo; \u0026ldquo;I wished the shape of my body was different\u0026rdquo;) and captures the higher-order, shared dimension among ED symptoms. Participants rated how frequently each statement applied to them during the past month on a scale from 0 (\u003cem\u003enever\u003c/em\u003e) to 4 (\u003cem\u003every often\u003c/em\u003e). Items responses were summed, with possible scores ranging from 0 to 28 (Cronbach\u0026rsquo;s \u0026alpha;\u0026thinsp;=\u0026thinsp;0.88).\u003c/p\u003e\n\u003ch3\u003eMeasures At 1- And 6-months Postpartum\u003c/h3\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eImpaired Mother-Infant Bonding.\u003c/span\u003e Postpartum mother-infant bonding was assessed using the Postpartum Bonding Questionnaire (PBQ; Brockington et al. \u003cspan class=\"CitationRef\"\u003e2001\u003c/span\u003e). The PBQ is a 25-item, factor-analytically derived, parent-report measure of a parent\u0026rsquo;s feelings or attitudes toward their baby. The PBQ assesses impaired bonding, rejection and anger, anxiety about care, and risk of abuse, represented as four subscales that can be summed for a total score. Participants rated their agreement with a series of statements on a 6-point Likert scale. Positive responses (e.g., \u0026ldquo;I feel close to my baby\u0026rdquo;) were scored from 0 (\u003cem\u003ealways\u003c/em\u003e) to 5 (\u003cem\u003enever\u003c/em\u003e), while negative responses (e.g., \u0026ldquo;My baby irritates me\u0026rdquo;) were scored from 0 (\u003cem\u003enever\u003c/em\u003e) to 5 (\u003cem\u003ealways\u003c/em\u003e). Items were summed to generate a total score, with low scores denoting good bonding and high scores indicating impaired bonding. Scores at 1- and 6-months postpartum were internally consistent (Cronbach\u0026rsquo;s \u0026alpha;\u0026thinsp;=\u0026thinsp;0.88 at 1 month and Cronbach\u0026rsquo;s \u0026alpha;\u0026thinsp;=\u0026thinsp;0.86 at 6 months). Scores at each time point were highly correlated (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.76, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and were thus aggregated to provide a robust measure of mother-infant impaired bonding during the first 6 months postpartum.\u003c/p\u003e\n\u003ch3\u003eMeasures At 1-year Postpartum\u003c/h3\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eInfant Socioemotional Dysfunction.\u003c/span\u003e The Ages and Stages Questionnaire: Social-Emotional, Second Edition (ASQ:SE-2; (Squires et al., \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e) was used to assess socioemotional dysfunction when the infant turned one year of age. Participants reported how frequently their infant had engaged in a series of behaviors (e.g., \u0026ldquo;Smiles at you and family members?\u0026rdquo;, \u0026ldquo;Cries for long periods of time?\u0026rdquo;) using the following scale: \u003cem\u003eoften or always\u003c/em\u003e (score\u0026thinsp;=\u0026thinsp;1), \u003cem\u003esometimes\u003c/em\u003e (score\u0026thinsp;=\u0026thinsp;5), and \u003cem\u003erarely or never\u003c/em\u003e (score\u0026thinsp;=\u0026thinsp;10). They were also asked to indicate \u003cem\u003eif this is a concern\u003c/em\u003e (score\u0026thinsp;=\u0026thinsp;5). Items were aggregated to obtain an overall score ranging from 0 to 345 (reverse coding items that represent competencies), with higher scores indicating greater infant socioemotional dysfunction. The correlation between maternal and paternal reports was significant (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.33, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Therefore, scores were aggregated to obtain a score of infant socioemotional dysfunction based on multiple parental reports to produce a less biased and more reliable estimate (Lengua et al., \u003cspan class=\"CitationRef\"\u003e2008\u003c/span\u003e). The ASQ:SE-2 has demonstrated good reliability and validity, and there was adequate internal consistency in the present sample (Cronbach\u0026rsquo;s \u0026alpha;\u0026thinsp;\u003cem\u003e=\u0026thinsp;.\u003c/em\u003e71).\u003c/p\u003e\n\u003ch3\u003eData Analytic Plan\u003c/h3\u003e\n\u003cp\u003eWe tested a series of mediation models in Mplus 8.0. (Muth\u0026eacute;n \u0026amp; Muth\u0026eacute;n, \u003cspan class=\"CitationRef\"\u003e2010\u003c/span\u003e). Missing data were addressed with full information maximum likelihood estimation (covariance coverage ranged from .74 to 1.00), which retains all participants and is preferred over more traditional approaches for handling missing data that introduce bias (e.g., pairwise deletion; Enders, \u003cspan class=\"CitationRef\"\u003e2010\u003c/span\u003e). A series of demographic characteristics (e.g., maternal age, relationship duration, first-time parenthood status, minority racial/ethnic identity, and low-income status) were screened for potential inclusion as control variables. First-time parenthood status was associated with mother-infant bonding and was therefore included as a control. We also controlled for week of pregnancy when the initial assessment occurred to account for differing time intervals between the pregnancy and follow-up assessments across participants.\u003c/p\u003e\n\u003cp\u003eMediation models were just-identified. To test for mediation, a nonparametric resampling method (bias-corrected bootstrap) with 10,000 resamples was performed to derive the 95% confidence intervals for indirect effects (Preacher et al., \u003cspan class=\"CitationRef\"\u003e2007\u003c/span\u003e). Bias-corrected bootstrapped confidence intervals were used to determine significance of effects given they are robust to violations of univariate and multivariate normality. Data management and analysis procedures for this project were registered (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://osf.io/hprk8\u003c/span\u003e\u003c/span\u003e), and we made no deviations from that plan. Because we had prior knowledge of data from this longitudinal study, we did not preregister study hypotheses.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eDescriptive statistics and correlations are reported in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. As expected for a community sample, levels of body surveillance, general depression, and body dissatisfaction in mothers during pregnancy were relatively low, as were impairments in bonding during the first 6 months postpartum and infant socioemotional dysfunction at 1-year postpartum. There was a large correlation between body surveillance and body dissatisfaction during pregnancy (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.54, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), as well as a moderate correlation between body surveillance and general depression (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.30, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Body surveillance in mothers was significantly correlated with impaired bonding during the first 6 months postpartum (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.16, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05). There was a moderate correlation between general depression and body dissatisfaction during pregnancy (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.34, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Small but significant correlations between general depression and impaired bonding (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.26, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and between body dissatisfaction and impaired bonding (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.23, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01) emerged. Last, impaired bonding was associated with greater infant socioemotional difficulties (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.21, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable border=\"1\" id=\"Tab1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003eDescriptive Statistics and Correlations\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1. Body Surveillance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2. General Depression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.30\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3. Body Dissatisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.54\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.34\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4. Impaired Bonding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.16\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.26\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.23\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5. Infant Socioemotional Dysfunction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.21\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\"\u003e\u003cem\u003eNote.\u003c/em\u003e Significant correlations are bolded.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\"\u003e*\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05. **\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01. ***\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eMediation Model With General Depression As Critical Mediator\u003c/h3\u003e\n\u003cp\u003eFirst, we tested a serial mediation model with body surveillance \u0026rarr; \u003cem\u003egeneral depression\u003c/em\u003e \u0026rarr; impaired mother-infant bonding \u0026rarr; infant socioemotional dysfunction. Full model results are reported in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003ea. Greater body surveillance was associated with greater general depression during pregnancy, 95% CI [1.29, 4.12]. Further, greater maternal depression predicted higher levels of impaired mother-infant bonding over the first 6 months postpartum, 95% CI [.05, .32]. In turn, bonding difficulties predicted greater socioemotional dysfunction for infants at 1 year of age, 95% CI [.04, .77]. The overall indirect effect of body surveillance on infant socioemotional dysfunction through maternal general depression and impaired mother-infant bonding was significant, 95% CI [.04, .59].\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable border=\"1\" id=\"Tab2\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003ePath Analyses Examining the Impact of Body Surveillance, General Depression, and Body Dissatisfaction During Pregnancy on Infant Socioemotional Dysfunction via Impaired Bonding\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eUnstandardized Estimate\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e95% CI\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eStandardized Estimate\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cspan class=\"BoldUnderline\"\u003eModel 1: General depression\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: Infant socioemotional dysfunction (ASQ), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eImpaired bonding (BOND)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.40\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[.04, .77]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.19\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGeneral depression (DEP)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.24, .43]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody surveillance (OBJ)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-2.34, 3.87]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: Impaired bonding (BOND), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eGeneral depression (DEP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[.05, .32]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.22\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody surveillance (OBJ)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.35, 2.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: General depression (DEP), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody surveillance (OBJ)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.70\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[1.29, 4.12]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.31\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eIndirect effects\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBJ \u0026rarr; DEP \u0026rarr; ASQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.64, 1.26]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBJ \u0026rarr; BOND \u0026rarr; ASQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.07, 1.09]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBJ \u0026rarr; DEP \u0026rarr; BOND \u0026rarr; ASQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.19\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[.04, .59]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cspan class=\"BoldUnderline\"\u003eModel 2: Body dissatisfaction\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: Infant socioemotional dysfunction (ASQ), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eImpaired bonding (BOND)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.42\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[.08, .79]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody dissatisfaction (BODY)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.51, .65]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody surveillance (OBJ)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-3.08, 4.16]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: Impaired bonding (BOND), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody dissatisfaction (BODY)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.24\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[.01, .48]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody surveillance (OBJ)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.81, 1.82]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: Body dissatisfaction (BODY), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody surveillance (OBJ)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[2.45, 4.15]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.54\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eIndirect effects\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBJ \u0026rarr; BODY \u0026rarr; ASQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-1.69, 2.24]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBJ \u0026rarr; BOND \u0026rarr; ASQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.29, 1.02]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eOBJ \u0026rarr; BODY \u0026rarr; BOND \u0026rarr; ASQ\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.34\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[.03, 1.00]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cspan class=\"BoldUnderline\"\u003eModel 3: Integrated model\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: Infant socioemotional dysfunction (ASQ), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eImpaired bonding (BOND)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.40\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[.04, .76]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.19\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGeneral depression (DEP)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.25, .46]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody dissatisfaction (BODY)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.62, .64]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody surveillance (OBJ)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-3.28, 3.97]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: Impaired bonding (BOND), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eGeneral depression (DEP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[.02, .30]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody dissatisfaction (BODY)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.07, .42]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody surveillance (OBJ)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.97, 1.67]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: General depression (DEP), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody surveillance (OBJ)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.68\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[1.26, 4.11]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.31\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003eOutcome\u003c/em\u003e: Body dissatisfaction (BODY), \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody surveillance (OBJ)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[2.44, 4.15]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.54\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eIndirect effects\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBJ \u0026rarr; DEP \u0026rarr; ASQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.68, 1.33]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBJ \u0026rarr; BODY \u0026rarr; ASQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-2.01, 2.16]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBJ \u0026rarr; BOND \u0026rarr; ASQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.37, .89]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eOBJ \u0026rarr; DEP \u0026rarr; BOND \u0026rarr; ASQ\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[.03, .55]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBJ \u0026rarr; BODY \u0026rarr; BOND \u0026rarr; ASQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-.03, .83]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\"\u003e\u003cem\u003eNote.\u003c/em\u003e Significant parameters are bolded.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\"\u003e\u003csup\u003ea\u003c/sup\u003e 95% confidence intervals based on 10,000 bootstrapped samples.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eMediation Model With Body Dissatisfaction As Critical Mediator\u003c/h3\u003e\n\u003cp\u003eNext, we tested a serial mediation model with body surveillance \u0026rarr; \u003cem\u003ebody dissatisfaction\u003c/em\u003e \u0026rarr; impaired mother-infant bonding \u0026rarr; infant socioemotional dysfunction. Full model results are reported in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003eb. Greater body surveillance was associated with greater body dissatisfaction during pregnancy, 95% CI [2.45, 4.15]. Further, greater body dissatisfaction predicted higher levels of impaired mother-infant bonding over the first 6 months postpartum, 95% CI [.01, .48]. In turn, bonding difficulties predicted greater socioemotional dysfunction for infants at 1 year of age, 95% CI [.08, .79]. The overall indirect effect of body surveillance on infant socioemotional dysfunction through maternal body dissatisfaction and impaired mother-infant bonding was significant, 95% CI [.03, 1.00].\u003c/p\u003e\n\u003ch3\u003eIntegrated Model With Depression And Body Dissatisfaction As Parallel Mediators\u003c/h3\u003e\n\u003cp\u003eFinally, we tested an integrated model with general depression and body dissatisfaction as parallel mediators in a larger serial mediation model. We covaried the residuals of general depression and body dissatisfaction as they are both dimensions of maternal mental health. Full model results are reported in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003ec. Greater body surveillance was associated with greater maternal depression, 95% CI [1.26, 4.11], and body dissatisfaction during pregnancy, 95% CI [2.44, 4.15]. Further, greater maternal depression associated with body surveillance predicted higher levels of impaired mother-infant bonding over the first 6 months postpartum, controlling for body dissatisfaction, 95% CI [.02, .30]. In turn, bonding difficulties predicted socioemotional dysfunction for infants at 1 year of age, 95% CI [.04, .76]. The overall indirect effect of body surveillance on infant socioemotional dysfunction at 1-year postpartum through maternal general depression and impaired mother-infant bonding was significant, 95% CI [.03, .55]. Notably, when controlling for depression, body dissatisfaction was no longer a significant mechanism through which body surveillance impacted mother-infant bonding and infant socioemotional dysfunction.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eLiving in a culture of persistent objectification, women may self-objectify and experience societal pressure to modify their bodies to achieve the thin ideal. During pregnancy, a period in which the body undergoes rapid changes to support fetal development, women who have internalized these messages and engage in more body surveillance may be at increased risk for negative mental health consequences, including body dissatisfaction and depression (Beech et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Brock et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Rubin \u0026amp; Steinberg, \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Maternal mental health, in turn, can undermine the mother-infant relationship and infant socioemotional functioning (McNamara et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Slomian et al., \u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). By integrating research and theory in the areas of objectification and maternal-infant health, we found support for a novel conceptual framework in which self-objectification during pregnancy, as manifested by body surveillance, contributes to impaired mother-infant bonding and infant socioemotional functioning at 1-year postpartum through maternal mental health difficulties during pregnancy (i.e., body dissatisfaction and depression). Specifically, we found that mothers who endorsed higher levels of body surveillance also reported higher levels of depressive symptoms and body dissatisfaction during pregnancy. In turn, depressive symptoms and body dissatisfaction were associated with greater mother-infant bonding impairments during the 6 months following childbirth, which contributed to subsequent infant socioemotional dysfunction at 1-year postpartum (i.e., difficulties self-soothing, feeding, and sleeping).\u003c/p\u003e \u003cp\u003eWhen examining maternal depressive symptoms and body dissatisfaction during pregnancy as parallel mechanisms, results suggested that maternal depressive symptoms uniquely contribute to bonding impairments and subsequent maladjustment. Thus, maternal prenatal depression, which was moderately correlated with body dissatisfaction, might be a particularly salient pathway through which body surveillance undermines bonding and infant development. A potential explanation for this finding is that body dissatisfaction during pregnancy could be a prodromal symptom of an underlying mood disorder (Chan et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Roomruangwong et al., \u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) or a risk factor for elevations in prenatal depression (Riquin et al., \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Indeed, a recent study found that risk of perinatal depression was four times higher in women dissatisfied with their body image (Riquin et al., \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Ultimately, results from the present study suggest that persistent depressed mood might be more detrimental to mother-infant bonding (e.g., by undermining maternal motivation and leading to disengagement) than unique aspects of body dissatisfaction. Nonetheless, given that it might contribute to risk for depression, body dissatisfaction remains an important target for investigations of prenatal mental health, particularly in perinatal research pursued within an objectification framework.\u003c/p\u003e\n\u003ch3\u003eTheoretical Implications\u003c/h3\u003e\n\u003cp\u003eThe present work makes several theoretical contributions to the literature on objectification. First, while pregnancy is a time when women may experience greater objectification and related consequences due to bodily changes, only a handful of studies (e.g., Rubin \u0026amp; Steinberg, \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Brock et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) have examined body surveillance, body dissatisfaction, and depression during this period. Thus, this study adds to limited research demonstrating that objectification theory, as originally posited by Fredrickson and Roberts (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e1997\u003c/span\u003e) and expanded over the years (Roberts et al., \u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) also applies to pregnant women.\u003c/p\u003e \u003cp\u003eSecond, to our knowledge, the present study is the first research to link body surveillance to the early mother-infant relationship and infant socioemotional functioning via prenatal depression and body dissatisfaction. While extant research has revealed an association between body surveillance and related mental health outcomes among mothers and children, no research to date has linked these variables during infancy. Further, results isolate a key developmental cascade in which maternal mental health during pregnancy, \u003cem\u003eprior to the birth of the child\u003c/em\u003e, predicts early parenting behaviors and infant socioemotional functioning. Researchers increasingly recognize the pregnancy-postpartum transition as a critical window for intervention and assert that this \u0026ldquo;may be the most important way to ensure healthy child development\u0026rdquo; (Saxbe et al., \u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Thus, prenatal maternal mental health represents a critical target for reducing risk for infant socioemotional difficulties, and results of the present study identify features of maternal mental health that have received limited attention in past research (i.e., body surveillance and body dissatisfaction) yet appear to have important implications for infant development.\u003c/p\u003e\n\u003ch3\u003eLimitations And Future Research Directions\u003c/h3\u003e\n\u003cp\u003eIt is important to acknowledge that the sample was comprised of women in committed relationships with men; participants also primarily identified as White and were from middle-class backgrounds, thereby limiting the generalizability of the results. There is a need for research examining objectification theory among more diverse populations (e.g., among sexual, gender, and racial minorities). For example, people of color, as well as sexual and gender minorities, experience unique forms of objectification, such as racialized sexual objectification and body policing (Flores et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). These additional forms of objectification may place pregnant people at even greater risk for self-objectification and related adverse mental health outcomes. There is also increasing recognition that researchers and clinicians alike must broaden their conceptualizations of pregnancy to include the experiences of not only cisgender women, but also transgender and nonbinary individuals (Moseson et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Roosevelt et al., \u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere were also limitations to our measurement approach. First, while the present work examined body surveillance as a manifestation of self-objectification and downstream consequences identified by objectification theory (e.g., body dissatisfaction, depression, Roberts et al., \u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) as well as novel consequences (e.g., infant outcomes), some aspects of the objectification model remain untested in pregnant women. We did not measure specific types of objectification that pregnant women may experience, such as objectification directed at their size and shape (e.g., because their bodies no longer conform to feminine ideals of thinness) or involving denial of autonomy and subjectivity (e.g., because their bodies become public property). Relatedly, we only included one indicator of self-objectification. Thus, future research should examine how other indicators of self-objectification, such as internalized objectifying views (Noll \u0026amp; Fredrickson, 1998) and beliefs (Lindner et al., 2017), as well as non-bodily indicators of self-objectification (e.g., feeling invisible or lacking autonomy; Talmon \u0026amp; Ginzburg, \u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), might impact infant socioemotional functioning. To conduct this important work, measures that specifically assess objectification and self-objectification in pregnant women will need to be developed and validated.\u003c/p\u003e \u003cp\u003eSecond, our measure of body dissatisfaction was not specifically designed for pregnancy and therefore may not capture specific appearance-related concerns associated with pregnancy (e.g., stretch marks, having a prototypical \u0026ldquo;baby bump\u0026rdquo;). Future research should consider newly developed measures, such as the Body Understanding Measure for Pregnancy Scale (BUMPs; Kirk \u0026amp; Preston, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) or the Body Experience during Pregnancy Scale (BEPS; Talmon \u0026amp; Ginzburg, \u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), that measure other facets of the body experience during pregnancy (e.g., body agency, estrangement, and visibility; satisfaction with appearing pregnant; weight gain concerns; physical burdens of pregnancy). Third, all data were collected using self-report questionnaires, raising the possibility of shared method bias. Although most objectification research has relied on self-report measures, there is increasing evidence that innovative approaches, such as eye tracking technology, can be utilized to assess the objectifying gaze, which may contribute to self-objectification (Gervais et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Karsay et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Fourth, measures of body surveillance, body dissatisfaction, and depression were gathered at the same time point. Although objectification theory posits that body surveillance contributes to subsequent body dissatisfaction and depression (Fredrickson \u0026amp; Roberts, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e1997\u003c/span\u003e), it is also possible that maternal depression contributes to increased body surveillance. Thus, future studies examining these constructs at different time points across pregnancy are necessary to establish causality.\u003c/p\u003e \u003cp\u003eFinally, other factors of potential relevance to the study aims warrant attention in future research. For example, we did not examine the impact of objective measures of weight, such as pre-pregnancy and pregnancy body-mass index (BMI) and gestational weight gain, on body surveillance, general depression, and body dissatisfaction during pregnancy. Research on this topic is particularly important given that pregnant people with higher BMI are more likely to experience weight stigma (Mulherin et al., \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Parker \u0026amp; Paus\u0026eacute;, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), which has the potential to exacerbate maternal prenatal mental health concerns and, in turn, infant outcomes. In addition, given that pregnancy and childbirth experiences may contribute to bonding impairments (e.g., Hanko et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Sockol et al., \u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e2014\u003c/span\u003e), research examining whether perinatal complications moderate the associations between prenatal body surveillance, body dissatisfaction, depression, and mother-infant bonding during the postpartum is warranted.\u003c/p\u003e\n\u003ch3\u003ePractice Implications\u003c/h3\u003e\n\u003cp\u003eThe present study sheds light on the importance of early interventions targeting not only maternal prenatal depression, but also body surveillance and dissatisfaction, to promote healthy infant development. Because body surveillance is a consequence of living in a culture that persistently objectifies women\u0026rsquo;s bodies, prevention efforts must begin at the societal level, long before people become pregnant. For instance, media campaigns can raise awareness of the insidious nature of valuing the appearance of girls and women over their other attributes and can help change perceptions of beauty by promoting body positivity and acceptance (e.g., #AerieReal and Dove\u0026rsquo;s Real Beauty campaign). Specific efforts to target objectification during pregnancy and the postpartum period are also warranted, such as campaigns promoting real images of mothers and their infants. For example, Mothercare\u0026rsquo;s #BodyProudMums is aimed at normalizing and celebrating the diversity and beauty of post-baby bodies. Broader dissemination of campaigns of this nature has the potential to promote maternal well-being. Finally, emerging evidence suggests that social media can be leveraged for the delivery of brief interventions to improve maternal body image and wellbeing (Wallis et al., \u003cspan citationid=\"CR95\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUnfortunately, societal change is slow, and objectification continues to manifest in ways that justify the patriarchy despite collective advances (Roberts et al., \u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Therefore, beyond broad prevention efforts, there is also a need for targeted interventions informed by careful screening. Providers who interact regularly with pregnant women (e.g., obstetricians, nurses, midwives) could screen for elevations in body surveillance and associated body dissatisfaction and, when indicated, deliver brief interventions to disrupt self-objectification by promoting embodiment, which emphasizes positive self-talk, body functionality and agency, and experiencing the body from a subjective position rather than viewing themselves as sexual objects (Piran, \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). It is critical that providers avoid protective paternalism and benevolent sexism discourses (e.g., restricting women\u0026rsquo;s behaviors during pregnancy to protect the fetus; Sutton et al., \u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Instead, providers should counteract societal objectification and related self-objectification in ways that normalize the experience of body surveillance and body dissatisfaction during pregnancy and empower expectant mothers to prioritize their own mental health. Indeed, research suggests that pregnant women may be especially motivated to make behavioral changes that promote maternal and infant health (Ayyala et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e); thus, pregnancy may be a promising developmental window for the delivery of interventions targeting self-objectification, body surveillance, and the cascade of negative mental health outcomes.\u003c/p\u003e \u003cp\u003eAdditionally, despite the prevalence and underdiagnosis of perinatal depression (Cox et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Underwood et al., \u003cspan citationid=\"CR94\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), there continues to be a critical need for universal screening and multidisciplinary approaches to maternal mental health care from a range of providers (e.g., obstetrics and gynecology, family medicine, and pediatric care providers; Muzik \u0026amp; Borovska, \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) assessing multiple indicators of risk. For example, results highlight the utility of screening for body surveillance and dissatisfaction as an early manifestation of depressive symptoms, which can be done briefly and as part of routine prenatal care (Riquin et al., \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Stunkard et al., \u003cspan citationid=\"CR87\" class=\"CitationRef\"\u003e1983\u003c/span\u003e). Further, perinatal depression screening can be effectively implemented by health and social service professionals with limited background in mental health (Segre et al., \u003cspan citationid=\"CR81\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Professionals who come in regular contact with pregnant women (e.g., physicians, social workers, nurses) but do not have formal training in the assessment of depression could facilitate discussions of how women are relating to their bodies as they change throughout pregnancy and the postpartum. This approach has the potential to identify women who would benefit from intervention but might otherwise be overlooked by current screening practices.\u003c/p\u003e \u003cp\u003eMore generally, our results suggest that doctors and clinicians might benefit from a broader conceptualization of maternal mental health during pregnancy including other dimensions of the perinatal experience, such as body shame and dissatisfaction. Women are routinely weighed throughout pregnancy for important medical reasons (e.g., to monitor fetal growth); however, routine weight assessments have the potential to increase body surveillance and adversely impact perinatal mental health. Thus, healthcare providers might consider approaching conversations about weight with sensitivity and with the goal of promoting a healthy pregnancy and baby. For instance, the National Institute of Child and Human Development\u0026rsquo;s \u003cem\u003ePregnancy for Every Body\u003c/em\u003e initiative aims to help people of all sizes achieve a healthy pregnancy (National Institute of Child and Human Development, 2019). In addition, providing psychoeducation on the natural bodily changes that occur across pregnancy may help mothers adjust to changing body ideals (Beech et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). By emphasizing body functionality, maternal healthcare providers may help women shift their focus away from their appearance-related concerns (Alleva \u0026amp; Tylka, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Beech et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFinally, interventions for pregnant couples that seek to increase partner support may be particularly beneficial given evidence that partners may play a unique role in enhancing maternal body satisfaction during pregnancy (Watson et al., \u003cspan citationid=\"CR97\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Indeed, given evidence that intimate partner humanization during pregnancy is associated with less body surveillance in mothers (Brock et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), it is important for interventions targeting self-objectification and its related consequences to include not only pregnant women, but also their partners.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe present study demonstrated that body surveillance during pregnancy impacts infant socioemotional functioning at 1-year postpartum through increased prenatal depressive symptoms and body dissatisfaction and impaired mother-bonding during the 6 months following childbirth. Further, results suggested that maternal depressive symptoms may uniquely contribute to bonding impairments and subsequent child outcomes. This work expands on the limited body of research applying objectification theory to the experience of pregnancy and childbirth and supports a novel conceptual framework within which maternal self-objectification, manifested as body surveillance during pregnancy, impacts infant development as early as 1-year postpartum. Results highlight the potential utility of prenatal interventions guided by objectification theory to reduce the consequences of sexual objectification on mothers and their children.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This research was supported by the Eunice Kennedy Shriver National Institute of Child Health \u0026amp; Human Development of the National Institutes of Health (F31HD107948). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also funded by several internal funding mechanisms awarded to PI Rebecca Brock from the UNL Department of Psychology, the Nebraska Tobacco Settlement Biomedical Research Development Fund, and the UNL Office of Research and Economic Development.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u003c/strong\u003e The authors have no competing interests to declare that are relevant to the content of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval:\u003c/strong\u003e Research was approved by the UNL Institutional Review Board (IRB Approval #: 20151215700EP; Title: Family Development Project).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u003c/strong\u003e This study complied with Transparency and Openness Promotion (TOP) Guidelines. The study PI, Rebecca L. Brock ([email protected]), should be contacted to request access to research materials, analysis code, and data. Data management and analysis procedures for this project are registered at https://osf.io/hprk8, and we made no deviations from that plan.\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Note:\u0026nbsp;\u003c/strong\u003eWe thank the families who participated in this research and the entire team of research assistants who contributed to various stages of the study. In particular, we thank Erin Ramsdell, Jennifer Blake, and Kailee Groshans for project coordination. Data from this sample have been published elsewhere (e.g., Brock et al., 2020; Ramsdell \u0026amp; Brock, 2020); however, this is the first article in which body surveilllane has been linked to mother-infant bonding and infant outcomes. Portions of this article were presented at the 2020 International Marc\u0026eacute; Society for Perinatal Mental Health virtual conference.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCOMPLIANCE WITH ETHICAL STANDARDS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure of potential conflicts of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors do not have any conflicts of interest to disclose.\u003c/p\u003e\n\u003cp\u003eThis research was supported by the Eunice Kennedy Shriver National Institute of Child Health \u0026amp; Human Development of the National Institutes of Health (F31HD107948). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also funded by several internal funding mechanisms awarded to PI Rebecca Brock from the UNL Department of Psychology, the Nebraska Tobacco Settlement Biomedical Research Development Fund, and the UNL Office of Research and Economic Development.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch involving human participants and/or animals\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present research involved human participants. Research was approved by the UNL Institutional Review Board (IRB Approval #: 20151215700EP; Title: Family Development Project).\u003c/p\u003e\n\u003cp\u003eNo animals were involved in the present research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants completed written informed consent procedures upon study enrollment.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlleva, J. M., \u0026amp; Tylka, T. L. (2021). Body functionality: A review of the literature. \u003cem\u003eBody Image\u003c/em\u003e, \u003cem\u003e36, \u003c/em\u003e149\u0026ndash;171. https://doi.org/10.1016/j.bodyim.2020.11.006\u003c/li\u003e\n\u003cli\u003eArpi, E., \u0026amp; Ferrari, F. (2013). Preterm birth and behaviour problems in infants and preschool-age children: A review of the recent literature. \u003cem\u003eDevelopmental Medicine and Child Neurology\u003c/em\u003e, 55(9), 788\u0026ndash;796. https://doi.org/10.1111/dmcn.12142\u003c/li\u003e\n\u003cli\u003eArroyo, A., \u0026amp; Andersen, K. K. (2016). The relationship between mother-daughter self-objectification: Identifying direct, indirect, and conditional direct effects. \u003cem\u003eSex Roles\u003c/em\u003e, \u003cem\u003e74\u003c/em\u003e(5\u0026ndash;6), 231\u0026ndash;\u0026ndash;241. https://doi.org/10.1007/s11199-015-0554-1\u003c/li\u003e\n\u003cli\u003eAyyala, M. S., Coughlin, J. W., Martin, L., Henderson, J., Ezekwe, N., Clark, J. M., Appel, L. J., \u0026amp; Bennett, W. L. (2020). Perspectives of pregnant and postpartum women and obstetric providers to promote healthy lifestyle in pregnancy and after delivery: A qualitative in-depth interview study. \u003cem\u003eBMC Women\u0026rsquo;s Health\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e(1), 44. https://doi.org/10.1186/s12905-020-0896-x\u003c/li\u003e\n\u003cli\u003eBarker, E. D., Jaffee, S. R., Uher, R., \u0026amp; Maughan, B. (2011). The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment. \u003cem\u003eDepression and Anxiety\u003c/em\u003e, \u003cem\u003e28\u003c/em\u003e(8), 696\u0026ndash;702. https://doi.org/10.1002/da.20856\u003c/li\u003e\n\u003cli\u003eBeech, O. D., Kaufmann, L., \u0026amp; Anderson, J. (2020). A systematic literature review exploring objectification and motherhood. \u003cem\u003ePsychology of Women Quarterly\u003c/em\u003e, \u003cem\u003e44\u003c/em\u003e(4), 036168432094981. https://doi.org/10.1177/0361684320949810\u003c/li\u003e\n\u003cli\u003eBergmeier, H., Hill, B., Haycraft, E., Blewitt, C., Lim, S., Meyer, C., \u0026amp; Skouteris, H. (2020). Maternal body dissatisfaction in pregnancy, postpartum and early parenting: An overlooked factor implicated in maternal and childhood obesity risk. \u003cem\u003eAppetite\u003c/em\u003e, \u003cem\u003e147, \u003c/em\u003e104525. https://doi.org/10.1016/j.appet.2019.104525\u003c/li\u003e\n\u003cli\u003eBicking Kinsey, C., \u0026amp; Hupcey, J. E. (2013). State of the science of maternal\u0026ndash;infant bonding: A principle-based concept analysis. \u003cem\u003eMidwifery\u003c/em\u003e, \u003cem\u003e29\u003c/em\u003e, 1314\u0026ndash;1320. https://doi.org/10.1016/j.midw.2012.12.019\u003c/li\u003e\n\u003cli\u003eBlissett, J., \u0026amp; Haycraft, E. (2011). Parental eating disorder symptoms and observations of mealtime interactions with children. \u003cem\u003eJournal of Psychosomatic Research\u003c/em\u003e, \u003cem\u003e70\u003c/em\u003e(4), 368\u0026ndash;371. https://doi.org/10.1016/j.jpsychores.2010.07.006\u003c/li\u003e\n\u003cli\u003eBrock, R. L., Ramsdell, E. L., S\u0026aacute;ez, G., \u0026amp; Gervais, S. J. (2021). Perceived humanization by intimate partners during pregnancy is associated with fewer depressive symptoms, less body dissatisfaction, and greater sexual satisfaction through reduced self-objectification. \u003cem\u003eSex Roles\u003c/em\u003e, \u003cem\u003e84\u003c/em\u003e(5\u0026ndash;6), 285\u0026ndash;298. https://doi.org/10.1007/s11199-020-01166-6\u003c/li\u003e\n\u003cli\u003eBrockington, I. F., Oates, J., George, S., Turner, D., Vostanis, P., Sullivan, M., Loh, C., \u0026amp; Murdoch, C. (2001). A screening questionnaire for mother-infant bonding disorders. \u003cem\u003eArchives of Women\u0026rsquo;s Mental Health\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e, 133\u0026ndash;140. https://doi.org/10.1007/s007370170010\u003c/li\u003e\n\u003cli\u003eChan, C. Y., Lee, A. M., Koh, Y. W., Lam, S. K., Lee, C. P., Leung, K. Y., \u0026amp; Tang, C. S. K. (2020). Associations of body dissatisfaction with anxiety and depression in the pregnancy and postpartum periods: A longitudinal study. \u003cem\u003eJournal of Affective Disorders\u003c/em\u003e, \u003cem\u003e263, \u003c/em\u003e582\u0026ndash;592. https://doi.org/10.1016/j.jad.2019.11.032\u003c/li\u003e\n\u003cli\u003eChapman, L., Cartwright-Hatton, S., Thomson, A., \u0026amp; Lester, K. J. (2021). Parental eating disorders: A systematic review of parenting attitudes, behaviours, and parent-child interactions. \u003cem\u003eClinical Psychology Review\u003c/em\u003e, \u003cem\u003e88\u003c/em\u003e, 102031. https://doi.org/10.1016/j.cpr.2021.102031\u003c/li\u003e\n\u003cli\u003eClark, A., Skouteris, H., Wertheim, E. H., Paxton, S. J., \u0026amp; Milgrom, J. (2009). The relationship between depression and body dissatisfaction across pregnancy and the postpartum. \u003cem\u003eJournal of Health Psychology\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e, 27\u0026ndash;35. https://doi.org/10.1177/1359105308097940\u003c/li\u003e\n\u003cli\u003eCoker, E., \u0026amp; Abraham, S. (2015). Body weight dissatisfaction before, during and after pregnancy: A comparison of women with and without eating disorders. \u003cem\u003eEating and Weight Disorders\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e(1), 71\u0026ndash;79. https://doi.org/10.1007/s40519-014-0133-4\u003c/li\u003e\n\u003cli\u003eCox, E. Q., Sowa, N. A., Meltzer-Brody, S. E., \u0026amp; Gaynes, B. N. (2016). The perinatal depression treatment cascade: Baby steps toward improving outcomes. \u003cem\u003eJournal of Clinical Psychiatry, 77\u003c/em\u003e(9), 1189\u0026ndash;1200. https://doi.org/10.4088/JCP.15r10174\u003c/li\u003e\n\u003cli\u003ede Cock, E. S. A., Henrichs, J., Vreeswijk, C. M. J. M., Maas, A. J. B. M., Rijk, C. H. A. M., \u0026amp; van Bakel, H. J. A. (2016). Continuous feelings of love? The parental bond from pregnancy to toddlerhood. \u003cem\u003eJournal of Family Psychology\u003c/em\u003e, \u003cem\u003e30\u003c/em\u003e, 125\u0026ndash;134. https://doi.org/10.1037/fam0000138\u003c/li\u003e\n\u003cli\u003eDeave, T., Heron, J., Evans, J., \u0026amp; Emond, A. (2008). The impact of maternal depression in pregnancy on early child development. \u003cem\u003eBJOG: An International Journal of Obstetrics \u0026amp; Gynaecology\u003c/em\u003e, \u003cem\u003e115\u003c/em\u003e(8), 1043\u0026ndash;1051. https://doi.org/10.1111/j.1471-0528.2008.01752.x\u003c/li\u003e\n\u003cli\u003eDryer, R., Graefin von der Schulenburg, I., \u0026amp; Brunton, R. (2020). Body dissatisfaction and Fat Talk during pregnancy: Predictors of distress. \u003cem\u003eJournal of Affective Disorders\u003c/em\u003e, \u003cem\u003e267, \u003c/em\u003e289\u0026ndash;296. https://doi.org/10.1016/j.jad.2020.02.031\u003c/li\u003e\n\u003cli\u003eDuke, R. E., Bryson, S., Hammer, L. D., \u0026amp; Agras, W. S. (2004). The relationship between parental factors at infancy and parent-reported control over children\u0026rsquo;s eating at age 7. \u003cem\u003eAppetite\u003c/em\u003e, \u003cem\u003e43\u003c/em\u003e(3), 247\u0026ndash;252. https://doi.org/10.1016/j.appet.2004.05.006\u003c/li\u003e\n\u003cli\u003eEnders, C. K. (2010). \u003cem\u003eApplied missing data analysis\u003c/em\u003e. Guilford Press.\u003c/li\u003e\n\u003cli\u003eFarrow, C. V., Haycraft, E., \u0026amp; Blissett, J. M. (2015). Teaching our children when to eat: How parental feeding practices inform the development of emotional eating-a longitudinal experimental design. \u003cem\u003eAmerican Journal of Clinical Nutrition\u003c/em\u003e, \u003cem\u003e101\u003c/em\u003e(5), 908\u0026ndash;913. https://doi.org/10.3945/ajcn.114.103713\u003c/li\u003e\n\u003cli\u003eField, T. (2017). Prenatal depression risk factors, developmental effects and interventions: A review. \u003cem\u003eJournal of Pregnancy and Child Health\u003c/em\u003e, \u003cem\u003e4\u003c/em\u003e(1), 301. https://doi.org/10.4172/2376-127x.1000301\u003c/li\u003e\n\u003cli\u003eFitzsimmons-Craft, E. E., \u0026amp; Bardone-Cone, A. M. (2012). Examining prospective mediation models of body surveillance, trait anxiety, and body dissatisfaction in African American and Caucasian college women. \u003cem\u003eSex Roles\u003c/em\u003e, \u003cem\u003e67\u003c/em\u003e(3\u0026ndash;4), 187\u0026ndash;200. https://doi.org/10.1007/s11199-012-0151-5\u003c/li\u003e\n\u003cli\u003eFlores, M. J., Watson, L. B., Allen, L. R., Ford, M., Serpe, C. R., \u0026amp; Choo, P. Y. (2018). Transgender people of color\u0026rsquo;s experiences of sexual objectification: Locating sexual objectification within a matrix of domination. \u003cem\u003eJournal of Counseling Psychology\u003c/em\u003e, \u003cem\u003e65\u003c/em\u003e(3), 308\u0026ndash;323. https://doi.org/10.1037/cou0000279\u003c/li\u003e\n\u003cli\u003eForbush, K. T., Wildes, J. E., \u0026amp; Hunt, T. K. (2014). Gender norms, psychometric properties, and validity for the Eating Pathology Symptoms Inventory. \u003cem\u003eInternational Journal of Eating Disorders\u003c/em\u003e, \u003cem\u003e47\u003c/em\u003e(1), 85\u0026ndash;91. https://doi.org/10.1002/eat.22180\u003c/li\u003e\n\u003cli\u003eForbush, K. T., Wildes, J. E., Pollack, L. O., Dunbar, D., Luo, J., Patterson, K., Petruzzi, L., Pollpeter, M., Miller, H., Stone, A., Bright, A., \u0026amp; Watson, D. D. (2013). Development and validation of the eating pathology symptoms inventory (EPSI). \u003cem\u003ePsychological Assessment\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(3), 859\u0026ndash;878. https://doi.org/10.1037/a0032639\u003c/li\u003e\n\u003cli\u003eFredrickson, B. L., \u0026amp; Roberts, T. A. (1997). Toward understanding women\u0026rsquo;s lived experiences and mental health risks. \u003cem\u003ePsychology of Women Quarterly\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(2), 173\u0026ndash;206. https://doi.org/10.1111/j.1471-6402.1997.tb00108.x\u003c/li\u003e\n\u003cli\u003eFuller-Tyszkiewicz, M., Broadbent, J., Richardson, B., Watson, B., Klas, A., \u0026amp; Skouteris, H. (2020). A network analysis comparison of central determinants of body dissatisfaction among pregnant and non-pregnant women. \u003cem\u003eBody Image\u003c/em\u003e, \u003cem\u003e32, \u003c/em\u003e111\u0026ndash;120. https://doi.org/10.1016/j.bodyim.2019.12.001\u003c/li\u003e\n\u003cli\u003eFuller-Tyszkiewicz, M., Skouteris, H., Watson, B. E., \u0026amp; Hill, B. (2013). Body dissatisfaction during pregnancy: A systematic review of cross-sectional and prospective correlates. \u003cem\u003eJournal of Health Psychology, 18\u003c/em\u003e(11), 1411\u0026ndash;1421. https://doi.org/10.1177/1359105312462437\u003c/li\u003e\n\u003cli\u003eGalbally, M., \u0026amp; Lewis, A. J. (2017). Depression and parenting: The need for improved intervention models. \u003cem\u003eCurrent Opinion in Psychology\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e, 61\u0026ndash;65. https://doi.org/10.1016/j.copsyc.2017.02.008\u003c/li\u003e\n\u003cli\u003eGervais, S. J., Holland, A. M., \u0026amp; Dodd, M. D. (2013). My eyes are up here: The nature of the objectifying gaze toward women. \u003cem\u003eSex Roles\u003c/em\u003e, \u003cem\u003e69\u003c/em\u003e(11\u0026ndash;12), 557\u0026ndash;570. https://doi.org/10.1007/s11199-013-0316-x\u003c/li\u003e\n\u003cli\u003eGoodman, S. H., \u0026amp; Gotlib, I. H. (1999). Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. \u003cem\u003ePsychological Review\u003c/em\u003e, \u003cem\u003e106\u003c/em\u003e(3), 458\u0026ndash;490. https://doi.org/10.1037/0033-295X.106.3.458\u003c/li\u003e\n\u003cli\u003eGoodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., \u0026amp; Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. \u003cem\u003eClinical Child and Family Psychology Review\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e, 1\u0026ndash;27. https://doi.org/10.1007/s10567-010-0080-1\u003c/li\u003e\n\u003cli\u003eHan, Z., Lutsiv, O., Mulla, S., Rosen, A., Beyene, J., \u0026amp; McDonald, S. D. (2011). Low gestational weight gain and the risk of preterm birth and low birthweight: A systematic review and meta-analyses. \u003cem\u003eActa Obstetricia et Gynecologica Scandinavica, 90\u003c/em\u003e(9), 935\u0026ndash;954. https://doi.org/10.1111/j.1600-0412.2011.01185.x\u003c/li\u003e\n\u003cli\u003eHanko, C., Bittner, A., Junge-Hoffmeister, J., Mogwitz, S., Nitzsche, K., \u0026amp; Weidner, K. (2020). Course of mental health and mother\u0026ndash;infant bonding in hospitalized women with threatened preterm birth. \u003cem\u003eArchives of Gynecology and Obstetrics\u003c/em\u003e, \u003cem\u003e301\u003c/em\u003e(1), 119\u0026ndash;128. https://doi.org/10.1007/s00404-019-05406-3\u003c/li\u003e\n\u003cli\u003eHentges, R. F., Graham, S. A., Plamondon, A., Tough, S., \u0026amp; Madigan, S. (2019). A developmental cascade from prenatal stress to child internalizing and externalizing problems. \u003cem\u003eJournal of Pediatric Psychology\u003c/em\u003e, \u003cem\u003e44\u003c/em\u003e(9), 1057\u0026ndash;1067. https://doi.org/10.1093/jpepsy/jsz044\u003c/li\u003e\n\u003cli\u003eHerba, C. M., Glover, V., Ramchandani, P. G., \u0026amp; Rondon, M. B. (2016). Maternal depression and mental health in early childhood: An examination of underlying mechanisms in low-income and middle-income countries. \u003cem\u003eThe Lancet Psychiatry\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e(10), 983\u0026ndash;992. https://doi.org/10.1016/S2215-0366(16)30148-1\u003c/li\u003e\n\u003cli\u003eHodgkinson, E. L., Smith, D. M., \u0026amp; Wittkowski, A. (2014). Women\u0026rsquo;s experiences of their pregnancy and postpartum body image: A systematic review and meta-synthesis. \u003cem\u003eBMC Pregnancy and Childbirth\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(1), 330. https://doi.org/10.1186/1471-2393-14-330\u003c/li\u003e\n\u003cli\u003eJohnson, S., Burrows, A., \u0026amp; Williamson, I. (2004). \u0026ldquo;Does my bump look big in this?\u0026rdquo; The meaning of bodily changes for first-time mothers-to-be. \u003cem\u003eJournal of Health Psychology, 9\u003c/em\u003e (3), 361\u0026ndash;374. https://doi.org/10.1177/1359105304042346\u003c/li\u003e\n\u003cli\u003eJones, B. A., \u0026amp; Griffiths, K. M. (2015). Self-objectification and depression: An integrative systematic review. \u003cem\u003eJournal of Affective Disorders\u003c/em\u003e, \u003cem\u003e171\u003c/em\u003e, 22\u0026ndash;32. https://doi.org/10.1016/j.jad.2014.09.011\u003c/li\u003e\n\u003cli\u003eKamysheva, E., Skouteris, H., Wertheim, E. H., Paxton, S. J., \u0026amp; Milgrom, J. (2008). Examination of a multi-factorial model of body-related experiences during pregnancy: The relationships among physical symptoms, sleep quality, depression, self-esteem, and negative body attitudes. \u003cem\u003eBody Image\u003c/em\u003e, \u003cem\u003e5\u003c/em\u003e(2), 152\u0026ndash;163. https://doi.org/10.1016/j.bodyim.2007.12.005\u003c/li\u003e\n\u003cli\u003eKarsay, K., Matthes, J., Platzer, P., \u0026amp; Plinke, M. (2018). Adopting the objectifying gaze: Exposure to sexually objectifying music videos and subsequent gazing behavior. \u003cem\u003eMedia Psychology\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(1), 27\u0026ndash;49. https://doi.org/10.1080/15213269.2017.1378110\u003c/li\u003e\n\u003cli\u003eKatz-Wise, S. L., Budge, S. L., Lindberg, S. M., \u0026amp; Hyde, J. S. (2013). Individuation or identification? Self-objectification and the mother-adolescent relationship. \u003cem\u003ePsychology of Women Quarterly\u003c/em\u003e, \u003cem\u003e37\u003c/em\u003e(3), 366\u0026ndash;380. https://doi.org/10.1177/0361684312468425\u003c/li\u003e\n\u003cli\u003eKinloch, K., \u0026amp; Jaworska, S. (2021). \u0026lsquo;Your mind is part of your body\u0026rsquo;: Negotiating the maternal body in online stories of postnatal depression on Mumsnet. \u003cem\u003eDiscourse, Context and Media\u003c/em\u003e, \u003cem\u003e39, \u003c/em\u003e100456. https://doi.org/10.1016/j.dcm.2020.100456\u003c/li\u003e\n\u003cli\u003eKirk, E., \u0026amp; Preston, C. (2019). Development and validation of the body understanding measure for pregnancy scale (BUMPs) and its role in antenatal attachment. \u003cem\u003ePsychological Assessment\u003c/em\u003e, \u003cem\u003e31\u003c/em\u003e(9), 1092\u0026ndash;1106. https://doi.org/10.1037/pas0000736\u003c/li\u003e\n\u003cli\u003eKukla, R. (2005). Pregnant bodies as public spaces. In H. S. \u0026amp; W. C. (Eds.), \u003cem\u003eMotherhood and space\u003c/em\u003e. Palgrave Macmillan, New York.\u003c/li\u003e\n\u003cli\u003eLefkovics, E., Baji, I., \u0026amp; Rig\u0026oacute;, J. (2014). Impact of maternal depression on pregnancies and on early attachment. \u003cem\u003eInfant Mental Health Journal\u003c/em\u003e, \u003cem\u003e35\u003c/em\u003e(4), 354\u0026ndash;365. https://doi.org/10.1002/imhj.21450\u003c/li\u003e\n\u003cli\u003eLengua, L. J., Bush, N. R., Long, A. C., Kovacs, E. A., \u0026amp; Trancik, A. M. (2008). Effortful control as a moderator of the relation between contextual risk factors and growth in adjustment problems. \u003cem\u003eDev Psychopathol\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e, 509\u0026ndash;528. https://doi.org/10.1017/S0954579408000254\u003c/li\u003e\n\u003cli\u003eLindner, D., \u0026amp; Tantleff-Dunn, S. (2017). The development and psychometric evaluation of the Self-Objectification Beliefs and Behaviors Scale. \u003cem\u003ePsychology of Women Quarterly, 41\u003c/em\u003e(2), 254\u0026ndash;272. https://doi.org/10.1177/0361684317692109\u003c/li\u003e\n\u003cli\u003eLoth, K. A., Bauer, K. W., Wall, M., Berge, J., \u0026amp; Neumark-Sztainer, D. (2011). Body satisfaction during pregnancy. \u003cem\u003eBody Image\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(3), 297\u0026ndash;300. https://doi.org/10.1016/j.bodyim.2011.03.002\u003c/li\u003e\n\u003cli\u003eLovering, M. E., Rodgers, R. F., George, J. E., \u0026amp; Franko, D. L. (2018). Exploring the tripartite influence model of body dissatisfaction in postpartum women. \u003cem\u003eBody Image\u003c/em\u003e, \u003cem\u003e24, \u003c/em\u003e44\u0026ndash;54. https://doi.org/10.1016/j.bodyim.2017.12.001\u003c/li\u003e\n\u003cli\u003eMason, Z. S., Briggs, R. D., \u0026amp; Silver, E. J. (2011). Maternal attachment feelings mediate between maternal reports of depression, infant social\u0026ndash;emotional development, and parenting stress. \u003cem\u003eJournal of Reproductive and Infant Psychology\u003c/em\u003e, \u003cem\u003e29\u003c/em\u003e, 382\u0026ndash;394. https://doi.org/10.1080/02646838.2011.629994\u003c/li\u003e\n\u003cli\u003eMcKinley, N. M., \u0026amp; Hyde, J. S. (1996). The Objectified Body Consciousness Scale: Development and validation. \u003cem\u003ePsychology of Women Quarterly\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e, 181\u0026ndash;215. https://doi.org/10.1111/j.1471-6402.1996.tb00467.x\u003c/li\u003e\n\u003cli\u003eMcNamara, J., Townsend, M. L., \u0026amp; Herbert, J. S. (2019). A systemic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding. \u003cem\u003ePLOS ONE\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(7), e0220032. https://doi.org/10.1371/journal.pone.0220032\u003c/li\u003e\n\u003cli\u003eMoehler, E., Brunner, R., Wiebel, A., Reck, C., \u0026amp; Resch, F. (2006). Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother-child bonding. \u003cem\u003eArchives of Women\u0026rsquo;s Mental Health\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e, 273\u0026ndash;278. https://doi.org/10.1007/s00737-006-0149-5\u003c/li\u003e\n\u003cli\u003eMoseson, H., Zazanis, N., Goldberg, E., Fix, L., Durden, M., Stoeffler, A., Hastings, J., Cudlitz, L., Lesser-Lee, B., Letcher, L., Reyes, A., \u0026amp; Obedin-Maliver, J. (2020). The imperative for transgender and gender nonbinary inclusion: Beyond women\u0026rsquo;s health. \u003cem\u003eObstetrics and Gynecology\u003c/em\u003e, \u003cem\u003e135\u003c/em\u003e(5), 1059\u0026ndash;1068. https://doi.org/10.1097/AOG.0000000000003816\u003c/li\u003e\n\u003cli\u003eMulherin, K., Miller, Y. D., Barlow, F. K., Diedrichs, P. C., \u0026amp; Thompson, R. (2013). Weight stigma in maternity care: Women\u0026rsquo;s experiences and care providers\u0026rsquo; attitudes. \u003cem\u003eBMC Pregnancy and Childbirth\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(1), 19. https://doi.org/10.1186/1471-2393-13-19\u003c/li\u003e\n\u003cli\u003eMuth\u0026eacute;n, L. K., \u0026amp; Muth\u0026eacute;n, B. O. (2010). \u003cem\u003eMplus user\u0026rsquo;s guide\u003c/em\u003e (6th ed.). Muth\u0026eacute;n \u0026amp; Muth\u0026eacute;n.\u003c/li\u003e\n\u003cli\u003eMuzik, M., \u0026amp; Borovska, S. (2011). Perinatal depression: Implications for child mental health. \u003cem\u003eMental Health in Family Medicine\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(4), 239\u0026ndash;247.\u003c/li\u003e\n\u003cli\u003eNational Institute of Child Health and Human Development (2019, December 18). \u003cem\u003ePregnancy for every body: Information for moms-to-be.\u003c/em\u003e https://www.nichd.nih.gov/ncmhep/initiatives/pregnancy-for-every-body/moms-to-be\u003c/li\u003e\n\u003cli\u003eNoll\u0026sbquo; S. M.\u0026sbquo; \u0026amp; Fredrickson\u0026sbquo; B. L. (1998). A mediational model linking self-objectification\u0026sbquo; body shame\u0026sbquo; and disordered eating. \u003cem\u003ePsychology of Women Quarterly\u0026sbquo; 22\u003c/em\u003e(4)\u0026sbquo; 623-636. https://doi.org/10.1111/j.1471-6402.1998.tb00181.x\u003c/li\u003e\n\u003cli\u003eNonnenmacher, N., Noe, D., Ehrenthal, J. C., \u0026amp; Reck, C. (2016). Postpartum bonding: The impact of maternal depression and adult attachment style. \u003cem\u003eArchives of Women\u0026rsquo;s Mental Health\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e, 927\u0026ndash;935. https://doi.org/10.1007/s00737-016-0648-y\u003c/li\u003e\n\u003cli\u003eO\u0026rsquo;Higgins, M., Roberts, I. S. J., Glover, V., \u0026amp; Taylor, A. (2013). Mother-child bonding at 1 year; associations with symptoms of postnatal depression and bonding in the first few weeks. \u003cem\u003eArchives of Women\u0026rsquo;s Mental Health\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(5), 381\u0026ndash;389. https://doi.org/10.1007/s00737-013-0354-y\u003c/li\u003e\n\u003cli\u003eParker, G., \u0026amp; Paus\u0026eacute;, C. (2018). \u0026ldquo;I\u0026rsquo;m just a woman having a baby\u0026rdquo;: Negotiating and resisting the problematization of pregnancy fatness. \u003cem\u003eFrontiers in Sociology\u003c/em\u003e, \u003cem\u003e3, \u003c/em\u003e5. https://www.frontiersin.org/articles/10.3389/fsoc.2018.00005\u003c/li\u003e\n\u003cli\u003ePiran, N. (2017). The developmental theory of embodiment: Discovering paths in the body journeys of girls and women. In \u003cem\u003eJourneys of embodiment at the intersection of body and culture: The developmental theory of embodiment \u003c/em\u003e(pp. 1\u0026ndash;42). Elsevier. https://doi.org/10.1016/B978-0-12-805410-9.00001-3\u003c/li\u003e\n\u003cli\u003ePorter, E., Lewis, A. J., Watson, S. J., \u0026amp; Galbally, M. (2019). Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort. \u003cem\u003eInfant Behavior and Development\u003c/em\u003e, \u003cem\u003e57, \u003c/em\u003e101336. https://doi.org/10.1016/j.infbeh.2019.101336\u003c/li\u003e\n\u003cli\u003ePreacher, K. J., Rucker, D. D., \u0026amp; Hayes, A. F. (2007). Addressing moderated mediation hypotheses: Theory, methods, and prescriptions. \u003cem\u003eMultivariate Behavioral Research\u003c/em\u003e, \u003cem\u003e42\u003c/em\u003e, 185\u0026ndash;227. https://doi.org/10.1080/00273170701341316\u003c/li\u003e\n\u003cli\u003eRamsdell, E. L., \u0026amp; Brock, R. L. (2021). Interparental relationship quality during pregnancy: Implications for early parent\u0026ndash;infant bonding and infant socioemotional development. \u003cem\u003eFamily Process\u003c/em\u003e, \u003cem\u003e60\u003c/em\u003e(3), 966\u0026ndash;983. https://doi.org/10.1111/famp.12599\u003c/li\u003e\n\u003cli\u003eRiquin, E., Lamas, C., Nicolas, I., Lebigre, C. D., Curt, F., Cohen, H., Legendre, G., Corcos, M., \u0026amp; Godart, N. (2019). A key for perinatal depression early diagnosis: The body dissatisfaction. \u003cem\u003eJournal of Affective Disorders\u003c/em\u003e, \u003cem\u003e245, \u003c/em\u003e340\u0026ndash;347. https://doi.org/10.1016/j.jad.2018.11.032\u003c/li\u003e\n\u003cli\u003eRoberts, B., Povich, D., \u0026amp; Mather, M. (2012). Low-income working families: The growing economic gap. \u003cem\u003eThe Working Poor Families Project Policy Brief. \u003c/em\u003ehttps://www.prb.org/resources/u-s-low-income-working-families-increasing/\u003c/li\u003e\n\u003cli\u003eRoberts, T.-A., Calogero, R. M., \u0026amp; Gervais, S. J. (2018). Objectification theory: Continuing contributions to feminist psychology. In \u003cem\u003eAPA handbook of the psychology of women: History, theory, and battlegrounds (Vol. 1, \u003c/em\u003epp. 249\u0026ndash;271). American Psychological Association. https://doi.org/10.1037/0000059-013\u003c/li\u003e\n\u003cli\u003eRodgers, R. F., O\u0026rsquo;Flynn, J. L., Bourdeau, A., \u0026amp; Zimmerman, E. (2018). A biopsychosocial model of body image, disordered eating, and breastfeeding among postpartum women. \u003cem\u003eAppetite\u003c/em\u003e, \u003cem\u003e126, \u003c/em\u003e163\u0026ndash;168. https://doi.org/10.1016/j.appet.2018.04.007\u003c/li\u003e\n\u003cli\u003eRodgers, R. F., Paxton, S. J., McLean, S. A., Campbell, K. J., Wertheim, E. H., Skouteris, H., \u0026amp; Gibbons, K. (2013). Do maternal body dissatisfaction and dietary restraint predict weight gain in young pre-school children? A 1-year follow-up study. \u003cem\u003eAppetite\u003c/em\u003e, \u003cem\u003e67, \u003c/em\u003e30\u0026ndash;36. https://doi.org/10.1016/j.appet.2013.03.009\u003c/li\u003e\n\u003cli\u003eRodgers, R. F., Wertheim, E. H., Damiano, S. R., \u0026amp; Paxton, S. J. (2020). Maternal influences on body image and eating concerns among 7- and 8-year-old boys and girls: Cross-sectional and prospective relations. \u003cem\u003eInternational Journal of Eating Disorders\u003c/em\u003e, \u003cem\u003e53\u003c/em\u003e(1), 79\u0026ndash;84. https://doi.org/10.1002/eat.23166\u003c/li\u003e\n\u003cli\u003eRoomruangwong, C., Kanchanatawan, B., Sirivichayakul, S., \u0026amp; Maes, M. (2017). High incidence of body image dissatisfaction in pregnancy and the postnatal period: Associations with depression, anxiety, body mass index and weight gain during pregnancy. \u003cem\u003eSexual and Reproductive Healthcare\u003c/em\u003e, \u003cem\u003e13, \u003c/em\u003e103\u0026ndash;109. https://doi.org/10.1016/j.srhc.2017.08.002\u003c/li\u003e\n\u003cli\u003eRoosevelt, L. K., Pietzmeier, S., \u0026amp; Reed, R. (2021). Clinically and culturally competent care for transgender and nonbinary people: A challenge to providers of perinatal care. \u003cem\u003eJournal of Perinatal and Neonatal Nursing\u003c/em\u003e, \u003cem\u003e35\u003c/em\u003e(2), 142\u0026ndash;149. https://doi.org/10.1097/JPN.0000000000000560\u003c/li\u003e\n\u003cli\u003eRosenblum, K. L., Dayton, C. J., \u0026amp; Muzik, M. (2009). Infant social and emotional development: The emergence of self in a relational context. In \u003cem\u003eHandbook of infant mental health\u003c/em\u003e (3rd ed., pp. 95\u0026ndash;119). Guilford Press.\u003c/li\u003e\n\u003cli\u003eRubin, L. R., \u0026amp; Steinberg, J. R. (2011). Self-objectification and pregnancy: Are body functionality dimensions protective? \u003cem\u003eSex Roles\u003c/em\u003e, \u003cem\u003e65\u003c/em\u003e(7), 606\u0026ndash;618. https://doi.org/10.1007/s11199-011-9955-y\u003c/li\u003e\n\u003cli\u003eSaxbe, D., Rossin-Slater, M., \u0026amp; Goldenberg, D. (2018). The transition to parenthood as a critical window for adult health. \u003cem\u003eAmerican Psychologist\u003c/em\u003e, \u003cem\u003e73\u003c/em\u003e(9), 1190\u0026ndash;1200. https://doi.org/10.1037/amp0000376\u003c/li\u003e\n\u003cli\u003eSegre, L. S., Brock, R. L., O\u0026rsquo;Hara, M. W., Gorman, L. L., \u0026amp; Engeldinger, J. (2011). Disseminating perinatal depression screening as a public health initiative: A train-the-trainer approach. \u003cem\u003eMaternal and Child Health Journal\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(6), 814\u0026ndash;821. https://doi.org/10.1007/s10995-010-0644-1\u003c/li\u003e\n\u003cli\u003eSkouteris, H., Carr, R., Wertheim, E. H., Paxton, S. J., \u0026amp; Duncombe, D. (2005). A prospective study of factors that lead to body dissatisfaction during pregnancy. \u003cem\u003eBody Image\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e(4), 347\u0026ndash;361. https://doi.org/10.1016/j.bodyim.2005.09.002\u003c/li\u003e\n\u003cli\u003eSlomian, J., Honvo, G., Emonts, P., Reginster, J. Y., \u0026amp; Bruy\u0026egrave;re, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. \u003cem\u003eWomen\u0026rsquo;s Health, 15, \u003c/em\u003e1\u0026ndash;55. https://doi.org/10.1177/1745506519844044\u003c/li\u003e\n\u003cli\u003eSockol, L. E., Battle, C. L., Howard, M., \u0026amp; Davis, T. (2014). Correlates of impaired mother-infant bonding in a partial hospital program for perinatal women. \u003cem\u003eArchives of Women\u0026rsquo;s Mental Health\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(5), 465\u0026ndash;469. https://doi.org/10.1007/s00737-014-0419-6\u003c/li\u003e\n\u003cli\u003eSpiel, E. C., Paxton, S. J., \u0026amp; Yager, Z. (2012). Weight attitudes in 3- to 5-year-old children: Age differences and cross-sectional predictors. \u003cem\u003eBody Image\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(4), 524\u0026ndash;527. https://doi.org/10.1016/j.bodyim.2012.07.006\u003c/li\u003e\n\u003cli\u003eSquires, J., Bricker, D., \u0026amp; Twombly, E. (2015). \u003cem\u003eASQ:SE-2\u003c/em\u003e. Paul H. Brookes Publishing.\u003c/li\u003e\n\u003cli\u003eStunkard, A. J., S\u0026oslash;rensen, T., \u0026amp; Schulsinger, F. (1983). Use of the Danish Adoption Register for the study of obesity and thinness. \u003cem\u003eResearch Publications - Association for Research in Nervous and Mental Disease\u003c/em\u003e, \u003cem\u003e60, \u003c/em\u003e115\u0026ndash;120.\u003c/li\u003e\n\u003cli\u003eSun, Q. (2018). Materialism, body surveillance, body shame, and body dissatisfaction: Testing a mediational model. \u003cem\u003eFrontiers in Psychology\u003c/em\u003e, \u003cem\u003e9, \u003c/em\u003e2088. https://doi.org/10.3389/fpsyg.2018.02088\u003c/li\u003e\n\u003cli\u003eSutton, R. M., Douglas, K. M., \u0026amp; McClellan, L. M. (2011). Benevolent sexism, perceived health risks, and the inclination to restrict pregnant women\u0026rsquo;s freedoms. \u003cem\u003eSex Roles\u003c/em\u003e, \u003cem\u003e65\u003c/em\u003e, 596\u0026ndash;605. https://doi.org/10.1007/s11199-010-9869-0\u003c/li\u003e\n\u003cli\u003eSzekely, E., Neumann, A., Sallis, H., Jolicoeur-Martineau, A., Verhulst, F. C., Meaney, M. J., Pearson, R. M., Levitan, R. D., Kennedy, J. L., Lydon, J. E., Steiner, M., Greenwood, C. M. T., Tiemeier, H., Evans, J., \u0026amp; Wazana, A. (2021). Maternal prenatal mood, pregnancy-specific worries, and early child psychopathology: Findings from the DREAM BIG consortium. \u003cem\u003eJournal of the American Academy of Child and Adolescent Psychiatry\u003c/em\u003e, \u003cem\u003e60\u003c/em\u003e(1), 186\u0026ndash;197. https://doi.org/10.1016/j.jaac.2020.02.017\u003c/li\u003e\n\u003cli\u003eTalmon, A., \u0026amp; Ginzburg, K. (2016). The nullifying experience of self-objectification: The development and psychometric evaluation of the Self-Objectification Scale. \u003cem\u003eChild Abuse \u0026amp; Neglect\u003c/em\u003e, \u003cem\u003e60\u003c/em\u003e, 46\u0026ndash;57. https://doi.org/10.1016/j.chiabu.2016.09.007\u003c/li\u003e\n\u003cli\u003eTalmon, A., \u0026amp; Ginzburg, K. (2018). \u0026ldquo;Who does this body belong to?\u0026rdquo; The development and psychometric evaluation of the Body Experience during Pregnancy Scale. \u003cem\u003eBody Image\u003c/em\u003e, \u003cem\u003e26\u003c/em\u003e, 19\u0026ndash;28. https://doi.org/10.1016/j.bodyim.2018.05.002\u003c/li\u003e\n\u003cli\u003eTiggemann, M., \u0026amp; Lynch, J. E. (2001). Body image across the life span in adult women: The role of self-objectification. \u003cem\u003eDevelopmental Psychology\u003c/em\u003e, \u003cem\u003e37\u003c/em\u003e(2), 243\u0026ndash;253. https://doi.org/10.1037//0012-1649.37.2.243\u003c/li\u003e\n\u003cli\u003eUnderwood, L., Waldie, K., D\u0026rsquo;Souza, S., Peterson, E. R., \u0026amp; Morton, S. (2016). A review of longitudinal studies on antenatal and postnatal depression. \u003cem\u003eArchives of Women\u0026rsquo;s Mental Health, 19\u003c/em\u003e(5), 711\u0026ndash;720. https://doi.org/10.1007/s00737-016-0629-1\u003c/li\u003e\n\u003cli\u003eWallis, K., Prichard, I., Hart, L., \u0026amp; Yager, Z. (2021). The Body Confident Mums challenge: A feasibility trial and qualitative evaluation of a body acceptance program delivered to mothers using Facebook. \u003cem\u003eBMC Public Health\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(1), 1052. https://doi.org/10.1186/s12889-021-11126-8\u003c/li\u003e\n\u003cli\u003eWaters, C. S., Hay, D. F., Simmonds, J. R., \u0026amp; van Goozen, S. H. M. (2014). Antenatal depression and children\u0026rsquo;s developmental outcomes: Potential mechanisms and treatment options. \u003cem\u003eEuropean Child and Adolescent Psychiatry, 23\u003c/em\u003e(10), 957\u0026ndash;971. https://doi.org/10.1007/s00787-014-0582-3\u003c/li\u003e\n\u003cli\u003eWatson, B., Broadbent, J., Skouteris, H., \u0026amp; Fuller-Tyszkiewicz, M. (2016). A qualitative exploration of body image experiences of women progressing through pregnancy. \u003cem\u003eWomen and Birth\u003c/em\u003e, \u003cem\u003e29\u003c/em\u003e(1), 72\u0026ndash;79. https://doi.org/10.1016/j.wombi.2015.08.007\u003c/li\u003e\n\u003cli\u003eWatson, B., Fuller-Tyszkiewicz, M., Broadbent, J., \u0026amp; Skouteris, H. (2015). The meaning of body image experiences during the perinatal period: A systematic review of the qualitative literature. \u003cem\u003eBody Image\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e, 102\u0026ndash;113. https://doi.org/10.1016/j.bodyim.2015.04.005\u003c/li\u003e\n\u003cli\u003eWatson, D., O\u0026rsquo;Hara, M. W., Naragon-Gainey, K., Koffel, E., Chmielewski, M., Kotov, R., Stasik, S. M., \u0026amp; Ruggero, C. J. (2012). Development and validation of new anxiety and bipolar symptom scales for an expanded version of the IDAS (the IDAS-II). \u003cem\u003eAssessment\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e, 399\u0026ndash;420. https://doi.org/10.1177/1073191112449857\u003c/li\u003e\n\u003cli\u003eWebb, H. J., \u0026amp; Haycraft, E. (2019). Parental body dissatisfaction and controlling child feeding practices: A prospective study of Australian parent-child dyads. \u003cem\u003eEating Behaviors\u003c/em\u003e, \u003cem\u003e32, \u003c/em\u003e1\u0026ndash;6. https://doi.org/10.1016/j.eatbeh.2018.10.002\u003c/li\u003e\n\u003cli\u003eWoolhouse, H., Gartland, D., Mensah, F., \u0026amp; Brown, S. J. (2015). Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: Implications for primary health care. \u003cem\u003eBJOG: An International Journal of Obstetrics and Gynaecology\u003c/em\u003e, \u003cem\u003e122\u003c/em\u003e(3), 312\u0026ndash;321. https://doi.org/10.1111/1471-0528.12837\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"self-objectification, pregnancy, perinatal period, objectification theory, body surveillance, body image, depression, mother-infant bonding, infant socioemotional functioning","lastPublishedDoi":"10.21203/rs.3.rs-2714781/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2714781/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Pregnancy represents a unique time during which women’s bodies undergo significant physical changes (e.g., expanding belly, larger breasts, weight gain) that can elicit increased objectification. Experiences of objectification set the stage for women to view themselves as sexual objects (i.e., self-objectification) and is associated with adverse mental health outcomes. Although women may experience heightened self-objectification and behavioral consequences (such as body surveillance) due to the objectification of pregnant bodies in Western cultures, there are remarkably few studies examining objectification theory among women during the perinatal period. The present study investigated the impact of body surveillance, a consequence of self-objectification, on maternal mental health, mother-infant bonding, and infant socioemotional outcomes in a sample of 159 women navigating pregnancy and postpartum. Utilizing a serial mediation model, we found that mothers who endorsed higher levels of body surveillance during pregnancy reported more depressive symptoms and body dissatisfaction, which were associated with greater impairments in mother-infant bonding following childbirth and more infant socioemotional dysfunction at 1-year postpartum. Maternal prenatal depressive symptoms emerged as a unique mechanism through which body surveillance predicted bonding impairments and subsequent infant outcomes. Results highlight the critical need for early intervention efforts that not only target general depression, but also promote body functionality and acceptance over the Western “thin ideal” of attractiveness among expecting mothers.","manuscriptTitle":"Self-objectification during the perinatal period: The role of body surveillance in maternal and infant wellbeing","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-03-21 15:27:17","doi":"10.21203/rs.3.rs-2714781/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"93a122fc-d6c1-4c39-ade6-1b7b49eba4fa","owner":[],"postedDate":"March 21st, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-10-16T20:48:05+00:00","versionOfRecord":{"articleIdentity":"rs-2714781","link":"https://doi.org/10.1007/s11199-023-01360-2","journal":{"identity":"sex-roles","isVorOnly":false,"title":"Sex Roles"},"publishedOn":"2023-05-02 20:41:25","publishedOnDateReadable":"May 2nd, 2023"},"versionCreatedAt":"2023-03-21 15:27:17","video":"","vorDoi":"10.1007/s11199-023-01360-2","vorDoiUrl":"https://doi.org/10.1007/s11199-023-01360-2","workflowStages":[]},"version":"v1","identity":"rs-2714781","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2714781","identity":"rs-2714781","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}