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Body image disturbances are common among women in the general population. Less is known about their prevalence and impact during pregnancy. This chapter examines the history of body image theory and research. Next, we examine issues related to body image during pregnancy, such as pregravid weight, gestational weight gain, and the unique ways women think about the changes to their body during pregnancy. The role of physical activity, mood, and eating disorders in relation to peripartum body image disturbance is also discussed. Finally, assessment of body image disturbance and existing treatments are presented. Future research is needed to develop peripartum-specific body image assessment tools and to assess the impact of psychosocial interventions during and after pregnancy on body image dissatisfaction.

The formation of an attachment bond to a parent or caregiver is a key developmental milestone that occurs during the first year of a child’s life. In this chapter, we examine the relation between maternal psychopathology and the development of the young child’s attachment relationship with his or her mother. In general, the identified direction of effects from research points to greater risk for child insecure or disorganized attachment when the mother is psychiatrically ill, yet the research is equivocal, and findings suggest that other risk factors, as well as resiliency factors, must be considered for their influences of attachment relationship formation in the context of maternal psychopathology. Studies have begun to elucidate some of the mediating and moderating factors, yet much work remains to be done in order to understand the complex relation between maternal mental health and the quality of attachment.

Becoming pregnant and giving birth can lead to considerable psychological, behavioral, and cognitive transformation. The nature and scope of change varies a great deal from woman to woman. This chapter summarizes qualitative and quantitative research on normal psychological adaptation to pregnancy, including recognition and acceptance of the pregnant state, experience of the boundary between self and fetus, and body image changes. It reviews research on internal representations of the fetus and fetal and neonatal attachment. Perinatal changes in stress reactivity and coping style are reviewed. The chapter explains the influence of women’s prenatal expectations about labor and delivery on subsequent experiences and reactions and describes normative postpartum mood reactivity. Perinatal effects on sleep, physical activity, sexual activity, and eating patterns are described. Controversies about the effects of pregnancy on cognition are examined. The chapter also covers topics related to the transition to motherhood, including influences on maternal self-esteem and self-efficacy.