Validated assessment tool — Condon, 1993
Maternal Antenatal Attachment Scale (MAAS)
19 items — two subscales — Quality of Attachment & Intensity of Preoccupation — scored by clinician
Clinician opening script — read aloud before starting
Read this to the patient before starting:
"I would like to ask you some questions about your thoughts and feelings about the baby you are carrying. These questions are about the relationship that is already beginning to develop between you and your baby during pregnancy.
For each question I will read you a statement and ask you to choose the response that best describes how you have been feeling or thinking over the past two weeks. There are no right or wrong answers — I am interested in your honest experience, however you have been feeling. Some of these questions may feel personal. You can ask me to clarify anything, and you can take as much time as you need.
This is not a test. It helps us understand how the pregnancy is going for you and whether there is anything we can do to support you better."
"I would like to ask you some questions about your thoughts and feelings about the baby you are carrying. These questions are about the relationship that is already beginning to develop between you and your baby during pregnancy.
For each question I will read you a statement and ask you to choose the response that best describes how you have been feeling or thinking over the past two weeks. There are no right or wrong answers — I am interested in your honest experience, however you have been feeling. Some of these questions may feel personal. You can ask me to clarify anything, and you can take as much time as you need.
This is not a test. It helps us understand how the pregnancy is going for you and whether there is anything we can do to support you better."
About the MAAS
Scoring & interpretation
Intensity of Preoccupation (12 items)
Measures the strength and frequency of the mother's thoughts about and preoccupation with the unborn baby. A higher score indicates greater intensity of preoccupation — thinking about the baby more often and for longer. Very low scores may indicate emotional disconnection from the pregnancy.
Quality of Attachment (7 items)
Measures the affective tone of the mother's relationship with the baby — whether thoughts about the baby are predominantly warm, tender, and positive, or are characterised by irritation, resentment, or indifference. Higher scores indicate better quality attachment.
How to administer
1
Read each item aloud exactly as written. Do not paraphrase. The MAAS uses a 1–5 response scale (not 0–4). Each question has five unique response options — read all five before the patient answers.2
The scale covers the past two weeks. If a patient refers to a specific day or event, gently redirect: "Thinking about the past two weeks as a whole, which option fits best?"3
Some items are reverse scored. The tool calculates scores automatically — select the patient's chosen response and the correct contribution to the subscale total is applied. Do not attempt to manually adjust scoring.4
Items are grouped by subscale below. The purple items contribute to Intensity of Preoccupation; the teal items contribute to Quality of Attachment. This is for your reference — do not indicate subscale grouping to the patient.5
Where a patient scores very low on the Quality subscale (<14) or discloses strongly negative feelings about the baby, treat this as clinically significant and consider whether to discuss immediately and/or refer to perinatal mental health services.!Administer in a private, unhurried setting. Some patients find questions about their feelings towards the baby emotionally activating, particularly if they have experienced pregnancy loss, fertility treatment, or ambivalence about the pregnancy. Be prepared to hold space for a range of responses.
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