Father-inclusive chatbot-based prenatal education during COVID-19 pandemic enhances maternal–fetal attachment in Korean primigravida women across levels of partner support

This study investigated whether a mobile chatbot-delivered intervention for prenatal education could enhance maternal-fetal attachment (MFA) among pregnant women with different levels of spousal support. In a quasi-experimental study conducted in January 2021, sixty volunteers who met all the eligibility criteria were enrolled: legally married, pregnant women aged 19 to 49 years, primigravida women from 21 to 32 weeks of gestation, and those in need of prenatal education. After completing a pre-questionnaire on pregnancy status, perception of prenatal education, and partner support, the women were asked to sequentially perform the given six tasks via a chatbot for two weeks, and then they filled out a post-questionnaire after completing the tasks. Both affective and cognitive-behavioral MFA outcomes were repeatedly measured before and after the intervention. The chatbot intervention enhanced affective MFA by increasing the intensity of prenatal education regardless of spousal support levels (p = .03): (1) low (n = 29; pre vs. post: p < .0042) and (2) high (n = 31; pre vs. post: p < .0042). In terms of cognitive-behavioral MFA, active paternal involvement in the chatbot-assisted baby talk helped women with low spousal support to differentiate themselves from the fetus (p = .02; pre vs. post: p < .0042) and to attribute characteristics and intention to the fetus (p = .011; pre vs. post: p < .0042), eliciting positive affect. This new mobile chatbot successfully served as a guide for pregnant couples starting prenatal education for the first time.