Investigating links between perinatal interoception, body satisfaction and maternal wellbeing.

Due to the significance of the body for our mental wellbeing it is crucial to improve our
understanding of factors that affect our bodily experience, particularly at times of great
bodily changes. To date there is little research investigating the role of visceral bodily signals
(referred to as interoception; Craig et al., 2002) during pregnancy on behavioural, cognitive
and emotional outcomes. Interoception in pregnancy extends from regular internal bodily
signals to also include signals that are only present during pregnancy, so there is a need to
develop specific instruments tailored for during pregnancy to capture the internal bodily
experience women have during this time.
Understanding links between interoception during pregnancy and negative perinatal
experiences may help early identification of women at risk of poor postnatal outcomes,
allowing for implementation of appropriate proactive interventions.
Project questions
Question 1: Would a pregnancy specific self-report scale to measure interoceptive
sensibility capture components of the interoceptive bodily experience that are unique to
pregnancy?
Question 2: What is the relative contribution of interoception and body dissatisfaction as
predictors of perinatal outcomes including attachment, self-concept, breastfeeding
intentions and success, and post-natal depression?
Question 3: Are currently validated behavioural measures of interoception such as
heartbeat detection tasks and 'probe-caught thought sampling tasks' also valid for pregnant
women?
Question 4: Would neuroimaging (EEG) measures of interoception elicit different neural
responses for pregnant women?
Question 5: Are any aspects of interoception during pregnancy related to perception and
experience during the birth, or experiences postnatally?

Research plan
YEAR ONE:
Scale development.
Qualitative information about awareness of bodily states during pregnancy will be gathered
from focus groups of pregnant women and midwives. Following this there will be two stages
of quantitative analysis using exploratory and confirmatory factor analysis from a large
sample of ~600 pregnant women, gathered online.
Relationship between body satisfaction, interoception and perinatal outcomes.
Using the newly developed scale, various perinatal outcomes will be analysed in the initial
sample of pregnant women to see how levels of interoception may predict negative
perinatal experience.
YEAR TWO:
Behavioural studies.
Self-reports may provide understanding of interoceptive sensibility (subjective awareness of
visceral activity) but not interoceptive accuracy (how accurate an individual is at detecting
and interpreting interoceptive signals when compared with objective measures). Therefore
behavioural measures of interoception are important to measure interoception in
pregnancy because much visceral activity occurs unconsciously. Twenty-four pregnant and
24 non-pregnant women will complete heart beat detection tasks and a 'probe-caught
thought sampling' task (Smallwood and Schooler, 2006).
Neuroimaging techniques.
Electroencephalograph (EEG) will also be used to measure the cortical activity of the sample
whilst performing the behavioural techniques described above. Comparison of activity in
specific cortical areas of the brain associated with perception of internal feelings, processing
of emotion, behaviour regulation and interpretation of sensory information will be made
between pregnant and non-pregnant women.
YEAR THREE:
Postnatal follow-up.
A subset of around 200 of the original pregnant women will be followed up after the birth of
their baby to investigate if any aspects of interoception during pregnancy are related to
experience during birth, or experiences postnatally. A small sample will also be invited for a
short semi-structured interview to also gather qualitative data about their experiences.