The journey of pregnancy, childbirth, and the postnatal period encompasses a myriad of physical, emotional, and psychological changes in mothers and their infants (Barnes, 2015; Puryear, 2014; Thomson & Downe, 2016; Lang, 2017; Varghese & D'Souza, 2018; Nakano et al., 2019). Central to this transformative period is the bonding process, which begins during the prenatal phase and intensifies with the arrival of the newborn. In its most basic sense, bonding is the deep emotional bond between the child and caregiver (usually the mother) (Kerstis et al., 2016; Köse, Çınar, & Altınkaynak, 2013; Lang, 2017). During the prenatal period, bonding begins when the mother discovers the movement and heartbeat of the fetus. The mother may also begin to feel a sense of bond with the fetus as she imagines what the baby will be like and how their lives will be together (Yılmaz & Beji, 2010). Labor itself is highly effective in bonding because of the physical effort and emotional intensity of the process (Kinsey et al., 2014; Thomson & Downe, 2016). The crying of the newborn, skin-to-skin contact, and early breastfeeding support this process by triggering the release of oxytocin, a hormone that supports bonding. This relationship, which begins during pregnancy, affects the emotional and social development of the baby throughout life (Kinsey et al., 2014; Köse, Çınar, & Altınkaynak, 2013; Lang, 2017).

It has been reported that factors such as planned pregnancy, readiness for birth, positive birth experience, support from health personnel, and the psychological well-being of the mother and father after birth positively affect the bonding process (Barnes, 2015; Karakaş & Şahin Dağlı, 2019; Kinsey et al., 2014). It is considered positive that the mother and baby stay together in the first few minutes after birth, the baby is seen and touched by the mother, the interaction is initiated, and a maternal bond is formed. However, mothers' problematic bonding relationships, unplanned or unwanted pregnancy, anxiety in the first days, insufficient knowledge about care, lack of social support, low socioeconomic status, cultural structures that prevent contact, excessive crying of the baby, serious physical defects in the baby, and caregivers' inability to cope with the situation may negatively affect bonding (Meltzer-Brody et al., 2018; Radoš et al., 2020; Varghese & D'Souza, 2018). This situation may cause the infant to experience psychological difficulties and psychopathological conditions both in the present and later periods (Barnes, 2015; O'Hara & Wisner, 2014; Ruppert, 2014).

The bond established in the first few years of life is an important part of an individual's personality and a determining factor in adult life. Individuals who have healthy bonds with their mothers feel safe in their relationships, are better able to regulate their emotions, have higher self-esteem, are more likely to form healthy relationships, and are less likely to experience anxiety and depression (Farré-Sender et al., 2018; Nakano et al., 2019; O'Hara & Wisner, 2014; Rizzo & Watsford, 2020). According to Bowlby, who studied bonding based on the mother-infant relationship, emotional bonding includes comfort, trust, and support. Bowlby argues that the infant-mother bond is a primary and autonomous state. This bond is a two-way relationship that develops when both parties meet one another's needs (Bowlby, 1982). Sigmund Freud, the famous psychiatrist, and founder of psychoanalytic theory, defines the relationship between the baby and its mother as satisfying hunger and achieving oral pleasure. On the other hand, Ainsworth stated that babies experience anxiety in an unfamiliar environment and react by crying, lip trembling, grimacing, looking away, withdrawing, and hiding their faces. Most developmental theorists emphasize the importance of early human development. However, there is still much that we do not know how bonding works or how it affects emotional development (Hakanen et al., 2019; Karakoç & Dönmez, 2014; Lang, 2017; Polte et al., 2019).

A mother who has a safe bond with her own mother and successfully completes the separation-individuation process can also form a secure bond with her own child. She will be able to meet her child's emotional needs, feel her child's emotions, and understand her child's feelings, creating a strong and intuitive bond between them. For healthy development, mothers must make their children feel loved and safe. A mother can do this by providing her child with a safe and consistent environment, responding to her child's needs in a timely and sensitive manner, and by being emotionally available to her child (Karakaş & Şahin Dağlı, 2019; McNamara et al., 2019; Mörelius et al., 2021). However, things may not always go well. If a mother's bonding relationship with her mother is traumatic, she may not be able to form a safe bond with her child. This can occur if the mother's trauma has not healed. When individuals are unable to manage their own traumatic emotions, they may “replay” their trauma to their children, which can lead to epigenetic transmission of trauma across generations. The greatest gift that a mother can give her child is to heal her own trauma and wounds so that she can start the journey as a healthy mother and bond with her child in a healthy manner (Allen, 2018; Ruppert, 2014; Radoš et al., 2020). This will help her child to feel loved and safe, which is essential for healthy development. Pregnancy and childbirth are unique times of new beginnings for many women; however, they are also the most physically and emotionally fragile periods in their lives. Mothers experience deep psychological transitions as well as physical and hormonal changes after birth (Wittkowski, Moehler, & Brockington, 2020; Wittkowski, Vatter, et al., 2020; Yılmaz & Beji, 2010). The physical and psychological difficulties experienced by all mothers can lead to serious health problems including depression and anxiety (Kerstis et al., 2016; O'Hara & Wisner, 2014; Öztürk & Saruhan, 2013; Rizzo & Watsford, 2020). Psychiatric problems in the postpartum period affect one out of every five women, and seven out of ten women with psychological problems do not receive treatment. The World Health Organization (WHO) reports that psychiatric diseases are among the most important indirect causes of maternal mortality in the first year after birth. Early recognition of psychiatric disorders that women may experience in the postpartum period and accompanying bonding problems with their babies can be achieved with qualified healthcare and follow-up in the antenatal and postnatal periods (Barnes, 2015; Stramrood & Slade, 2017).

In terms of maternal mental health, the high number of interventional deliveries and high rates of cesarean sections in Turkey, as well as the fact that breastfeeding rates are gradually decreasing compared to previous years, are important risks (Organisation for Economic Cooperation and Development (OECD), 2020). In addition, mother-infant mental health may be negatively affected by sociodemographic changes due to recent financial crises and uncontrolled migration. In Turkey, the growth and development of infants aged 0–6 years were monitored, and immunization was provided in line with the WHO recommendations. However, monitoring mother-infant bonding and mental health is not routine in Turkey and many women with problems are left to fend for themselves (Republic of Türkiye Ministiry of Health, General Directorate of Public Health, 2018).

Early recognition of psychiatric problems that may occur in the postpartum period and providing the necessary support before the problems grow are important (Puryear, 2014; Stramrood & Slade, 2017). This initiative will provide a cost-effective way to improve community mental health, as well as maternal and infant mental health, without disrupting the mother-infant bond. Although bonding to the mother and sociocultural factors affecting bonding to the mother continue to be studied as important issues attracting the attention of researchers in Turkey, the measurement tools used to evaluate bonding are insufficient.

Therefore, the aim of the study is to perform the Turkish validity and reliability study of the Postpartum Bonding Questionnaire (PBQ), which can more specifically measure the mother-infant bonds in the postpartum period.