There was no dictionary definition of “transition to motherhood,” so before considering the definition of ‘transition to motherhood’ in this study, the dictionary meanings of “transition to motherhood” and “transition” were examined. The Cambridge English Dictionary [40], defined “motherhood” as the fact or state of being a mother and “transition” as a change from one system or method to another, often a gradual one. Therefore, in this study, “transition to motherhood” was defined as the process of a woman becoming a mother.

We reviewed the use of transition to motherhood in medicine, psychology, and women’s studies to confirm the concept in other disciplines. In the medical field, transition to motherhood was defined as a process that includes adaptation to a new stressor, physical pain, lactation, and attachment [21]. These processes were seen as dependent on the secretion of oxytocin, which starts from childbirth to the postpartum period, and plays a role in relieving maternal stress responses, supporting positive emotions, and regulating maternal behavior [21].

In psychology, the transition to motherhood involved the physical and internal changes that women acquire as mothers, which redefine their place in the sociocultural structure [8]. It is a phrase that is marked with physiological, social, and cultural changes [8]. Psychology defined the period from birth to one year as the period of maternal transition [22].

In women’s studies, transition to motherhood is defined as a dynamic, diverse, and complex process rather than a naturally ingrained, stable, and fixed process and should be interpreted within historical, cultural, social, economic, and political contexts [9]. Furthermore, transition to motherhood is a concept that includes pregnancy, childbirth, nurturing, work, leisure, and economic activity, and is defined as a period of redefining self-identity and undergoing biological changes for a woman [9,41].

Nursing views transition to motherhood as a process of personal or interpersonal change that occurs when a woman assumes the role of a mother and evaluates herself as a mother [42]. It also considers the woman’s experiences while becoming a mother after childbirth [42] and is defined as the process of change and adaptation [23]. The term “transition to motherhood” was first used by Rubin [5] and was defined as a series of developmental processes in which a woman learns maternal roles and develops maternal identity during pregnancy and childbirth [5,43]. Mercer [44,45] further explained that becoming a mother is an intellectual process of recognizing the identity of a mother, acquiring the maternal role, and ultimately becoming a mother. In 2004, Mercer [45] defined maternity as a broad-scale transformation process from being a woman to a mother, through personal integration by restructuring reality, rather than simply acquiring it, and recommended that the term maternal acquisition be withdrawn. Roy [46] interpreted maternal transformation as an adaptation based on adaptation theory and viewed it as a process of adapting to changes that come with the commencement of the mother’s role, along with changes in relationships, ability, and behaviors after childbirth [24]. It is interpreted as a concept that includes physical and psychological changes from pregnancy to postpartum [25,47]. Moreover, the transition to motherhood is viewed as a period in which women change their perception of themselves [26,48] and interpret the transition as a process of forming a new identity [26]. Therefore, change to maternal identity in nursing can be defined as a process of adaptation to becoming a mother, as a woman plays the role of a mother and establishes an identity during her pregnancy and the postpartum period.

Considering the concept of transition to motherhood as described above, physical, sociocultural, and economic dimensions of maternal transformation were identified, while in nursing studies, it appeared to mainly focus on the adaptation to motherhood. However, considering that women’s social activities are increasing socioculturally and that the transformation process includes changes in multiple dimensions such as identity, roles, and relationships [18], it is necessary to define and clarify the concept of transition to motherhood in a wider range of dimensions, including social and relational aspects.

Attributes are the key characteristics that simultaneously appear with the concept [49]. From the literature surveyed for this study, the concept of transition to motherhood was defined or used as follows:

① A significant event in a woman’s life, that requires adjustments on physical, biological, psychological, cultural, and social levels [49]

② A process of response and adaptation that changes according to an individual’s continuous assessment of a situation [23]

③ Transformation process of the self through complex physical, cognitive, behavioral, and emotional changes [26]

④ A woman’s reactions to the concrete physical changes [27]

⑤ A changing conception of self as related to others [28]

⑥ Integrating the role of a mother into her sense of self and forming a relationship with her infant [23]

⑦ A dialog between internal and external positions, where internal positions are perceived as part of oneself and external as part of the environment [8]

⑧ Forging a new identity by a woman as a mother, that revolves around her functioning in a new role [29]

⑨ Process of personal or interpersonal change that occurs by taking on the role of a mother and evaluating oneself as a mother [23]

⑩ A stressful experience, generating a sense of loss in terms of autonomy, time, appearance, and occupational identity [30]

As a borderline case includinig some important attributes of the concept [20], the following is presented:

‘B’ is a 17-year-old high school student who became pregnant and dropped out of school. B gave birth by cesarean section 4 days ago and is currently recovering. After giving birth, B became aware of the physical changes, such as secretion of breastmilk and surgical scarring in her body that was brought on by motherhood. Upon seeing the bloody lochia, B felt upset as she thought that she was sick (physical dimension). B was afraid of these changes in her body, so she asked the nurse and was relieved to hear the nurse explain that these changes were a normal process. B also felt joy in the fact that the painful process had ended and that she could return to the life before pregnancy. However, she felt sad that she now has a surgical scar on her body (emotional dimension). At the time of breastfeeding, B felt confused when the nurse called her “Jane’s mother” or “mommy” and did not call her by her own name (social dimension). Additionally, during breastfeeding time, all the attention and affection of her boyfriend and her parents were toward the newborn. B also felt that the nurse was only interested in the baby’s condition during breastfeeding and was indifferent to her feelings and changes, which made B feel alienated and jealous of her baby. Thus, she felt that she is no longer a priority and felt irritable returning to life as before no longer was possible.

This case contains the physical, psychological, and social attributes of the transition to motherhood, where B was aware of her physical and psychological changes (physical and psychological dimension) and also was recognized and referred to as a mother by those around her (social dimension). However, she failed to form and develop a relationship with her newborn and had not reconstructed her relationship with her boyfriend as parents. Thus, this is an example in which the properties of the relational dimension of transition to motherhood are excluded.

A contrary case is a clear example of something that is not a defined concept, which does not contain any of the important properties of the said concept [20], as illustrated in the following case:

‘C’ is a 32-year-old woman who has been married for 5 years, as well as a working woman who exercises every day, takes care of herself thoroughly, and is recognized at work. Over the past year, she had been desperately wanting a baby and had undergone artificial insemination and in vitro fertilization several times but failed. After long consideration, C adopted a 3-month-old girl and decided to raise her well. During the daytime a babysitter cared for the baby, and C spent time with the baby after work. However, C became increasingly tired and overwhelmed as she watched the baby cry constantly. Despite trying to figure out why the baby was crying, her efforts were in vain and she grew to resent the baby. She told her husband that raising a child was not easy and that she had found it difficult, but instead of consoling and offering support, he said that it was her choice and that she should do her best in the role. C thought that she would be happy when she had a baby, which she so desperately wanted; However, she increasingly disliked the baby and thought it was because the child was not hers biologically. Her sense of burden in caring for the baby became heavier over time, in contrast to the respect she enjoyed at work. Therefore, she worked hard to build her career without caring for her daughter after work hours. One day, the child continued crying for no apparent reason and she took her to the emergency room. The nurse asked her about the baby, but she could not answer the question properly because she could not figure out the meaning of her daughter’s usual crying. She felt so exhausted and miserable at the thought that she could do nothing as a mother, and grabbing the nurse, cried.

In this case, the attributes of physical, psychological, social, and relational dimensions are not included in C’s transition to motherhood.