This randomized controlled trial aims to evaluate the effect of mindfulness practices integrated into childbirth preparation education on fear of childbirth, prenatal stress, and childbirth self-efficacy in pregnant women.Participants will be randomly assigned either to the childbirth education group with mindfulness practices or to the standard childbirth education/control group. Results will be evaluated using the prenatal self-assessment childbirth fear subscale, the perceived stress scale before childbirth, and the self-efficacy scale during labor before and after intervention.This study aims to provide evidence on whether mindfulness practices in childbirth preparation classes affect pregnant women's fear of childbirth, prenatal stress, and childbirth self-efficacy.
Pregnant women aged 18 years or older
Gestational age between 28 and 38 weeks
Primiparous (first pregnancy)
Able to understand and speak Turkish
• Pregnant women with high-risk pregnancies (history of antepartum bleeding, intrauterine growth restriction, placenta previa, membrane rupture, preeclampsia, hypertension, diabetes, or other medical conditions, fetal anomalies, or any contraindication to normal vaginal delivery, substance or alcohol dependence)
pregnant women with a diagnosed psychiatric illness or who have undergone psychotherapy or medication treatment in the last six months,
pregnant women who have previously participated in childbirth preparation classes,
pregnant women with experience in yoga and meditation before or during pregnancy,
Parallel
Mindfulness-based childbirth preparation education
BehavioralThis intervention consists of a structured childbirth preparation education program that integrates mindfulness practices into routine antenatal education. The program includes breathing exercises, body awareness activities, mindful relaxation, and guided meditation. The intervention is delivered in group sessions by a trained midwife, with four sessions conducted over a two-week period. The content is designed to reduce fear of childbirth, decrease prenatal stress, and enhance childbirth self-efficacy.
Birth fear level
Birth fear will be assessed using the Prenatal Self-Assessment Questionnaire Birth Fear Subscale. Changes in birth fear scores from baseline to post-intervention will be compared between the mindfulness-based childbirth education group and the standard childbirth education group. The Prenatal Self-Assessment Scale determines women's adaptation to pregnancy and motherhood. The Prenatal Self-Assessment Scale is a 4-point Likert-type scale with 7 subscales and 79 items. The Childbirth Fear Subscale of the Prenatal Self-Assessment Scale can be used independently. The overall Cronbach's alpha value for the Prenatal Self-Assessment Scale is 0.81. The Fear of Childbirth Subscale consists of ten items. Scores on the scale range from 10 to 40. The Cronbach's alpha value for the Fear of Childbirth Subscale is 0.84. Lower scores on the scale indicate a decrease in the level of fear of childbirth, while higher scores indicate an increase in the level of fear of childbirth.
Prenatal stress level
Stress during pregnancy will be assessed by administering the Prenatal Stress Questionnaire (PSQ) to pregnant women between the 28th and 38th weeks of pregnancy. High scores on the scale indicate that pregnant women perceive high levels of stress before delivery. Changes from baseline to post-intervention will be compared between the mindfulness-based childbirth education group and the standard childbirth education group. Scores on the scale and each subscale range from 1 to 5 points. An increase in the total score indicates an increase in the stress level perceived by pregnant women. The total Cronbach's alpha coefficient for the scale is 0.70.
Childbirth self-efficacy
Birth self-efficacy will be measured among pregnant women between the 28th and 38th weeks of pregnancy using the Birth Self-Efficacy Scale. Changes from baseline to post-intervention will be analyzed between the awareness-based childbirth education group and the standard childbirth education group. The Self-Efficacy Scale for Childbirth has two subscales: expectation of outcome and expectation of efficacy. Each subscale consists of 16 questions. Scores for each subscale range from 16 to 160. The total possible score for both subscales ranges from 32 to 320. High scores on the scale indicate that pregnant women have high confidence in themselves and a strong belief in their ability to succeed during childbirth. The Cronbach's alpha coefficient for the scale was found to be 0.90.
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