Traumatic childbirth perception as a mediator between antenatal anxiety and prenatal attachment: A cross-sectional study

Authors : Merve Murat Mehmed Ali, Elif Zahide Çelebi, Elif Tozkır

Pages : 439-446

View : 35 | Download : 40

Publication Date : 2025-09-30

Article Type : Research Paper

Abstract :Background and Aim: Antenatal anxiety has been associated with adverse obstetric outcomes such as preterm birth, low birth weight, and impaired maternal–fetal bonding. Emerging evidence suggests that women’s perception of childbirth as traumatic may influence this relationship; however, the mediating role of traumatic birth perception remains understudied. This study aimed to investigate the effect of antenatal anxiety on prenatal attachment and to investigate the mediating role of traumatic childbirth perception in this association. Methods: The cross-sectional and correlational study was conducted with 233 pregnant women attending routine antenatal care at a hospital Istanbul, Türkiye between August - November 2024. Data was collected using a Personal Information Form, Stirling Antenatal Anxiety Scale, Traumatic Childbirth Perception Scale, and Prenatal Attachment Inventory. Mediation analysis was conducted using PROCESS Macro (Model 4) with 5000 bootstrap resamples to estimate indirect effects. Results and Conclusion: Antenatal anxiety was positively correlated with traumatic childbirth perception (β = 1.83, p < .01), and both were negatively associated with prenatal attachment (β = -0.75 and β = -0.11, respectively; p < .01). Mediation analysis confirmed that traumatic childbirth perception partially mediated the relationship between antenatal anxiety and prenatal attachment (indirect effect: γ = -0.194, SE = 0.067, 95% CI [-0.335, -0.072]). Traumatic birth perception plays a significant mediating role in the negative impact of antenatal anxiety on maternal–fetal attachment. These findings highlight the importance of early screening for anxiety and trauma-related beliefs in antenatal care settings to promote psychological preparedness and emotional bonding.
Keywords : Antenatal anksiyete, Anne-bebek bağlanması, Aracılık analizi, Gebelik, Travmatik doğum

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