Relationship Among Fear of Childbirth, Sexual Quality of Life, and Depression During Pregnancy: A Cross-Sectional Study Publisher Pubmed



Ashrafinia F ; Jomeen J ; Hajimaghsoudi S ; Chen H ; Kelley EL ; Heydari O ; Mirzaee Z
Source: Women's Health Published:2026

Abstract

Background: Fear of childbirth (FOC) is a significant psychological concern that can adversely affect maternal well-being and childbirth outcomes. While various factors influencing FOC have been investigated, the influence of sexual quality of life (SQOL) has not yet been sufficiently researched. Objective: This study aimed to examine the relationships among FOC, SQOL, and depression in pregnant women. Design: A descriptive, cross-sectional study. Methods: A cross-sectional study was conducted among 614 low-risk primiparous pregnant women aged 18–35 years in Kerman, Iran, between June 2022 and April 2023. Data were collected using the Wijma Delivery Expectancy/Experience Questionnaire Version A, the Edinburgh Postnatal Depression Scale, and the Female Sexual Quality of Life Questionnaire. A path analysis was conducted to examine the effects of SQOL, depression, and sociodemographic factors on FOC. Results: The average age of the mothers was 26.9 ± 4.5 years, and that of the spouses was 29.9 ± 4.2 years. The average gestational age was 35 weeks. SQOL was not significantly correlated to FOC. In contrast, FOC was positively associated with depression (p < 0.001) and the age of the spouse (p = 0.008). The mother’s age (p = 0.004) and the presence of chronic diseases (p < 0.001) were also significant negative predictors. In addition, maternal age was associated with better SQOL (p = 0.022), while depression (p < 0.001) and gestational age (p = 0.029) were significant negative predictors. Conclusion: Depression was a significant factor negatively related to both FOC and SQOL. Early detection and timely intervention for depression may reduce fear before labor and improve overall well-being during pregnancy. © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).