Evaluation of the relationship between birth beliefs and readiness for childbirth in pregnant women: a cross-sectional study

Evaluation of the relationship between birth beliefs and readiness for childbirth in pregnant women: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of the relationship between birth beliefs and readiness for childbirth in pregnant women: a cross-sectional study İmran Ülkü Alev Gökgöz, Hava Özkan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8846042/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background Pregnancy and childbirth is a multifaceted experience for women that has physical, emotional and cultural dimensions as well as biological ones. Women may sometimes perceive birth as a meaningful and transformative process and sometimes as a medical necessity to be completed. Therefore, understanding beliefs about birth and readiness levels during pregnancy is important for individualizing midwifery care and planning appropriate counseling. This study was conducted to determine the relationship between birth beliefs and birth readiness levels of pregnant women. Methods This descriptive and cross-sectional study was conducted between October and December 2022 in a public maternity hospital in the capital of Turkey. The sample size was calculated with a 95% confidence level and a 3% margin of error, and 1000 pregnant women who met the inclusion criteria and voluntarily participated in the study were included in the study. Data were collected using a sociodemographic and obstetric information form, Beliefs of Childbirth Scale and Birth Readiness Scale administered by face-to-face interview method. Descriptive statistics (percentage, mean, SD) and inferential tests (independent t-test, ANOVA, and Kruskal–Wallis) were used. Results The mean age of the participants was 28.0 ± 5.0 years, most of them were not working and half of them were primipara. Of the pregnant women, 67.6% preferred vaginal delivery and 32.4% preferred cesarean section. The belief in natural process was higher in those who preferred vaginal delivery and the belief in medical process was higher in those who preferred cesarean section. Birth readiness levels of pregnant women who preferred cesarean section were significantly higher. In addition, a positive correlation was found between natural process belief and readiness (r = 0.312, p < 0.001). Conclusions As a result of this study, a positive and weak relationship was found between ‘Natural Process’ belief and birth readiness. In addition, pregnant women who preferred cesarean section had a higher level of readiness, suggesting the effect of the preference for planability and controlled process. The findings suggest that it may be useful to evaluate women's beliefs about birth in pregnancy care and to structure counseling by considering these individual differences. birth beliefs readiness for childbirth vaginal birth natural process belief pregnancy Background Pregnancy and childbirth is one of the most critical developmental, social and psychological transitions in a woman's life cycle [ 1 , 2 ]. This process is not just a biological event; it is a multidimensional experience with physical, emotional and cultural layers [ 2 ]. Women's experiences during childbirth are recognized as important health outcomes that affect their quality of life [ 3 , 4 ]. The systematic review by Downe et al. (2018) shows that the meaning of childbirth for women is determined by three main phenomena: the physical and psychosocial nature of childbirth, socio-cultural norms, and the level of responsiveness of the care service to women's individual values. In this context, women may perceive childbirth as a meaningful and transformative experience for them, or they may perceive it as a medical necessity that must be completed [ 5 ]. In the context of behavioral sciences, human behavior is shaped by various factors such as the individual's experiences and attitudes and beliefs that change depending on the events. Pre-evaluation of people's attitudes and beliefs makes these behaviors and decisions predictable and even changeable [ 6 , 7 ]. Within this framework, perceptions of childbirth are also linked to the mental representations that develop during pregnancy, referred to as birth-related mindsets. The model described by Hoffmann and Banse (2021) captures the general tendency to conceptualize childbirth as either a more ‘natural’ or a more ‘medicalized’ process” [ 8 ]. This tendency is shaped by more specific cognitive structures concerning the physical nature of childbirth and how it should occur-namely, core beliefs about childbirth [ 9 , 10 ]. As shown in Preis and Benyamini's (2017, 2018) studies, these beliefs are addressed in two dimensions [ 9 , 11 ]. The belief that childbirth is a natural process considers birth as a normal and safe physiological event, that the female body is fit to give birth, that interventions are only necessary when necessary, and that pain is a natural part of the process [ 12 , 13 ]. In contrast, medical birth beliefs view birth as a risky process and emphasize the necessity of modern interventions [ 9 , 11 , 14 ]. It is known that these beliefs are influenced by various factors such as individual and social experiences, perinatal care quality, risk perception and cultural values [ 9 , 15 ]. Pregnant women’s perceived psychological and physical preparedness when making decisions about the childbirth process is referred to as ‘readiness’ This concept refers to a multidimensional structure that includes not only physiological or practical preparation but also self-management skills, the ability to access and use information, confidence in childbirth and the capacity to plan [ 16 ]. The World Health Organization (WHO) considers birth preparation as one of the essential elements of antenatal care and emphasizes that this preparation is decisive in reducing maternal mortality [ 17 ]. It has been reported that women who are not adequately prepared for labor have higher rates of adverse outcomes such as preterm labor, prolonged labor, various obstetric complications and postpartum hemorrhage [ 18 ]. In addition, studies have shown that low levels of birth preparedness are associated with fear of childbirth, anxiety, and difficulties in coping with uncertainty [ 19 , 20 ]. Furthermore, women with lower levels of preparedness appear to have an increased risk of psychological birth trauma, while the protective effect of social support strengthens as preparedness improves [ 21 ]. These findings indicate that childbirth readiness is a critical determinant of both physical and psychological birth outcomes. Consequently, the importance of education and counseling practices that support birth preparedness has been increasingly emphasized [ 22 , 23 ]. WHO recommends that caesarean section rates should be kept within the range of 10–15% at the population level; however, global caesarean section rates are increasing and now account for more than one-fifth of all births [ 24 ]. The fact that the cesarean section rate in Turkey has reached level of 61.2% makes it particularly necessary to examine the psychosocial factors related to childbirth more closely [ 25 ]. Although the relationship between birth beliefs and fear of childbirth, birth preference and birth experience has been examined in the literature [ 13 , 26 – 28 ], no study has been found to address the relationship with readiness. Understanding women's birth beliefs and readiness levels during pregnancy is important in terms of individualizing midwifery care, reducing unnecessary medical interventions during the birth process and supporting women to experience an empowered preparation process for birth. This study was conducted to determine the effects of birth beliefs of pregnant women on their level of readiness for childbirth. Methods Study Design This study was designed as a cross-sectional study and was conducted in accordance with the STROBE guidelines. The study was conducted between October 2022 and December 2022 in a hospital located in the capital of Turkey, which has a high annual pregnancy outpatient clinic volume and receives referrals from across the region. This center was chosen because it serves a large pregnant population with different socio-economic and demographic characteristics and has a high patient circulation, which allowed the study to reach the targeted sample size (n = 1000). Participants and procedure The sample size was calculated with a 95% confidence interval and a margin of error of 3% ( d = 0.03 ) in order to increase the precision of estimation and minimize sampling error. According to the sampling formula with known population, it was determined that at least 964 pregnant women should be reached to ensure this precision in a population of approximately 10,000. Thanks to the full-time presence of the researcher in the outpatient clinic during the data collection process and the high patient circulation of the hospital, the targeted number was reached and the study was completed with a total of 1000 pregnant women (500 primiparous and 500 multiparous). Only second and third trimester pregnant women were included in this study. It has been reported that attitudes and emotional states related to pregnancy are not yet stable in the first trimester, and anxiety and beliefs about childbirth become more pronounced as the pregnancy progresses [ 29 ]. In addition, it has been shown that the effect of antenatal education and preparation for delivery emerges especially in the later trimesters [ 30 ]. Inclusion criteria included being 20 years of age or older, having a spontaneous pregnancy, and having communication and literacy skills sufficient to answer the data collection tools in the study. Pregnant women with a psychiatric diagnosis that may affect participation in the data collection process or with known chronic medical conditions such as heart disease, diabetes, hypertension or kidney disease were excluded from the study. In addition, women who developed a medical complication during pregnancy that could limit participation in the study were excluded. Data Collection Tools A personal information form, Birth Beliefs Scale (BBS) and Ready for Birth Subscale of the Prenatal Self‑Evaluation Questionnaire for used for data collection. Personal information form This form includes questions about the pregnant women’s sociodemographic and obstetric characteristics. Birth Beliefs Scale (BBS) The scale was developed by Preis et al. (2017) to assess women's birth beliefs [ 11 ]. The scale, whose Turkish validity and reliability study was conducted by Paker and Ertem (2022), has two sub-dimensions: natural process belief and medical process belief [ 31 ]. Five items assess the belief that birth is a natural process (items 3, 5, 7, 8 and 11) and six items assess the belief that birth is a medical process (items 1, 2, 4, 6, 9 and 10). Thus, the BBS consists of 11 items in total in mixed order. On this five-point Likert-type scale, each item is rated on a scale of 1 to 5 (1 means Strongly Disagree, 5 means Strongly Agree). The minimum and maximum points a participant can score on the Medical Process Belief Subscale are 6 and 30 points, respectively; the minimum and maximum points a participant can score on the Natural Process Belief Subscale are 5 and 25 points, respectively. The sum of the scores obtained from each subscale is divided by the number of items of the subscale and the arithmetic mean of the scores for each subscale is calculated. The higher arithmetic mean score a participant obtains from a subscale indicates the direction of birth belief. Each subscale is evaluated separately. Paker and Ertem reported the Cronbach's alpha reliability coefficient as 0.890 for the natural process subscale and 0.868 for the medical process subscale [ 31 ]. In this study, Cronbach's alpha reliability coefficient was 0.70 for the natural process sub-dimension and 0.72 for the medical process sub-dimension. Prenatal Self Evaluation Questionnaire- Preparation for Labor Subscale (PFL) The preparation for labor subscale (PFL) of the Prenatal Self-Evaluation Questionnaire (PSEQ) developed by Lederman et al. (1979) to assess women's adaptation to motherhood in the prenatal process was used to determine the readiness levels of pregnant women for childbirth. [ 32 ]. PSEQ consists of 7 subscales and 79 items. There are 10 items (items 7, 13, 24, 25, 26, 38, 47, 48, 56 and 72) covering the preparation for labor subscale and the items are rated on a four-point Likert scale (4 very much so, 3 moderately so, 2 somewhat so, and 1 not at all). Positive statements in the preparation for labor subscale (items 7, 24, 25, 26, 38, 47, 48, 56) are reverse scored. The sum of the scores obtained from the scale varies between 10 and 40; low scores indicate a high level of birth readiness, while high scores indicate a low level of birth readiness (inadequate adaptation). The Turkish validity and reliability of the scale was conducted by Taşçı Beydağ and Mete (2008) and Cronbach's alpha value in the scale is 0.72 [ 33 ]. The present study calculated Cronbach's alpha value to be 0,63. Data collection The data were gathered through face-to-face interviews with pregnant women following their prenatal check-ups. After the examination, participants completed the questionnaires in a private setting, which took approximately 10–15 minutes. The sessions concluded after the researcher addressed the participants' questions and provided requested information. Data Analysis The data were analyzed using the SPSS 20.0 software package (Statistical Package for the Social Sciences). Descriptive statistics (number, percentage, minimum–maximum values, mean, and standard deviation) and inferential tests, including independent samples t-test, one-way ANOVA, and Kruskal–Wallis test, were employed. Pearson correlation analysis and Cronbach’s α coefficient were also used. The normality of the data was assessed through skewness and kurtosis values (± 2). A p-value of < 0.05 was considered statistically significant. Results The distribution of pregnant women according to their socio-demographic and obstetric characteristics is given in Table 1 . The mean age of the pregnant women was 28.0 ± 5.0 years. 37.4% of the pregnant women were high school graduates and 79.2% were not working. Obstetric characteristics revealed that 50% of the participants were primiparous and 50% were in the second trimester of pregnancy. 81.4% of the participants planned their pregnancy and 91.4% had regular prenatal check-ups. Regarding mode of delivery preferences, 67.6% of the pregnant women preferred vaginal delivery and 53.9% of this group stated that they found vaginal delivery healthier. While 32.1% of the pregnant women who planned cesarean delivery cited fear of childbirth as the reason, the remaining 52.8% stated other reasons such as perceiving cesarean section as a faster and safer process or the recommendations of the social environment (family elders, etc.). When Table 1 was analyzed, a statistically significant difference was found between the natural process sub-dimension scores of pregnant women according to their educational status, planned mode of delivery and reasons for preference ( p < 0.05, Table 1 ). In the medical process sub-dimension, it was determined that the differences in mean scores based on the age of pregnant women, employment status, regularity of prenatal check-ups, planned mode of delivery, and reasons for preference were statistically significant ( p < 0.05, Table 1 ). Table 1 Comparison of socio-demographic and obstetric characteristics of pregnant women and mean scores of BBS subscales Characteristics n % Natural Process Medical Process x̄ ±SD Test and P value x̄ ±SD Test and P value Age (28,0 ± 5,0) 20–25 341 34.1 4.31 ± 0.64 F = 0.75 P = 0.52 3.69 ± 0.67 F = 5.60 p = 0.001 26–30 344 34.4 4.25 ± 0.62 3.73 ± 0.69 30–35 251 25.1 4.26 ± 0.61 3.93 ± 0.92 36 or older 64 6.4 4.35 ± 0.57 3.86 ± 0.72 Education level Primary school 155 15.5 4.28 ± 0.67 F = 3.90 p = 0.009 3.72 ± 0.63 F = 1.27 p = 0.28 Middle school 229 22.9 4.33 ± 0.59 3.72 ± 0.62 High school 374 37.4 4.32 ± 0.57 3.83 ± 0.84 University 242 24.2 4.16 ± 0.68 3.77 ± 0.81 Employment status Employed 208 20.8 4.25 ± 0.64 t = 0.81 p = 0.41 3.95 ± 1.00 t = 3.68 p = 0.0001 Unemployed 792 79.2 4.29 ± 0.62 3.73 ± 0.67 Trimester 2nd Trimester 500 50.0 4.30 ± 0.62 t = 0.85 p = 0.39 3.75 ± 0.70 t = 1.18 p = 0.23 3rd Trimester 500 50.0 4.26 ± 0.63 3.80 ± 0.81 Number of pregnancies 1 500 50.0 4.27 ± 0.62 F = 0.91 p = 0.43 3.77 ± 0.84 F = 2.37 p = 0.06 2 279 27.9 4.26 ± 0.65 3.86 ± 0.69 3 135 13.5 4.30 ± 0.67 3.71 ± 0.60 4 86 8.6 4.28 ± 0.62 3.64 ± 0.65 Pregnancy intention Intended pregnancy 814 81.4 4.29 ± 0.61 t = 1.33 p = 0.18 3.76 ± 0.77 t = 1.54 p = 0.12 Unwanted pregnancy 186 18.6 4.22 ± 0.67 3.85 ± 0.67 Regular antenatal care attendance Yes 914 91.4 4.28 ± 0.63 t = 0.64 p = 0.52 3.75 ± 0.76 t = 2.72 p = 0.007 No 86 8.6 4.24 ± 0.62 3.99 ± 0.67 Preferred mode of delivery Vaginal birth 676 67.6 4.37 ± 0.59 t = 7.01 p = 0.0001 3.63 ± 0.75 t = 8.86 p = 0.0001 Cesarean section 324 32.4 4.0 ± 0.66 4.07 ± 0.69 Reasons for Preferring Vaginal Birth (n = 676) Early mobilization 128 18.9 4.32 ± 0.59 KW = 50.23 p = 0.0001 3.66 ± 0.61 KW = 106.94 p = 0.0001 Perceived to be healthier 364 53.9 4.41 ± 0.56 3.64 ± 0.65 Better ability to care for the baby 28 4.1 4.45 ± 0.45 3.55 ± 0.68 Other 156 23.1 4.32 ± 0.65 3.60 ± 1.02 Reasons for Preferring Cesarean Section (n = 324) Scheduled delivery 31 9.6 4.14 ± 0.58 KW = 55.74 p = 0.0001 4.24 ± 0.57 KW = 108.50 p = 0.0001 Fear of vaginal birth 104 32.1 3.94 ± 0.74 4.07 ± 0.69 Desire for tubal ligation 18 5.5 3.96 ± 0.52 3.87 ± 0.52 Other 171 52.8 4.16 ± 0.62 3.77 ± 0.76 The comparison of birth readiness scores of pregnant women according to their socio-demographic and obstetric characteristics is presented in Table 2 . In the analysis, it was found that there was a statistically significant difference between the birth readiness scores of pregnant women according to their age, educational status, trimester, parity, Preferred mode of delivery and reasons for preference ( p < 0.05, Table 2 ). Table 2 Comparison of sociodemographic and obstetric characteristics by PFL scores Characteristics PFL Test and p value x̄±SD Age (28,0 ± 5,0) 20–25 26–30 30–35 36 or older 31.10 ± 4.59 31.26 ± 4.61 32.28 ± 4.50 33.26 ± 3.96 F = 6.71 p = 0.0001 Education level Primary school Middle school High school University 32.05 ± 4.62 32.23 ± 4.20 31.55 ± 4.59 30.75 ± 4.76 F = 4.79 p = 0.003 Employment status Employed Unemployed 32.06 ± 4.73 31.47 ± 4.53 t = 1.65 p = 0.09 Trimester 2nd Trimester 3rd Trimester 31.29 ± 4.65 31.89 ± 4.48 t = 2.06 p = 0.03 Number of pregnancies 1 2 3 4 30.48 ± 4.58 32.75 ± 4.02 32.44 ± 4.60 33.66 ± 4.24 F = 24.74 p = 0.0001 Pregnancy intention Intended pregnancy Unwanted pregnancy 31.53 ± 4.59 31.87 ± 4.53 t = 0.92 p = 0.35 Regular antenatal care attendance Yes No 31.54 ± 4.56 32.08 ± 4.70 t = 1.03 p = 0.30 Preferred mode of delivery Vaginal birth 32.00 ± 4.43 t = 4.10 p = 0.0001 Cesarean section 30.74 ± 4.77 Reasons for Preferring Vaginal Birth (n = 676) Early mobilization 31.56 ± 4.75 KW = 23.27 p = 0.0001 Perceived to be healthier 32.37 ± 4.33 Better ability to care for the baby 30.42 ± 4.65 Other 31.87 ± 4.21 Reasons for Preferring Cesarean Section (n = 324) Scheduled delivery 29.38 ± 4.71 KW = 28.37 p = 0.0001 Fear of vaginal birth 29.82 ± 4.68 Desire for tubal ligation 31.66 ± 4.20 Other 31.28 ± 4.82 The relationship between pregnant women’s birth beliefs and their level of childbirth readiness is presented in Table 3 . A positive, weak, and statistically significant correlation was found between the ‘Natural Process’ belief scores and childbirth readiness scores ( r = 0.312, p < 0.001). Table 3 The relationship between BBS and PFL mean scores Scales PFL Natural Process Belief r p -0.16 0.060 Medical Process Belief r p 0.312 0.000 Discussion This study examined the relationship between birth beliefs and birth readiness levels of pregnant women in Türkiye. Overall, the findings suggest that women's perceptions of childbirth can reflect both their preferences and their level of readiness in certain ways. Since birth preparation is known to be an important process both psychologically and practically, understanding these relationships is valuable for improving pregnancy care [ 34 – 36 ]. According to the results of our study, perceiving birth as a “natural process” was associated with a higher level of birth readiness. On the other hand, the readiness levels of women who perceived birth as a “medical process” did not show a significant difference. This suggests that birth beliefs are not unidirectionally related to readiness and that different types of beliefs may have different meanings in the psychological readiness of pregnant women. In the literature, it is stated that birth beliefs may be related to women's attitudes and behaviors [ 37 – 39 ]; our study presents a pattern consistent with this view. Findings regarding birth preferences show a similar pattern. Pregnant women who chose vaginal delivery had higher natural process beliefs, while those who chose cesarean section had higher medical process beliefs (Table 1 ) overlaps with previous studies in the literature [ 9 , 26 , 28 , 31 , 40 ]. Therefore, the relationship between natural childbirth beliefs and readiness found in our study suggests that supporting belief systems may be a fundamental step in improving birth outcomes. When the reasons for pregnant women’s preferred mode of delivery were examined, the most commonly cited reasons were ‘better ability to care for the baby’ and ‘perceived to be healthier’ (Table 1 ). The higher natural-process belief and lower PFL score (indicating a higher level of readiness) observed in this group are consistent with findings showing that vaginal birth reduces postpartum fatigue and facilitates adaptation to motherhood [ 41 ] and that it improves breastfeeding success [ 42 ]. This suggests that the confidence of the pregnant women in our study in the natural process was combined with preparation for the role of motherhood. In contrast, among pregnant women who preferred cesarean section, ‘scheduled delivery’ and ‘fear of vaginal birth’ emerged as the leading reasons, and these women also had higher medical-process belief scores (Table 1 ). This trend is in line with studies reporting that cesarean section is perceived as a more planned and controllable option in health systems where birth is medicalized [ 43 , 44 ]. Indeed, Bubpawong et al. (2025) state that in low- and middle-income countries, cesarean section is coded as ‘modern, painless and the safest’ method; the medical intervention functions as a control strategy for women [ 45 ]. In our study, the fact that women who preferred cesarean section had higher levels of birth readiness and that readiness levels increased especially in those who wanted the date of delivery to be determined suggests that belief in the medical process can function as a coping strategy that supports readiness by reducing uncertainty. The results regarding the age variable vary as in the literature. Preis et al. reported that age was not a determinant however, in this study, the higher level of medical process beliefs in women aged 30 years and older is in line with the findings of Alp Yılmaz and Durgun Ozan (2020) who showed that age can affect birth beliefs in a Türkiye sample [ 26 ]. Increased perception of risk with advancing age may contribute to a more medicalized view of childbirth [ 46 , 47 ]. In our study, the fact that the 20–25 age group with the lowest medical process beliefs had the highest level of readiness for childbirth indicates a higher perception of readiness in the younger age group (Table 2 ). This finding is in line with the findings of studies showing that younger pregnant women report more positive trends in their level of preparation for childbirth [ 48 , 49 ]. In contrast to this relationship, Jafari et al. (2026) associated older age with higher readiness [ 36 ]; it may be related to how “readiness” is understood in different societies in different cultures. Socio-demographic variables such as educational level and employment status also play a role in birth beliefs (Table 1 ). In our study, the higher level of medical process belief in working women suggests that this group may be more open to medical intervention. However, in the literature, there are studies reporting that medical process beliefs are higher in non-working women [ 40 , 50 , 51 ] and a study reporting that this tendency can be seen in working women [ 26 ]. Similarly, natural process beliefs were found to be higher in women with lower levels of education in our study; however, other studies have reported that natural process beliefs increase with increasing educational level [ 9 , 13 , 38 , 40 ]. These differences indicate that the effect of socioeconomic status on birth beliefs may vary according to the cultural context. In the analyses related to educational level, it was determined that the level of birth readiness of women with university degrees was higher than the other groups (Table 2 ). This finding is in parallel with studies reporting that readiness for childbirth increases with increasing educational level [ 36 , 52 ]. Considering that readiness is a multidimensional process that includes information literacy, self-management and planning skills, it is an expected result that higher education level supports these elements. On the other hand, the lower natural process belief of university graduates may reflect an approach that emphasizes managing the birth process with knowledge, planning and self-efficacy [ 29 ]. In this direction, the high readiness levels of educated women may be related to conscious awareness based on their capacity to manage the process rather than beliefs about childbirth. Limitations and generalizability of the study The main limitation of this study is that it has a cross-sectional design and the data were obtained from a single center. Therefore, the findings represent only the region where the study was conducted. Although the sample was kept large with a margin of error of 3% in order to reflect the region at a high level, it is thought that multi-center studies in different cultural contexts will increase the generalizability of the results. Conclusion and recommendations This study demonstrated that pregnant women’s preparation for childbirth is influenced by their beliefs about childbirth. Based on these findings, the following recommendations can be made: Regular assessment of women’s childbirth-related beliefs, fears, and need for control during antenatal follow-ups may be beneficial. To support women’s desire for control and predictability during the childbirth process, strengthening practices such as childbirth education, informational sessions, and birth plan development is recommended. To enhance pregnant women’s access to accurate information, the use of clear, up-to-date, and accessible educational materials should be encouraged. Future research should include multicenter and longitudinal designs covering different cultures and regions to improve the generalizability of the findings. Declarations Ethics approval and consent to participate Ethical approval for the study was obtained from the Ethics Committee of Atatürk University, Faculty of Medicine (Number: B.30.2.ATA.0.01.00/117). Pregnant women who met the research criteria were informed about the study, and then the data were collected after obtaining their consent. The ethical principles and the Declaration of Helsinki were followed during the study. Consent for publication Not applicable. The manuscript does not contain any individual person’s data in any form (including individual details, images, or videos). Competing interests The authors declare no competing interests. Funding This study was supported by the Atatürk University Scientific Research Projects Coordination Office (Project No: TYL-2022-11403). The funder provided administrative support and institutional oversight as part of the academic curriculum requirement; however, no financial compensation or grant was provided for the conduct of the research. Author Contribution IÜAG: Conceptualization, Methodology, Data curation, Writing- Original draft preparation. HÖ: Supervision, Software, Validation, Investigation, Visualization, Writing- Reviewing and Editing. All authors were actively involved in interpretation of the data and writing the manuscript. All authors read and approved the final manuscript. Acknowledgements We would like to thank all pregnant women who participated in the study and the staff at the institution where the study was conducted for their interest and kindness. Data Availability The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. References Tunçalp Ӧ, Were WM, MacLennan C, Oladapo OT, Gülmezoglu AM, Bahl R, et al. Quality of care for pregnant women and newborns-the WHO vision. BJOG. 2015;122:1045–9. https://doi.org/10.1111/1471-0528.13451 . Khaled M, Corner GW, Horton K, Khoddam H, Stoycos S, Saxbe DE. Prenatal relationship conflict behavior predicts childbirth experiences and birth outcomes. 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Springer. 2017;295:1127–33. Brekalo M, Kuljanac A, Nakić-Radoš S. Intolerance of uncertainty and fear of childbirth: Role of perceived preparedness for childbirth. Clínica y Salud SciELO Espana. 2024;35:35–8. Alizadeh-Dibazari Z, Abbasalizadeh F, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Evaluation of childbirth readiness and its associated factors and consequences in pregnant women referring to health centers in Tabriz, Iran and providing strategies to promote childbirth readiness: a sequential explanatory mixed method study protocol. BMJ open. Br Med J Publishing Group. 2024;14:e087038. Ju D, Zhang K, Yuan M, Li B, Zeng T. Mediating role of childbirth readiness in the relationship between social support and psychological birth trauma in primiparous women: a nationwide cross-sectional study in China. BMJ open. Br Med J Publishing Group. 2024;14:e080481. Miquelutti MA, Cecatti JG, Makuch MY. Developing strategies to be added to the protocol for antenatal care: An exercise and birth preparation program. Clin Elsevier. 2015;70:231–6. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization; 2016. World Health Organisation. Caesarean section rates continue to rise, amid growing inequalities in access [Internet]. 2021 [cited 2026 Feb 2]. https://www.who.int/news/item/16-06-2021-caesarean-section-rates-continue-to-rise-amid-growing-inequalities-in-access . Accessed 2 Feb 2026. Republic of Türkiye Ministry of Health. Health Statistics Yearbook 2024 – Press Bulletin [Internet]. 2024. https://www.saglik.gov.tr/TR-111038/saglik-istatistikleri-yilligi-2024-haber-bulteni.html Alp Yilmaz F, Durgun Ozan Y. Women’s birth beliefs and associated factors in an obstetrics clinic in the Southeastern Anatolian Region of Turkey. J Health Res [Internet] Emerald Publishing Ltd. 2020;34:345–51. https://doi.org/10.1108/JHR-07-2019-0166 . [cited 2022 Apr 2];. Preis H, Benyamini Y, Eberhard-Gran M, Garthus-Niegel S. Childbirth preferences and related fears - comparison between Norway and Israel. BMC Pregnancy Childbirth [Internet]. 2018 [cited 2023 Oct 6];18:362. https://doi.org/10.1186/s12884-018-1997-5 Preis H, Eisner M, Chen R, Benyamini Y. First-time mothers’ birth beliefs, preferences, and actual birth: A longitudinal observational study. Women Birth. 2019;32:e110–7. https://doi.org/10.1016/j.wombi.2018.04.019 . Tola YO, Akingbade O, Akinwaare MO, Adesuyi EO, Arowosegbe TM, Ndikom CM, et al. Psychoeducation for psychological issues and birth preparedness in low- and middle-income countries: a systematic review. AJOG Glob Rep [Internet]. 2022;2:100072. https://doi.org/10.1016/j.xagr.2022.100072 . [cited 2026 Feb 4];. El-shrqawy EH, Elnemer A, Mohamed Elsayed H. Effect of antenatal education on pregnant women`s knowledge, attitude and preferences of delivery mode. BMC Pregnancy Childbirth [Internet]. 2024;24:740. https://doi.org/10.1186/s12884-024-06922-0 . [cited 2026 Feb 4];. Paker S, Ertem G, Validity. and Reliability Study of the Turkish Form of the Birth Beliefs Scale. terh [İnternet]. 2022 [cited 2023 Oct 17];32:1–8. https://doi.org/10.4274/terh.galenos.2020.89814 Lederman R, Weis K. Psychosocial Adaptation to Pregnancy [Internet]. New York, NY: Springer; 2009. [cited 2026 Feb 5]. https://doi.org/10.1007/978-1-4419-0288-7 . Beydağ KT, Mete S. Validity and reliability study of the Prenatal Self-Evaluation Questionnaire [Turkish]. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi [Internet]. 2010 [cited 2022 Apr 2];11:16–24. Available from: https://dergipark.org.tr/en/pub/ataunihem/issue/2640/33958 Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Perceptions of primiparous women about the effect of childbirth preparation classes on their childbirth experience: A qualitative study. Midwifery [Internet]. 2021 [cited 2026 Feb 8];103:103154. https://doi.org/10.1016/j.midw.2021.103154 Taheri M, Takian A, Taghizadeh Z, Jafari N, Sarafraz N. Creating a positive perception of childbirth experience: systematic review and meta-analysis of prenatal and intrapartum interventions. Reprod Health [Internet]. 2018;15:73. https://doi.org/10.1186/s12978-018-0511-x . [cited 2026 Feb 8];. Jafari T, Rajati F, Kazeminia M, Rezavand N, Rajati M. Readiness of pregnant women for birth and associated factors among women attending Moatezadi Hospital, Kermanshah, Iran (2022). International Journal of Africa Nursing Sciences [Internet]. 2026 [cited 2026 Feb 8];24:100928. https://doi.org/10.1016/j.ijans.2025.100928 Bar-On S, Benyamini Y, Ebrahimoff M, Many A. Mother knows best? Comparing primiparous parturients’ expectations and predictions with actual birth outcomes. J Perinat Med De Gruyter. 2014;42:435–9. Vogels-Broeke M, Daemers D, Budé L, de Vries R, Nieuwenhuijze M. Women’s Birth Beliefs During Pregnancy and Postpartum in the Netherlands: A Quantitative Cross-Sectional Study. J Midwifery Women’s Health [Internet]. 2023 [cited 2023 Nov 28];68:210–20. https://doi.org/10.1111/jmwh.13473 Cesuroğlu S, Hayta H, Erkal M, Kunttaş Y, Yavaş G. The effect of birth beliefs and fear on birth preferences in pregnant women. Curr Psychol [Internet]. 2024;43:34624–32. https://doi.org/10.1007/s12144-024-06992-5 . [cited 2026 Feb 8];. Çubukçu B, Şahin SA. The effect of pregnant women’s childbirth beliefs on fear of childbirth. Women’s Studies International Forum [Internet]. 2025 [cited 2025 Apr 3];108:103017. https://doi.org/10.1016/j.wsif.2024.103017 Lai Y-L, Hung C-H, Stocker J, Chan T-F, Liu Y. Postpartum fatigue, baby-care activities, and maternal–infant attachment of vaginal and cesarean births following rooming-in. Appl Nurs Res [Internet]. 2015;28:116–20. https://doi.org/10.1016/j.apnr.2014.08.002 . [cited 2025 June 19];. Negrini R, da Silva Ferreira RD, Guimarães DZ. Value-based care in obstetrics: comparison between vaginal birth and caesarean section. BMC Pregnancy Childbirth [Internet]. 2021 [cited 2025 June 19];21:333. https://doi.org/10.1186/s12884-021-03798-2 Boz İ, Teskereci G, Akman G. How did you choose a mode of birth? Experiences of nulliparous women from Turkey. Women and Birth [Internet]. 2016 [cited 2023 Oct 13];29:359–67. https://doi.org/10.1016/j.wombi.2016.01.005 Jenabi E, Khazaei S, Bashirian S, Aghababaei S, Matinnia N. Reasons for elective cesarean section on maternal request: a systematic review. Volume 33. Taylor & Francis; 2020. pp. 3867–72. [cited 2026 Feb 8];. https://doi.org/10.1080/14767058.2019.1587407 . The Journal of Maternal-Fetal & Neonatal Medicine [Internet] Bubpawong S, Nuampa S, Ratinthorn A, Ruchob R. Multi-level factors influencing caesarean section preferences among women in low- and middle- income countries: A systematic review. Midwifery [Internet]. 2025;147:104423. https://doi.org/10.1016/j.midw.2025.104423 . [cited 2026 Feb 8];. Jenabi E, Khazaei,Salman B. Saeid, Aghababaei, Soodabeh, and Matinnia N. Reasons for elective cesarean section on maternal request: a systematic review. The Journal of Maternal-Fetal & Neonatal Medicine [Internet]. Taylor & Francis; 2020 [cited 2025 Apr 3];33:3867–72. https://doi.org/10.1080/14767058.2019.1587407 Walker KF, Thornton JG. Timing and mode of delivery with advancing maternal age. Best Pract Res Clin Obstet Gynaecol. 2021;70:101–11. https://doi.org/10.1016/j.bpobgyn.2020.06.005 . Feyisa Balcha W, Mulat Awoke A, Tagele A, Geremew E, Giza T, Aragaw B et al. Practice of Birth Preparedness and Complication Readiness and Its Associated Factors:A Health Facility-Based Cross-Sectional Study Design. Inquiry [Internet]. 2024 [cited 2025 June 19];61:00469580241236016. https://doi.org/10.1177/00469580241236016 Mesele M, Anmut W. Birth preparedness and complication readiness practice among women attending antenatal care follow up in Yirgalem general hospital, southern Ethiopia. PLOS Glob Public Health [Internet]. 2022;2:e0000864. https://doi.org/10.1371/journal.pgph.0000864 . [cited 2025 June 19];. Dinç B, Okyay EK. Kadınların doğum inançları ve etkileyen faktörler. Anatol J Health Res [İnternet]. 2021;2:57–63. https://doi.org/10.29228/anatoljhr.52200 . [cited 2023 Dec 2];. Sanavi FS, Rakhshani F, Ansari-Moghaddam A, Edalatian M. Reasons for Elective Cesarean Section amongst Pregnant Women; A Qualitative Study. J Reprod Infertil. 2012;13:237–40. Alizadeh-Dibazari Z, Abbasalizadeh F, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Evaluation of childbirth readiness and its associated factors and consequences in pregnant women referring to health centers in Tabriz, Iran and providing strategies to promote childbirth readiness: a sequential explanatory mixed method study protocol. Br Med J Publishing Group. 2024. https://doi.org/10.1136/bmjopen-2024-087038 . [cited 2026 Feb 9]. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8846042","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":602647916,"identity":"918213f6-78e0-4aa9-b9b5-dfce8219f10f","order_by":0,"name":"İmran Ülkü Alev Gökgöz","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBklEQVRIie3RMUvDQBTA8RcO0uW1o5wEzFd45SAIPfSrCEK6OOgSugvnEpxbMvgZ/AZXDnSJcRXSoX6DiougQl8p2A5psjrcf7h7BH7cgwD4fP+wcHudEh+BBdAEcu97C5EbAkzSHcH2x/6I6yaDo5f3zxsjFVmxtB/mVcVFTrDKHJxHtnmxaKyimZEJ2ZDmM1MntCgpmFYOcHBxgKQQ9Y3UZIEclrUmeUWib5gc2IyJ+N6S3sr9lJWOp0x+20m4eYUXQ3IwsQm8MQk6yAgrqY4dXs/zyaWixRMP1RixbCZxkYoaMz28f757XH7R2fChuOUhG5308mayS+zNFjr/pM/n8/naWgOQUFM6LYM+OAAAAABJRU5ErkJggg==","orcid":"","institution":"Atatürk University","correspondingAuthor":true,"prefix":"","firstName":"İmran","middleName":"Ülkü Alev","lastName":"Gökgöz","suffix":""},{"id":602647917,"identity":"aea69b8f-0731-4c2e-91c5-86f95af7aafc","order_by":1,"name":"Hava Özkan","email":"","orcid":"","institution":"Atatürk University","correspondingAuthor":false,"prefix":"","firstName":"Hava","middleName":"","lastName":"Özkan","suffix":""}],"badges":[],"createdAt":"2026-02-11 01:38:44","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8846042/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8846042/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104429028,"identity":"c4c14231-6142-4078-9562-46b94e9c1b99","added_by":"auto","created_at":"2026-03-11 15:18:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1302060,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8846042/v1/4d917f21-48e2-4221-9a79-43dbb4469872.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Evaluation of the relationship between birth beliefs and readiness for childbirth in pregnant women: a cross-sectional study","fulltext":[{"header":"Background","content":"\u003cp\u003ePregnancy and childbirth is one of the most critical developmental, social and psychological transitions in a woman's life cycle [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This process is not just a biological event; it is a multidimensional experience with physical, emotional and cultural layers [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Women's experiences during childbirth are recognized as important health outcomes that affect their quality of life [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The systematic review by Downe et al. (2018) shows that the meaning of childbirth for women is determined by three main phenomena: the physical and psychosocial nature of childbirth, socio-cultural norms, and the level of responsiveness of the care service to women's individual values. In this context, women may perceive childbirth as a meaningful and transformative experience for them, or they may perceive it as a medical necessity that must be completed [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the context of behavioral sciences, human behavior is shaped by various factors such as the individual's experiences and attitudes and beliefs that change depending on the events. Pre-evaluation of people's attitudes and beliefs makes these behaviors and decisions predictable and even changeable [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Within this framework, perceptions of childbirth are also linked to the mental representations that develop during pregnancy, referred to as birth-related mindsets. The model described by Hoffmann and Banse (2021) captures the general tendency to conceptualize childbirth as either a more \u0026lsquo;natural\u0026rsquo; or a more \u0026lsquo;medicalized\u0026rsquo; process\u0026rdquo; [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. This tendency is shaped by more specific cognitive structures concerning the physical nature of childbirth and how it should occur-namely, core beliefs about childbirth [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. As shown in Preis and Benyamini's (2017, 2018) studies, these beliefs are addressed in two dimensions [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The belief that childbirth is a natural process considers birth as a normal and safe physiological event, that the female body is fit to give birth, that interventions are only necessary when necessary, and that pain is a natural part of the process [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In contrast, medical birth beliefs view birth as a risky process and emphasize the necessity of modern interventions [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. It is known that these beliefs are influenced by various factors such as individual and social experiences, perinatal care quality, risk perception and cultural values [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePregnant women\u0026rsquo;s perceived psychological and physical preparedness when making decisions about the childbirth process is referred to as \u0026lsquo;readiness\u0026rsquo; This concept refers to a multidimensional structure that includes not only physiological or practical preparation but also self-management skills, the ability to access and use information, confidence in childbirth and the capacity to plan [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The World Health Organization (WHO) considers birth preparation as one of the essential elements of antenatal care and emphasizes that this preparation is decisive in reducing maternal mortality [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. It has been reported that women who are not adequately prepared for labor have higher rates of adverse outcomes such as preterm labor, prolonged labor, various obstetric complications and postpartum hemorrhage [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In addition, studies have shown that low levels of birth preparedness are associated with fear of childbirth, anxiety, and difficulties in coping with uncertainty [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Furthermore, women with lower levels of preparedness appear to have an increased risk of psychological birth trauma, while the protective effect of social support strengthens as preparedness improves [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. These findings indicate that childbirth readiness is a critical determinant of both physical and psychological birth outcomes. Consequently, the importance of education and counseling practices that support birth preparedness has been increasingly emphasized [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWHO recommends that caesarean section rates should be kept within the range of 10\u0026ndash;15% at the population level; however, global caesarean section rates are increasing and now account for more than one-fifth of all births [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The fact that the cesarean section rate in Turkey has reached level of 61.2% makes it particularly necessary to examine the psychosocial factors related to childbirth more closely [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Although the relationship between birth beliefs and fear of childbirth, birth preference and birth experience has been examined in the literature [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], no study has been found to address the relationship with readiness. Understanding women's birth beliefs and readiness levels during pregnancy is important in terms of individualizing midwifery care, reducing unnecessary medical interventions during the birth process and supporting women to experience an empowered preparation process for birth.\u003c/p\u003e \u003cp\u003eThis study was conducted to determine the effects of birth beliefs of pregnant women on their level of readiness for childbirth.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis study was designed as a cross-sectional study and was conducted in accordance with the STROBE guidelines. The study was conducted between October 2022 and December 2022 in a hospital located in the capital of Turkey, which has a high annual pregnancy outpatient clinic volume and receives referrals from across the region. This center was chosen because it serves a large pregnant population with different socio-economic and demographic characteristics and has a high patient circulation, which allowed the study to reach the targeted sample size (n\u0026thinsp;=\u0026thinsp;1000).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eParticipants and procedure\u003c/h3\u003e\n\u003cp\u003eThe sample size was calculated with a 95% confidence interval and a margin of error of 3% (\u003cem\u003ed\u0026thinsp;=\u0026thinsp;0.03\u003c/em\u003e) in order to increase the precision of estimation and minimize sampling error. According to the sampling formula with known population, it was determined that at least 964 pregnant women should be reached to ensure this precision in a population of approximately 10,000. Thanks to the full-time presence of the researcher in the outpatient clinic during the data collection process and the high patient circulation of the hospital, the targeted number was reached and the study was completed with a total of 1000 pregnant women (500 primiparous and 500 multiparous).\u003c/p\u003e \u003cp\u003eOnly second and third trimester pregnant women were included in this study. It has been reported that attitudes and emotional states related to pregnancy are not yet stable in the first trimester, and anxiety and beliefs about childbirth become more pronounced as the pregnancy progresses [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. In addition, it has been shown that the effect of antenatal education and preparation for delivery emerges especially in the later trimesters [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Inclusion criteria included being 20 years of age or older, having a spontaneous pregnancy, and having communication and literacy skills sufficient to answer the data collection tools in the study. Pregnant women with a psychiatric diagnosis that may affect participation in the data collection process or with known chronic medical conditions such as heart disease, diabetes, hypertension or kidney disease were excluded from the study. In addition, women who developed a medical complication during pregnancy that could limit participation in the study were excluded.\u003c/p\u003e\n\u003ch3\u003eData Collection Tools\u003c/h3\u003e\n\u003cp\u003eA personal information form, Birth Beliefs Scale (BBS) and Ready for Birth Subscale of the Prenatal Self‑Evaluation Questionnaire for used for data collection.\u003c/p\u003e\n\u003ch3\u003ePersonal information form\u003c/h3\u003e\n\u003cp\u003eThis form includes questions about the pregnant women\u0026rsquo;s sociodemographic and obstetric characteristics.\u003c/p\u003e\n\u003ch3\u003eBirth Beliefs Scale (BBS)\u003c/h3\u003e\n\u003cp\u003eThe scale was developed by Preis et al. (2017) to assess women's birth beliefs [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The scale, whose Turkish validity and reliability study was conducted by Paker and Ertem (2022), has two sub-dimensions: natural process belief and medical process belief [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Five items assess the belief that birth is a natural process (items 3, 5, 7, 8 and 11) and six items assess the belief that birth is a medical process (items 1, 2, 4, 6, 9 and 10). Thus, the BBS consists of 11 items in total in mixed order. On this five-point Likert-type scale, each item is rated on a scale of 1 to 5 (1 means Strongly Disagree, 5 means Strongly Agree). The minimum and maximum points a participant can score on the Medical Process Belief Subscale are 6 and 30 points, respectively; the minimum and maximum points a participant can score on the Natural Process Belief Subscale are 5 and 25 points, respectively. The sum of the scores obtained from each subscale is divided by the number of items of the subscale and the arithmetic mean of the scores for each subscale is calculated. The higher arithmetic mean score a participant obtains from a subscale indicates the direction of birth belief. Each subscale is evaluated separately. Paker and Ertem reported the Cronbach's alpha reliability coefficient as 0.890 for the natural process subscale and 0.868 for the medical process subscale [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. In this study, Cronbach's alpha reliability coefficient was 0.70 for the natural process sub-dimension and 0.72 for the medical process sub-dimension.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003ePrenatal Self Evaluation Questionnaire- Preparation for Labor Subscale (PFL)\u003c/h2\u003e \u003cp\u003eThe preparation for labor subscale (PFL) of the Prenatal Self-Evaluation Questionnaire (PSEQ) developed by Lederman et al. (1979) to assess women's adaptation to motherhood in the prenatal process was used to determine the readiness levels of pregnant women for childbirth. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. PSEQ consists of 7 subscales and 79 items. There are 10 items (items 7, 13, 24, 25, 26, 38, 47, 48, 56 and 72) covering the preparation for labor subscale and the items are rated on a four-point Likert scale (4 very much so, 3 moderately so, 2 somewhat so, and 1 not at all). Positive statements in the preparation for labor subscale (items 7, 24, 25, 26, 38, 47, 48, 56) are reverse scored. The sum of the scores obtained from the scale varies between 10 and 40; low scores indicate a high level of birth readiness, while high scores indicate a low level of birth readiness (inadequate adaptation). The Turkish validity and reliability of the scale was conducted by Taş\u0026ccedil;ı Beydağ and Mete (2008) and Cronbach's alpha value in the scale is 0.72 [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. The present study calculated Cronbach's alpha value to be 0,63.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eThe data were gathered through face-to-face interviews with pregnant women following their prenatal check-ups. After the examination, participants completed the questionnaires in a private setting, which took approximately 10\u0026ndash;15 minutes. The sessions concluded after the researcher addressed the participants' questions and provided requested information.\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe data were analyzed using the SPSS 20.0 software package (Statistical Package for the Social Sciences). Descriptive statistics (number, percentage, minimum\u0026ndash;maximum values, mean, and standard deviation) and inferential tests, including independent samples t-test, one-way ANOVA, and Kruskal\u0026ndash;Wallis test, were employed. Pearson correlation analysis and Cronbach\u0026rsquo;s α coefficient were also used. The normality of the data was assessed through skewness and kurtosis values (\u0026plusmn;\u0026thinsp;2). A p-value of \u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe distribution of pregnant women according to their socio-demographic and obstetric characteristics is given in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. The mean age of the pregnant women was 28.0\u0026thinsp;\u0026plusmn;\u0026thinsp;5.0 years. 37.4% of the pregnant women were high school graduates and 79.2% were not working. Obstetric characteristics revealed that 50% of the participants were primiparous and 50% were in the second trimester of pregnancy. 81.4% of the participants planned their pregnancy and 91.4% had regular prenatal check-ups. Regarding mode of delivery preferences, 67.6% of the pregnant women preferred vaginal delivery and 53.9% of this group stated that they found vaginal delivery healthier. While 32.1% of the pregnant women who planned cesarean delivery cited fear of childbirth as the reason, the remaining 52.8% stated other reasons such as perceiving cesarean section as a faster and safer process or the recommendations of the social environment (family elders, etc.). When Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e was analyzed, a statistically significant difference was found between the natural process sub-dimension scores of pregnant women according to their educational status, planned mode of delivery and reasons for preference (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). In the medical process sub-dimension, it was determined that the differences in mean scores based on the age of pregnant women, employment status, regularity of prenatal check-ups, planned mode of delivery, and reasons for preference were statistically significant (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" style=\"width: 553px;\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eComparison of socio-demographic and obstetric characteristics of pregnant women and mean scores of BBS subscales\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 184px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eCharacteristics\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 20px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003en\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 24.8889px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 144px;\" colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNatural Process\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 140px;\" colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eMedical Process\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003ex̄\u0026nbsp;\u0026plusmn;SD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 71px;\" align=\"left\"\u003e\n\u003cp\u003eTest\u003c/p\u003e\n\u003cp\u003eand\u0026nbsp;\u003cem\u003eP\u003c/em\u003e\u0026nbsp;value\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003ex̄\u0026nbsp;\u0026plusmn;SD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 77px;\" align=\"left\"\u003e\n\u003cp\u003eTest\u003c/p\u003e\n\u003cp\u003eand\u0026nbsp;\u003cem\u003eP\u003c/em\u003e\u0026nbsp;value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eAge (28,0\u0026thinsp;\u0026plusmn;\u0026thinsp;5,0)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 20px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"width: 24.8889px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"width: 144px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"width: 140px;\" colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e20\u0026ndash;25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e341\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e34.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eF\u0026thinsp;=\u0026thinsp;0.75\u003c/p\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eF\u0026thinsp;=\u0026thinsp;5.60\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e26\u0026ndash;30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e344\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e34.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e30\u0026ndash;35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e251\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e25.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.26\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.93\u0026thinsp;\u0026plusmn;\u0026thinsp;0.92\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e36 or older\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e6.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 512.889px;\" colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003ePrimary school\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e155\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e15.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eF\u0026thinsp;=\u0026thinsp;3.90\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.009\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eF\u0026thinsp;=\u0026thinsp;1.27\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.28\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eMiddle school\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e229\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e22.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eHigh school\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e374\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e37.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eUniversity\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e242\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e24.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.68\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 512.889px;\" colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eEmployment status\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eEmployed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e208\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e20.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.81\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.95\u0026thinsp;\u0026plusmn;\u0026thinsp;1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003et\u0026thinsp;=\u0026thinsp;3.68\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eUnemployed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e792\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e79.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 512.889px;\" colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTrimester\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e2nd Trimester\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e500\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e50.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.85\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.18\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.23\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e3rd Trimester\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e500\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e50.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.26\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 512.889px;\" colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eNumber of pregnancies\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e500\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e50.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eF\u0026thinsp;=\u0026thinsp;0.91\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eF\u0026thinsp;=\u0026thinsp;2.37\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.06\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e279\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e27.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.26\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e135\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e13.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e8.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 512.889px;\" colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePregnancy intention\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eIntended pregnancy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e814\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e81.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.33\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.54\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.12\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eUnwanted pregnancy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e186\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e18.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 512.889px;\" colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eRegular antenatal care attendance\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e914\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e91.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.64\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003et\u0026thinsp;=\u0026thinsp;2.72\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.007\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e8.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.24\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.99\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 512.889px;\" colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePreferred mode of delivery\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eVaginal birth\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e676\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e67.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.37\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003et\u0026thinsp;=\u0026thinsp;7.01\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003et\u0026thinsp;=\u0026thinsp;8.86\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eCesarean section\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e324\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e32.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 512.889px;\" colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eReasons for Preferring Vaginal Birth (n\u0026thinsp;=\u0026thinsp;676)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eEarly mobilization\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e128\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e18.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eKW\u0026thinsp;=\u0026thinsp;50.23\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.66\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eKW\u0026thinsp;=\u0026thinsp;106.94\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003ePerceived to be healthier\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e364\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e53.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.41\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eBetter ability to care for the baby\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e4.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.45\u0026thinsp;\u0026plusmn;\u0026thinsp;0.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.68\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eOther\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e156\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e23.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.60\u0026thinsp;\u0026plusmn;\u0026thinsp;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 512.889px;\" colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eReasons for Preferring Cesarean Section (n\u0026thinsp;=\u0026thinsp;324)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eScheduled delivery\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e9.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 71px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eKW\u0026thinsp;=\u0026thinsp;55.74\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.24\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 77px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eKW\u0026thinsp;=\u0026thinsp;108.50\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eFear of vaginal birth\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e104\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e32.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eDesire for tubal ligation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e5.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184px;\" align=\"left\"\u003e\n\u003cp\u003eOther\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n\u003cp\u003e171\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 24.8889px;\" align=\"left\"\u003e\n\u003cp\u003e52.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e4.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63px;\" align=\"left\"\u003e\n\u003cp\u003e3.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe comparison of birth readiness scores of pregnant women according to their socio-demographic and obstetric characteristics is presented in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. In the analysis, it was found that there was a statistically significant difference between the birth readiness scores of pregnant women according to their age, educational status, trimester, parity, Preferred mode of delivery and reasons for preference (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab2\" style=\"width: 380px;\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eComparison of sociodemographic and obstetric characteristics by PFL scores\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 184.044px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eCharacteristics\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003ePFL\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 101px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eTest and \u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003ex̄\u0026plusmn;SD\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eAge (28,0\u0026thinsp;\u0026plusmn;\u0026thinsp;5,0)\u003c/p\u003e\n\u003cp\u003e20\u0026ndash;25\u003c/p\u003e\n\u003cp\u003e26\u0026ndash;30\u003c/p\u003e\n\u003cp\u003e30\u0026ndash;35\u003c/p\u003e\n\u003cp\u003e36 or older\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e31.10\u0026thinsp;\u0026plusmn;\u0026thinsp;4.59\u003c/p\u003e\n\u003cp\u003e31.26\u0026thinsp;\u0026plusmn;\u0026thinsp;4.61\u003c/p\u003e\n\u003cp\u003e32.28\u0026thinsp;\u0026plusmn;\u0026thinsp;4.50\u003c/p\u003e\n\u003cp\u003e33.26\u0026thinsp;\u0026plusmn;\u0026thinsp;3.96\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 101px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eF\u0026thinsp;=\u0026thinsp;6.71\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePrimary school\u003c/p\u003e\n\u003cp\u003eMiddle school\u003c/p\u003e\n\u003cp\u003eHigh school\u003c/p\u003e\n\u003cp\u003eUniversity\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e32.05\u0026thinsp;\u0026plusmn;\u0026thinsp;4.62\u003c/p\u003e\n\u003cp\u003e32.23\u0026thinsp;\u0026plusmn;\u0026thinsp;4.20\u003c/p\u003e\n\u003cp\u003e31.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.59\u003c/p\u003e\n\u003cp\u003e30.75\u0026thinsp;\u0026plusmn;\u0026thinsp;4.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 101px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eF\u0026thinsp;=\u0026thinsp;4.79\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.003\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eEmployment status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEmployed\u003c/p\u003e\n\u003cp\u003eUnemployed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e32.06\u0026thinsp;\u0026plusmn;\u0026thinsp;4.73\u003c/p\u003e\n\u003cp\u003e31.47\u0026thinsp;\u0026plusmn;\u0026thinsp;4.53\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 101px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.65\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.09\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTrimester\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e2nd Trimester\u003c/p\u003e\n\u003cp\u003e3rd Trimester\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e31.29\u0026thinsp;\u0026plusmn;\u0026thinsp;4.65\u003c/p\u003e\n\u003cp\u003e31.89\u0026thinsp;\u0026plusmn;\u0026thinsp;4.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 101px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003et\u0026thinsp;=\u0026thinsp;2.06\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.03\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eNumber of pregnancies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e30.48\u0026thinsp;\u0026plusmn;\u0026thinsp;4.58\u003c/p\u003e\n\u003cp\u003e32.75\u0026thinsp;\u0026plusmn;\u0026thinsp;4.02\u003c/p\u003e\n\u003cp\u003e32.44\u0026thinsp;\u0026plusmn;\u0026thinsp;4.60\u003c/p\u003e\n\u003cp\u003e33.66\u0026thinsp;\u0026plusmn;\u0026thinsp;4.24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 101px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eF\u0026thinsp;=\u0026thinsp;24.74\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePregnancy intention\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIntended pregnancy\u003c/p\u003e\n\u003cp\u003eUnwanted pregnancy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e31.53\u0026thinsp;\u0026plusmn;\u0026thinsp;4.59\u003c/p\u003e\n\u003cp\u003e31.87\u0026thinsp;\u0026plusmn;\u0026thinsp;4.53\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 101px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.92\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.35\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 361px;\" colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eRegular antenatal care attendance\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e31.54\u0026thinsp;\u0026plusmn;\u0026thinsp;4.56\u003c/p\u003e\n\u003cp\u003e32.08\u0026thinsp;\u0026plusmn;\u0026thinsp;4.70\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 101px;\" align=\"left\"\u003e\n\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.03\u003c/p\u003e\n\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.30\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 361px;\" colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePreferred mode of delivery\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eVaginal birth\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e32.00\u0026thinsp;\u0026plusmn;\u0026thinsp;4.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 101px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003et\u0026thinsp;=\u0026thinsp;4.10\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eCesarean section\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e30.74\u0026thinsp;\u0026plusmn;\u0026thinsp;4.77\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 361px;\" colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eReasons for Preferring Vaginal Birth (n\u0026thinsp;=\u0026thinsp;676)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eEarly mobilization\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e31.56\u0026thinsp;\u0026plusmn;\u0026thinsp;4.75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 101px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eKW\u0026thinsp;=\u0026thinsp;23.27\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003ePerceived to be healthier\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e32.37\u0026thinsp;\u0026plusmn;\u0026thinsp;4.33\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eBetter ability to care for the baby\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e30.42\u0026thinsp;\u0026plusmn;\u0026thinsp;4.65\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eOther\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e31.87\u0026thinsp;\u0026plusmn;\u0026thinsp;4.21\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 361px;\" colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eReasons for Preferring Cesarean Section (n\u0026thinsp;=\u0026thinsp;324)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eScheduled delivery\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e29.38\u0026thinsp;\u0026plusmn;\u0026thinsp;4.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 101px;\" rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eKW\u0026thinsp;=\u0026thinsp;28.37\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ep\u0026thinsp;=\u0026thinsp;0.0001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eFear of vaginal birth\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e29.82\u0026thinsp;\u0026plusmn;\u0026thinsp;4.68\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eDesire for tubal ligation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e31.66\u0026thinsp;\u0026plusmn;\u0026thinsp;4.20\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 184.044px;\" align=\"left\"\u003e\n\u003cp\u003eOther\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 75.956px;\" align=\"left\"\u003e\n\u003cp\u003e31.28\u0026thinsp;\u0026plusmn;\u0026thinsp;4.82\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe relationship between pregnant women\u0026rsquo;s birth beliefs and their level of childbirth readiness is presented in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e. A positive, weak, and statistically significant correlation was found between the \u0026lsquo;Natural Process\u0026rsquo; belief scores and childbirth readiness scores (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.312, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eThe relationship between BBS and PFL mean scores\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eScales\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003ePFL\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eNatural Process Belief\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er\u003c/p\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-0.16\u003c/p\u003e\n\u003cp\u003e0.060\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eMedical Process Belief\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003er\u003c/p\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.312\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study examined the relationship between birth beliefs and birth readiness levels of pregnant women in Türkiye. Overall, the findings suggest that women's perceptions of childbirth can reflect both their preferences and their level of readiness in certain ways. Since birth preparation is known to be an important process both psychologically and practically, understanding these relationships is valuable for improving pregnancy care [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e–\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAccording to the results of our study, perceiving birth as a “natural process” was associated with a higher level of birth readiness. On the other hand, the readiness levels of women who perceived birth as a “medical process” did not show a significant difference. This suggests that birth beliefs are not unidirectionally related to readiness and that different types of beliefs may have different meanings in the psychological readiness of pregnant women. In the literature, it is stated that birth beliefs may be related to women's attitudes and behaviors [\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e–\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e]; our study presents a pattern consistent with this view.\u003c/p\u003e \u003cp\u003eFindings regarding birth preferences show a similar pattern. Pregnant women who chose vaginal delivery had higher natural process beliefs, while those who chose cesarean section had higher medical process beliefs (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) overlaps with previous studies in the literature [\u003cspan class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e]. Therefore, the relationship between natural childbirth beliefs and readiness found in our study suggests that supporting belief systems may be a fundamental step in improving birth outcomes.\u003c/p\u003e \u003cp\u003eWhen the reasons for pregnant women’s preferred mode of delivery were examined, the most commonly cited reasons were ‘better ability to care for the baby’ and ‘perceived to be healthier’ (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). The higher natural-process belief and lower PFL score (indicating a higher level of readiness) observed in this group are consistent with findings showing that vaginal birth reduces postpartum fatigue and facilitates adaptation to motherhood [\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e] and that it improves breastfeeding success [\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e]. This suggests that the confidence of the pregnant women in our study in the natural process was combined with preparation for the role of motherhood.\u003c/p\u003e \u003cp\u003eIn contrast, among pregnant women who preferred cesarean section, ‘scheduled delivery’ and ‘fear of vaginal birth’ emerged as the leading reasons, and these women also had higher medical-process belief scores (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). This trend is in line with studies reporting that cesarean section is perceived as a more planned and controllable option in health systems where birth is medicalized [\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e]. Indeed, Bubpawong et al. (2025) state that in low- and middle-income countries, cesarean section is coded as ‘modern, painless and the safest’ method; the medical intervention functions as a control strategy for women [\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e]. In our study, the fact that women who preferred cesarean section had higher levels of birth readiness and that readiness levels increased especially in those who wanted the date of delivery to be determined suggests that belief in the medical process can function as a coping strategy that supports readiness by reducing uncertainty.\u003c/p\u003e \u003cp\u003eThe results regarding the age variable vary as in the literature. Preis et al. reported that age was not a determinant however, in this study, the higher level of medical process beliefs in women aged 30 years and older is in line with the findings of Alp Yılmaz and Durgun Ozan (2020) who showed that age can affect birth beliefs in a Türkiye sample [\u003cspan class=\"CitationRef\"\u003e26\u003c/span\u003e]. Increased perception of risk with advancing age may contribute to a more medicalized view of childbirth [\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn our study, the fact that the 20–25 age group with the lowest medical process beliefs had the highest level of readiness for childbirth indicates a higher perception of readiness in the younger age group (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). This finding is in line with the findings of studies showing that younger pregnant women report more positive trends in their level of preparation for childbirth [\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e]. In contrast to this relationship, Jafari et al. (2026) associated older age with higher readiness [\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e]; it may be related to how “readiness” is understood in different societies in different cultures.\u003c/p\u003e \u003cp\u003eSocio-demographic variables such as educational level and employment status also play a role in birth beliefs (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). In our study, the higher level of medical process belief in working women suggests that this group may be more open to medical intervention. However, in the literature, there are studies reporting that medical process beliefs are higher in non-working women [\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e] and a study reporting that this tendency can be seen in working women [\u003cspan class=\"CitationRef\"\u003e26\u003c/span\u003e]. Similarly, natural process beliefs were found to be higher in women with lower levels of education in our study; however, other studies have reported that natural process beliefs increase with increasing educational level [\u003cspan class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e]. These differences indicate that the effect of socioeconomic status on birth beliefs may vary according to the cultural context.\u003c/p\u003e \u003cp\u003eIn the analyses related to educational level, it was determined that the level of birth readiness of women with university degrees was higher than the other groups (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). This finding is in parallel with studies reporting that readiness for childbirth increases with increasing educational level [\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e]. Considering that readiness is a multidimensional process that includes information literacy, self-management and planning skills, it is an expected result that higher education level supports these elements. On the other hand, the lower natural process belief of university graduates may reflect an approach that emphasizes managing the birth process with knowledge, planning and self-efficacy [\u003cspan class=\"CitationRef\"\u003e29\u003c/span\u003e]. In this direction, the high readiness levels of educated women may be related to conscious awareness based on their capacity to manage the process rather than beliefs about childbirth.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and generalizability of the study\u003c/h2\u003e \u003cp\u003eThe main limitation of this study is that it has a cross-sectional design and the data were obtained from a single center. Therefore, the findings represent only the region where the study was conducted. Although the sample was kept large with a margin of error of 3% in order to reflect the region at a high level, it is thought that multi-center studies in different cultural contexts will increase the generalizability of the results.\u003c/p\u003e \u003c/div\u003e "},{"header":"Conclusion and recommendations","content":"\u003cp\u003eThis study demonstrated that pregnant women’s preparation for childbirth is influenced by their beliefs about childbirth. Based on these findings, the following recommendations can be made:\u003c/p\u003e\u003cp\u003eRegular assessment of women’s childbirth-related beliefs, fears, and need for control during antenatal follow-ups may be beneficial.\u003c/p\u003e\u003cp\u003eTo support women’s desire for control and predictability during the childbirth process, strengthening practices such as childbirth education, informational sessions, and birth plan development is recommended.\u003c/p\u003e\u003cp\u003eTo enhance pregnant women’s access to accurate information, the use of clear, up-to-date, and accessible educational materials should be encouraged.\u003c/p\u003e\u003cp\u003eFuture research should include multicenter and longitudinal designs covering different cultures and regions to improve the generalizability of the findings.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003eEthical approval for the study was obtained from the Ethics Committee of Atat\u0026uuml;rk University, Faculty of Medicine (Number: B.30.2.ATA.0.01.00/117). Pregnant women who met the research criteria were informed about the study, and then the data were collected after obtaining their consent. The ethical principles and the Declaration of Helsinki were followed during the study.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eNot applicable. The manuscript does not contain any individual person\u0026rsquo;s data in any form (including individual details, images, or videos).\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis study was supported by the Atat\u0026uuml;rk University Scientific Research Projects Coordination Office (Project No: TYL-2022-11403). The funder provided administrative support and institutional oversight as part of the academic curriculum requirement; however, no financial compensation or grant was provided for the conduct of the research.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eI\u0026Uuml;AG: Conceptualization, Methodology, Data curation, Writing- Original draft preparation. H\u0026Ouml;: Supervision, Software, Validation, Investigation, Visualization, Writing- Reviewing and Editing. All authors were actively involved in interpretation of the data and writing the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eWe would like to thank all pregnant women who participated in the study and the staff at the institution where the study was conducted for their interest and kindness.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eTun\u0026ccedil;alp Ӧ, Were WM, MacLennan C, Oladapo OT, G\u0026uuml;lmezoglu AM, Bahl R, et al. Quality of care for pregnant women and newborns-the WHO vision. 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[cited 2026 Feb 9].\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"birth beliefs, readiness for childbirth, vaginal birth, natural process belief, pregnancy","lastPublishedDoi":"10.21203/rs.3.rs-8846042/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8846042/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePregnancy and childbirth is a multifaceted experience for women that has physical, emotional and cultural dimensions as well as biological ones. Women may sometimes perceive birth as a meaningful and transformative process and sometimes as a medical necessity to be completed. Therefore, understanding beliefs about birth and readiness levels during pregnancy is important for individualizing midwifery care and planning appropriate counseling. This study was conducted to determine the relationship between birth beliefs and birth readiness levels of pregnant women.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis descriptive and cross-sectional study was conducted between October and December 2022 in a public maternity hospital in the capital of Turkey. The sample size was calculated with a 95% confidence level and a 3% margin of error, and 1000 pregnant women who met the inclusion criteria and voluntarily participated in the study were included in the study. Data were collected using a sociodemographic and obstetric information form, Beliefs of Childbirth Scale and Birth Readiness Scale administered by face-to-face interview method. Descriptive statistics (percentage, mean, SD) and inferential tests (independent t-test, ANOVA, and Kruskal\u0026ndash;Wallis) were used.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe mean age of the participants was 28.0\u0026thinsp;\u0026plusmn;\u0026thinsp;5.0 years, most of them were not working and half of them were primipara. Of the pregnant women, 67.6% preferred vaginal delivery and 32.4% preferred cesarean section. The belief in natural process was higher in those who preferred vaginal delivery and the belief in medical process was higher in those who preferred cesarean section. Birth readiness levels of pregnant women who preferred cesarean section were significantly higher. In addition, a positive correlation was found between natural process belief and readiness (r\u0026thinsp;=\u0026thinsp;0.312, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAs a result of this study, a positive and weak relationship was found between \u0026lsquo;Natural Process\u0026rsquo; belief and birth readiness. In addition, pregnant women who preferred cesarean section had a higher level of readiness, suggesting the effect of the preference for planability and controlled process. The findings suggest that it may be useful to evaluate women's beliefs about birth in pregnancy care and to structure counseling by considering these individual differences.\u003c/p\u003e","manuscriptTitle":"Evaluation of the relationship between birth beliefs and readiness for childbirth in pregnant women: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-11 15:18:03","doi":"10.21203/rs.3.rs-8846042/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-09T09:51:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-25T12:44:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"260322384120182853731898099424690217414","date":"2026-03-21T14:27:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"323472860877132240349488338499015583125","date":"2026-03-11T14:23:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-08T03:13:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"324867293595840747953019649019777828494","date":"2026-03-08T02:14:15+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-06T03:27:56+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-13T12:56:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-13T03:04:13+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-13T03:03:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2026-02-11T01:32:36+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3214ebe6-5ecd-4107-9123-d65f2bdb0157","owner":[],"postedDate":"March 11th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-23T10:41:07+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-11 15:18:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8846042","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8846042","identity":"rs-8846042","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}