{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T08:18:45Z","timestamp":1770970725645,"version":"3.50.1"},"reference-count":59,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"unspecified","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004366","name":"Tabriz University of Medical Sciences","doi-asserted-by":"crossref","award":["70398"],"award-info":[{"award-number":["70398"]}],"id":[{"id":"10.13039\/501100004366","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,23]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Childbirth readiness can reflect women\u2019s childbirth readiness in terms of knowledge, psychological aspects and planning. The purpose of this study was to evaluate childbirth readiness, its related factors and consequences in Iranian pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This longitudinal study was the first stage (quantitative stage) of a sequential explanatory mixed-method study. It followed women during late pregnancy (from 37 weeks of gestation) and the postpartum period (4\u20136 weeks after childbirth) from March to September 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Health centres of Tabriz, Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>This study involved 360 pregnant women with a gestational age of 37 weeks and above, selected via cluster sampling. Participants were excluded for high-risk pregnancies, unfavourable incidents in the last 3\u2009months, mental-psychological diseases or a prior caesarean section.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Childbirth readiness and its related factors were assessed using several instruments completed from the 37th week of pregnancy onward, including the Childbirth Readiness Scale, a sociodemographic questionnaire, the Pregnancy Experience Scale and the Wijma Delivery Expectancy\/Experience Questionnaire Version A. The consequences of childbirth readiness were then evaluated 4\u20136\u2009weeks post partum using the Childbirth Experience Questionnaire, the Edinburgh Postnatal Depression Scale and the Postpartum-Specific Anxiety Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean (SD) childbirth readiness score was 67.83 (9.41) out of 90. In the adjusted general linear model (GLM), several factors were significantly associated with lower readiness. These included a higher fear of childbirth score (\u03b2 \u22120.12, 95%\u2009CI \u22120.16 to \u22120.08, p&lt;0.001), first pregnancy (\u03b2 \u22125.84, 95%\u2009CI \u22129.71 to \u22121.96, p=0.003), nulliparity (\u03b2 \u221212.50, 95%\u2009CI \u221215.95 to \u22129.05, p&lt;0.001), no history of abortion (\u03b2 \u22122.90, 95%\u2009CI \u22125.42 to \u22120.43, p=0.021), non-participation in readiness classes (\u03b2 \u22122.24, 95%\u2009CI \u22124.41 to \u22120.08, p=0.042), lower educational attainment (\u03b2 \u22124.55, 95%\u2009CI \u22127.60 to \u22121.50, p=0.004) and having a husband who was a worker (\u03b2 \u22122.07, 95%\u2009CI \u22123.87 to \u22120.28, p=0.023). In contrast, being a homeowner was associated with a higher readiness score (\u03b2 2.14, 95%\u2009CI 0.05 to 4.24, p=0.045). Based on GLM, pregnancy experience was not significantly associated with childbirth readiness, and childbirth readiness was not significantly associated with childbirth experience or postpartum anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Key factors associated with readiness included fear of childbirth, obstetric history (gravidity, parity, history of abortion and participation in childbirth readiness classes), maternal education, home ownership, husband\u2019s occupation\u2014though several associations showed small effect sizes. After adjustment, readiness did not independently predict childbirth experience or postpartum mental health. The low participation rate in readiness courses highlights a major service gap. Integrating readiness assessment into prenatal care and expanding access to targeted education are recommended to improve outcomes such as birth satisfaction and caesarean rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-112218","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T15:27:25Z","timestamp":1770737245000},"page":"e112218","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal study of childbirth readiness and its related factors and consequences among low-risk pregnant women attending health centres in Tabriz, Iran"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-1372","authenticated-orcid":false,"given":"Zohreh","family":"Alizadeh-Dibazari","sequence":"first","affiliation":[{"name":"Department of Midwifery, TaMS.C, Islamic Azad University, Tabriz, Iran (the Islamic Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"Abbasalizadeh","sequence":"additional","affiliation":[{"name":"Women Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-9333","authenticated-orcid":false,"given":"Sakineh","family":"Mohammad-Alizadeh-Charandabi","sequence":"additional","affiliation":[{"name":"Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8360-4309","authenticated-orcid":false,"given":"Mojgan","family":"Mirghafourvand","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"2026021223254242000_16.2.e112218.1","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1037\/fam0000650","article-title":"Prenatal relationship conflict behavior predicts childbirth experiences and birth outcomes","volume":"34","author":"Khaled","year":"2020","journal-title":"J Fam Psychol"},{"key":"2026021223254242000_16.2.e112218.2","doi-asserted-by":"publisher","DOI":"10.1080\/01674820400017830"},{"key":"2026021223254242000_16.2.e112218.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2004.04.014"},{"key":"2026021223254242000_16.2.e112218.4","doi-asserted-by":"crossref","first-page":"231","DOI":"10.6061\/clinics\/2015(04)02","article-title":"Developing strategies to be added to the protocol for antenatal care: an exercise and birth preparation program","volume":"70","author":"Miquelutti","year":"2015","journal-title":"Clinics (Sao Paulo)"},{"key":"2026021223254242000_16.2.e112218.5","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1186\/s12884-022-04574-6","article-title":"Childbirth Readiness Scale (CRS): instrument development and psychometric properties","volume":"22","author":"Mengmei","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026021223254242000_16.2.e112218.6","doi-asserted-by":"crossref","first-page":"e88","DOI":"10.1016\/j.wombi.2018.04.008","article-title":"Women\u2019s experience of midwife-led counselling and its influence on childbirth fear: A qualitative study","volume":"32","author":"Larsson","year":"2019","journal-title":"Women Birth"},{"key":"2026021223254242000_16.2.e112218.7","doi-asserted-by":"crossref","first-page":"100512","DOI":"10.1016\/j.srhc.2020.100512","article-title":"Midwife-led integrated pre-birth training and its impact on the fear of childbirth. 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