ArticleBMC psychology2026
Childbirth attitudes in parous and nulliparous women: the roles of cognitive flexibility, perceived social support, and obstetric factors.
Article in BMC psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildbirth is frequently associated with increased negative emotions, leading to psychological challenges for many pregnant women. In this study, childbirth attitudes are defined as encompassing both fear of childbirth and negative evaluative attitudes toward childbirth. Factors shaping these attitudes, including perceived social support and cognitive flexibility in parous and nulliparous women, remain underexplored. This study aims to examine the influence of perceived social support and cognitive flexibility on childbirth attitudes among parous and nulliparous women based on sociodemographic and obstetric factors.
methodsA cross-sectional research design included 362 (55.5% parous) pregnant women in Turkey. The data were analyzed using Pearson correlation, ANOVA, hierarchical regression, and network analysis.
resultsHierarchical regression analyses revealed that cognitive flexibility showed the strongest association among the examined variables with childbirth attitudes among both parous and nulliparous women (R² = 0.067). The dimensions of cognitive flexibility, namely, control and alternatives were found to account for unique variance and were the only significant associated factors of childbirth fear (CFI-Control: β = -0.460, p < 0.001; CFI-Alternatives: β = 0.128, p = 0.024). In network analyses, CFI-Alternatives exhibited the highest strength, betweenness, and closeness in the nulliparous group, whereas friends and family were most central in the parous group.
conclusionsThese findings suggest that cognitive flexibility is modestly associated with childbirth attitudes, particularly within Turkish culture, where social support may not consistently mitigate fear. The study emphasizes the importance of targeting cognitive flexibility in prenatal care, particularly for pregnant women without prior childbirth experience.
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