The sample consists of 496 individuals, with a mean age of 25.17 years (SD = 7.08), ranging from 18 to 42 years. Regarding educational status, the majority of participants have attained at least a high school diploma, with 61.7% having completed university, 20.8% high school, 6.7% secondary school, and 5.8% primary school. A smaller proportion of participants, 5%, have completed postgraduate education. The sociodemographic characteristics of the participants are presented in Table 1.

Pearson correlation analyses were conducted to examine the relationships between childbirth fear (WCF-PPS) and various psychosocial variables including childhood trauma and attachment styles. The results revealed a significant positive correlation between WCF-PPS and anxious attachment (r = .257, p < .001), suggesting that individuals with higher levels of anxious attachment tend to report greater fear of childbirth.

In addition, childhood trauma total score (r = .090, p = .049) and emotional abuse (r = .094, p = .039) were also weakly but significantly correlated with childbirth fear. Other trauma subtypes, such as physical and sexual abuse, emotional and physical neglect, and avoidant attachment, did not show statistically significant associations with WCF-PPS (all p > .05). The Pearson correlations between WCF-PPS and CTQ-SF, ECR-RS are presented in Table 2.

These findings indicate that anxious attachment and specific dimensions of childhood trauma, particularly emotional abuse, may play a modest role in influencing fear of childbirth among nulliparous women.

A multiple linear regression analysis was conducted to examine the predictive effects of childhood trauma (CTQ-SF total and subscales), attachment styles (ECR-RS_avoidant and ECR-RS_anxious), and age on birth fear (WCF-PPS). The regression model was found to be significant (F (9, 435) = 2.977, p = .002), and the model's variables explained approximately 5.8% of the variance in WCF-PPS scores (R² = .058, adjusted R² = .039).

Upon examining the regression coefficients, it was found that only the anxious attachment style (ECR-RS_anxious) significantly predicted birth fear (β = .172, t = 3.652, p < .001). This result indicates that as an individual’s attachment anxiety increases, their level of birth fear also significantly rises. On the other hand, the total score and subscales of childhood trauma (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect), avoidant attachment style (ECR-RS_avoidant), and age did not contribute significantly to the model (p > .05). Results of Multiple Linear Regression Analysis Predicting Birth Fear (WCF-PPS) are presented in Table 3.

This study aimed to quantitatively examine the influence of individuals’ early traumatic experiences and attachment dynamics in close relationships on their levels of fear related to childbirth. Our findings revealed that anxious attachment was the strongest predictor of childbirth fear, whereas childhood trauma, particularly emotional abuse, exhibited a modest but significant association. These results underscore the importance of psychosocial factors in understanding fear of childbirth.

Consistent with our findings, a Finnish birth cohort study including 2,556 women reported that emotional abuse and emotional neglect significantly increased the risk of childbirth fear, whereas physical abuse, physical neglect, and sexual abuse were not statistically significant predictors (Porthan et al., 2023). Similarly, a study conducted in Norway with 2,365 pregnant women revealed that 18% of those with a history of childhood abuse experienced severe fear of childbirth, compared to 10% among those without such a history. This association was particularly evident among primiparous women (adjusted OR: 2.00; 95% CI: 1.30–3.08) (Lukasse et al., 2010). These findings support our results, suggesting that emotional abuse, in particular, may contribute to increased childbirth fear.

From the perspective of Bowlby’s attachment theory, attachment patterns appear to play a pivotal role in childbirth-related anxiety. In a study by Reisz et al. (2019), it was found that mothers with secure attachment styles reported higher levels of perceived support during childbirth and greater satisfaction with their birth experiences. The theoretical constructs of a “secure base” and a “safe haven” were emphasized as protective factors during the childbirth process.

Conversely, women with avoidant attachment styles have been reported to be at greater risk for experiencing postnatal trauma symptoms. In a recent study by Yıldırım et al. (2025), pregnant women with avoidant attachment styles were shown to have higher levels of childbirth fear compared to those with secure attachment styles. Furthermore, elevated anxiety levels and previous negative birth experiences were also cited as factors contributing to fear of childbirth. In our current study, while no statistically significant relationship was found between avoidant attachment and fear of childbirth, a significant association was observed specifically with anxious attachment. Bowlby defined anxious attachment as a pattern characterized by an intense need for closeness and a fear of abandonment, which develops as a result of inconsistent responses from caregivers (Bowlby, 1988). In adulthood, individuals with this attachment style tend to display excessive reassurance seeking, emotional fluctuations, and heightened separation anxiety in their relationships (Mikulincer & Shaver, 2016). These characteristics may increase anxiety and the need for support during childbirth — a process marked by uncertainty and loss of control — and thereby contribute to greater fear of childbirth. Golmakani et al. (2020) also reported that fear can increase attachment anxiety. This situation can create a cycle that feeds anxiety during the birth process.