Background Fear of childbirth is a serious pregnancy concern in nulliparous women. Although salutogenic theory can facilitate the effective management of fear, it requires identification of the factors causing fear of childbirth. This study aimed to explain nulliparous women's experiences with fear of vaginal birth according to the salutogenic theory. Design A qualitative study based on a directed content analysis. Method This study was performed on Iranian nulliparous women in the second or third trimester of pregnancy. Fifteen women were selected through purposive sampling, with the data collected through in-depth as well as semi-structured interviews. The extracted codes were then organized in MAXQDA-2020. Results The factors causing fear of childbirth were organized into 3 themes and 7 categories as follows: sense of coherence (comprehensibility, manageability, and meaningfulness), generalized resistance resources (internal and external resources), and perceived expectations (expected results and parturient's expectations). Also, participants with a fear of childbirth expressed desire to undergo vaginal birth, based on results. Conclusion According to salutogenic theory and women's expectations, the study findings could provide an in-depth understanding of childbirth fear in nulliparous women. Furthermore, they can gain deeper insights into various facets of childbirth anxiety and utilize available resources to support their desire for a vaginal delivery. Given the multicultural nature of Iranian society, further studies are required to explore women's experiences concerning the fear of childbirth.
Kananikandeh et al. (Mon,) studied this question.