Implementing an educational intervention program to alleviate anxiety among primigravida women: a prospective, quasi-experimental study

Pregnancy-related anxiety may result in adverse health outcomes in women. Research indicates that initiatives aimed at alleviating anxiety in women with no prior history of pregnancy experience are highly beneficial. However, evidence on culturally adapted childbirth education interventions for reducing pregnancy-related anxiety among primigravida women in Saudi Arabia remains limited. This study aimed to evaluate changes in pregnancy-related anxiety following participation in a culturally adapted childbirth education program among primigravida women in Saudi Arabia. This prospective quasi-experimental pretest-posttest study was conducted at a public hospital in the eastern region of Saudi Arabia among 122 primigravida women recruited during their second trimester of pregnancy. Participants attended a structured childbirth education program consisting of weekly 2-hour sessions over eight weeks. Anxiety levels were assessed before and after the intervention using the Pregnancy Anxiety Questionnaire. Pre- and post-intervention anxiety scores were compared using paired-samples t-tests, with effect sizes reported as Cohen’s dz and 95% confidence intervals for the mean differences. Pearson’s correlation was used to examine associations between continuous variables. Analyses were conducted using SPSS version 29. Total PRAQ-R2 scores decreased significantly from pre-test (M = 28.38, SD = 9.27) to post-test (M = 19.23, SD = 7.35), a mean reduction of 9.15 points (95% CI 7.42 to 10.88), t(121) = 10.46, p < 0.001, Cohen’s dz = 0.95. Significant reductions were also observed for all three subscales: fear of giving birth (mean difference 4.02, 95% CI 3.35 to 4.69; dz = 1.08), worries about bearing a child with physical or mental disabilities (2.63, 95% CI 1.95 to 3.31; dz = 0.70), and concern about one’s appearance (2.50, 95% CI 1.89 to 3.11; dz = 0.74), all p < 0.001. Anxiety levels did not differ significantly by age, educational level, or employment status. Overall, these findings demonstrate a significant within-group reduction in pregnancy-related anxiety scores following participation in the program. Pregnancy-related anxiety scores decreased significantly among primigravida women following participation in the childbirth education program. However, because this study used a single-group pretest–posttest design without a control group, the observed reduction cannot be attributed exclusively to the intervention. Further controlled studies are needed to determine the effectiveness and long-term impact of the AMANI Birth program.