Journal of Midwifery and Reproductive Health

Journal of Midwifery and Reproductive Health

Impact of Peplau’s Communication Therapy on Tokophobia, Stress and Anxiety in Primiparous Pregnant Women: A Quasi-Experimental Study

Document Type : Original Research Article

Authors
Yasman Darabpour Ghandali 1
Kourosh Zarea 2
Amin Sattari 3
Hossein Komili-Sani 4
Mohammad Hossein Haghighizadeh 5
1 BSc Student of Nursing, Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Full Professor, Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3 PhD Student in Medical Ethics, Department of Medical Ethics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
4 Lecturer, Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
5 Lecturer, Department of Statistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
10.22038/jmrh.2026.88932.2695
Abstract
Background & aim: Tokophobia is a common concern among pregnant women that can negatively affect their mental health and complicate labor. This study evaluated the effect of Peplau’s communication therapy on tokophobia, stress, and anxiety in primiparous pregnant women.
Methods: A quasi-experimental pre-test/post-test design was used. Sixty nulliparous women with tokophobia from health centers in Ahvaz, South Iran, were assigned to either an experimental group, who underwent eight sessions of Peplau’s communication therapy or a control group, who received routine care only. Data were collected using Hartman’s Fear of Childbirth Scale, Cohen’s Perceived Stress Scale, and Beck’s Anxiety Inventory, and analyzed using Chi-square, t-test and ANCOVA.
Results: Before the intervention, no significant differences were found between groups in mean scores of tokophobia, stress, or anxiety, indicating homogeneity. After the intervention, the mean tokophobia score decreased to 19.10±7.80 in the experimental group compared to 29.40±6.94 in the control group (P<0.001; 95% CI: 6.48 to 14.11). Stress levels were also significantly reduced in the experimental group (20.40±5.15) compared to the control group (28.16±4.61) (P<0.001; 95% CI: -10.29 to -5.29). Similarly, anxiety scores decreased to 9.13±7.64 in the experimental group, while remaining higher at 16.16±7.55 in the control group (P<0.001; 95% CI: -9.99 to -2.04).
Conclusion: Peplau’s interpersonal communication therapy effectively reduces tokophobia, stress, and anxiety in primiparous pregnant women. Healthcare providers could consider integrating this structured communication model into routine prenatal care to improve maternal psychological outcomes.
Keywords
Communication Therapy
Tokophobia
Stress
Anxiety
Primiparous Women
Subjects
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Journal of Midwifery and Reproductive Health
Volume 14, Issue 4
Autumn 2026
Pages 5675-5686