Pain beliefs, cognitive flexibility, and birth preferences in primigravida

Background The aim of our study is to investigate the relationship between pain beliefs and preference for the method of childbirth. In addition, the relationship between pain beliefs in pregnant women with cognitive flexibility, depression, and anxiety has been investigated as a secondary purpose. Metods: This study was conducted in the Department of Obstetrics and Gynecology at a tertiary healthcare facility in southern Türkiye, with a total of 222 women experiencing their first pregnancy (2021). This is a single-center descriptive cross-sectional study with an analytical component. Statistical procedures were performed using SPSS Version 22 and IBM SPSS AMOS Version 22. Results were considered statistically significant if the p-value was ≤ 0.05. Results It was observed that pregnant women who prefer cesarean section have higher organic pain beliefs (p = 0.029). The CFI-Control is associated with both BDI (β=-0.154, 95% CI:-0.285;-0.024,p = 0.021) and STAI-T (β = 0.258, 95% CI:-0.372;-0.131, p < 0.001) results negatively and significantly. In addition, BDI significantly is associated with PBQ-Organic positively (β = 0.153, 95% CI: 0.029; 0.271, p = 0.015). While the total effect of CFI-C on PBQ-Organic was significant (β =-0.143, 95% CI:-0.267;0.015, p = 0.026), its direct effect was not significant (β=-0.122, 95% CI:-0.247;0.006, p = 0.064). Our results demonstrate the mediating effect of BDI on the impact of CFI-C on PBQ-O (β=-0.021, 95% CI:-0.058;-0.002, p = 0.025). As negative pain beliefs increase in pregnant women, the preference for cesarean section also increases. Conclusions Our findings suggest that higher cognitive flexibility, together with lower depressive symptoms and more adaptive pain beliefs, is associated with a lower preference for cesarean section.