Abstract
Health literacy is crucial for women to access and utilize health information effectively, especially during the pivotal stages of pregnancy and early motherhood. This cross-sectional study aimed to explore the relationship between health literacy and fear of childbirth (FOC) among 270 pregnant women attending prenatal clinics in Qom, Iran. Health literacy was assessed using the Health Literacy for Iranian Adults questionnaire, while FOC was measured with the Hartman questionnaire. The results indicated that 29.6% of the participants had limited health literacy, with a significant difference in overall health literacy scores between women with FOC (mean score: 72.10 ± 13.68) and those without (mean score: 77.10 ± 14.06, p = 0.011). Multivariable logistic regression revealed the predictor variables for fear of childbirth included health literacy (OR 0.96, 95% CI 0.94-0.99, p = 0.009), planned pregnancy (Yes/No) (OR 3.01, 95% CI 1.29-7.01, p = 0.011), and income (sufficient/insufficient) (OR 2.92, 95% CI 1.03-8.27, p = 0.044). These findings highlight the use of effective strategies for regular monitoring of women's health literacy, as well as targeted interventions to increase health literacy among pregnant women, especially low-income women, which can potentially contribute to improving reproductive decision-making and reducing fear of childbirth.