<![CDATA[Pathological fear of childbirth (tokophobia) is commonly experienced by primigravida pregnant women due to lack of previous birthing experience and exposure to negative narratives. This condition increases the risk of labor complications and elective cesarean section without medical indications. Objective: This study aimed to analyze the effectiveness of psychoeducation-based midwifery counseling in reducing tokophobia levels among primigravida pregnant women. Methods: A quasi-experimental study using a pretest-posttest control group design was conducted involving 60 third-trimester primigravida pregnant women, divided into an intervention group (n=30) and a control group (n=30). The intervention group received four sessions of psychoeducation-based midwifery counseling, while the control group received standard antenatal care (ANC). Tokophobia levels were measured before and after the intervention using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A. Data were analyzed using paired t-test and independent t-test. Results: The baseline tokophobia scores were comparable between the intervention (88.40 ± 7.12) and control groups (87.90 ± 6.85; p = 0.785). Post-intervention, the intervention group demonstrated a significant reduction in tokophobia score to 52.15 ± 6.05 (p < 0.001). Conversely, the control group showed no significant change (84.30 ± 7.10; p = 0.124). Inter-group comparison post-intervention confirmed a statistically significant difference in effectiveness (p < 0.001). Conclusion: Psychoeducation-based midwifery counseling is highly effective in significantly reducing tokophobia levels in primigravida women by restructuring cognitive perceptions and breaking the fear-tension-pain cycle. Integrating psychoeducational interventions into routine ANC services at primary health care facilities is strongly recommended.]]>
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