Junaid KP, Sen A, Kumar P
… +3 more, Pillai RR, Antony S, Pv A
Women Health
· 2026 Jan · PMID 41736649
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Postpartum depression is highly prevalent among expectant and new mothers and has far-reaching implications for the well-being of both mother and child. In this context, the present study attempts to estimate the prevale...Postpartum depression is highly prevalent among expectant and new mothers and has far-reaching implications for the well-being of both mother and child. In this context, the present study attempts to estimate the prevalence of postpartum depression in India at national and sub-national levels. We performed a systematic literature search in PubMed, Scopus, and EMBASE, including studies published between 2015 and 2023. Inclusion criteria encompassed research conducted in India, focusing on mothers from delivery up to one year postpartum. Observational studies reporting event numbers and total participants were included. The random-effects model was used. Sensitivity and subgroup analyses were conducted. The review analyzed 62 studies involving 21,262 women. The prevalence of postpartum depression was estimated to be 23.5 percent (95 percent CI: [19.3 percent-28.2 percent]) in India. We observed a substantial heterogeneity (I2 = 96.9 percent). Doi plot results showed an insignificant small study effect (Luis Furuya-Kanamori asymmetry index of -0.03). We identified significant associations between postpartum depression prevalence and various factors, including Indian states, study settings, literature quality score, publication year, and study period. In response to the findings, the study recommends targeted interventions, improved access to mental health services, and integrated mental health services with routine antenatal and postnatal care.
Women Health
· 2026 Jan · PMID 41732095
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Generational trends in the prevalence of menstrual-related symptoms (MRSs) among females residing in an aspirational district of India are investigated along with potential physiological, dietary, lifestyle, menstrual ma...Generational trends in the prevalence of menstrual-related symptoms (MRSs) among females residing in an aspirational district of India are investigated along with potential physiological, dietary, lifestyle, menstrual management, and socioeconomic risk factors. Using multi-stage stratified random sampling, primary data were collected from 400 respondents via face-to-face interviews utilising a semi-structured questionnaire. Each respondent's Menstrual Symptom Score (MSS) was calculated to assess the burden of symptoms. Statistical analyses, including one-way ANOVA, t-tests and multiple linear regression, were employed to explore the association between MSS and predictor variables. The most frequently reported symptoms were tiredness (66.3 percent), irritation (56.5 percent), lower back pain (49.5 percent), and menstrual pain (45 percent). The mean MSS was 3.42 (95 percent CI: 3.17, 3.67). Reproductive-age respondents reported significantly higher MSS than older respondents, who recalled fewer symptoms during their reproductive years, suggesting a potential generational difference in symptom burden. Bivariate analysis showed a significant association between higher MSS and intake frequency of pulses, junk/fast food, meat/fish/eggs, vegetables and milk, late bedtime, menstrual flow duration, heavy lifting during menses as tasks and chores, non-utilization of cotton cloth absorbent, family type and education. Multivariate analysis identified age-group, age at menarche, irregular pulse and vegetable consumption, late bedtime, prolonged menstrual flow, heavy lifting during menstruation, and higher educational attainment as key predictors. The findings indicate that certain symptoms are common among respondents, contributing to reduced productivity and well-being. The observed generational differences underscore the importance of physiological, dietary, lifestyle, menstrual-related practices and sociodemographic factors in reducing the symptom burden.
Endometriosis affects approximately 10-15 percent of women of reproductive age, yet its clinical presentation remains inconsistently reported. This scoping review mapped the global spectrum of endometriosis-related sympt...Endometriosis affects approximately 10-15 percent of women of reproductive age, yet its clinical presentation remains inconsistently reported. This scoping review mapped the global spectrum of endometriosis-related symptoms and examined factors influencing symptom reporting. Following the JBI framework, studies were identified using two databases to identify studies published between 2004 to 2024. Of the 1286 articles initially screened, 95 articles were included. Studies reported on a range of symptoms (49 symptoms) involving multiple organ systems, with the most commonly reported symptoms being dysmenorrhea, pelvic pain and dyspareunia. Symptom assessment varied widely, with predominant use of numerical rating and visual analogue scales and limited uptake of endometriosis-specific tools. Symptom cyclicity was inconsistently reported, and minority populations were under-represented. Overall, the findings highlight substantial heterogeneity in symptom classification and measurement, contributing to an incomplete understanding of disease burden. These findings set a basis for the creation of standardized, culturally sensitive, and multidimensional symptom assessment frameworks necessary to improve diagnostic accuracy, equity, and global comparability in endometriosis research and care. Open Science Framework (OSF) registration: https://doi.org/10.17605/OSF.IO/6BWRE.
Adolescent girls experience various difficulties in managing the menstrual process and require support for healthy self-management. The study aimed to evaluate the effectiveness of animation-assisted menstrual education...Adolescent girls experience various difficulties in managing the menstrual process and require support for healthy self-management. The study aimed to evaluate the effectiveness of animation-assisted menstrual education provided to boarding secondary school students. The study used a quasi-experimental one-group pretest-posttest design involving female students in Türkiye between May 1, 2023, and January 1, 2024. The sample comprised 43 students who met the inclusion criteria and provided parental consent. The data were collected using a Personal Information Form and a Knowledge Test. Institutional permission and ethics committee approval were obtained before the study. Students received animation-supported menstruation training sessions lasting approximately 30 minutes, conducted once a week for four weeks. The data were analyzed using descriptive statistics, paired two-sample t-tests, the McNemar test, linear regression, and analysis of covariance (ANCOVA). The analysis results indicated a statistically significant difference between the students' mean pretest and posttest knowledge scores ( < .001). Specifically, the mean knowledge score increased from 11.88 at pretest to 18.28 at posttest. The findings suggest that animation-supported menstrual education significantly increased students' knowledge levels.
Menopause indicates the end of the female reproductive lifespan. The hormonal shifts prior to this event result in a frequently symptomatic period known as perimenopause, which has been linked to unfavorable changes in b...Menopause indicates the end of the female reproductive lifespan. The hormonal shifts prior to this event result in a frequently symptomatic period known as perimenopause, which has been linked to unfavorable changes in body composition. This study explored women's experiences of perimenopause, including perception of body shape and weight. Perimenopausal women living in Ireland were recruited via convenience sampling to participate in semi-structured virtual interviews with a focus on experiences of weight and body shape. Interviews were recorded, transcribed and subjected to thematic analysis. Seventeen participants with an average age of 50.6 ± 2.8 years participated. Six main themes were produced, describing the far-reaching impact of menopause and its symptoms. The women expressed a differing experience of weight and body shape during perimenopause, compared to previous experiences. They were attempting to make sense of body shape and weight variations, with body image often negatively affected. Women aspired to make lifestyle changes, driven by a desire to manage weight, reduce symptoms, or improve present/future health. Challenges specific to this life stage, including symptoms or additional life factors, act as barriers to engaging with healthy lifestyle strategies. Women are seeking guidance to navigate perimenopause and any weight and body shape changes indicating that targeted lifestyle interventions are required, with a role for supportive weight management strategies.
Menstrual health & hygiene (MHH) affects millions of women and girls worldwide and has increasingly been recognized within public health and gender-related scholarship, yet the organization and thematic structure of this...Menstrual health & hygiene (MHH) affects millions of women and girls worldwide and has increasingly been recognized within public health and gender-related scholarship, yet the organization and thematic structure of this research remain unevenly documented. This study explores how MHH research has been structured and developed in recent years through a bibliometric analysis of peer-reviewed literature published between 2014 and early 2025. Articles were retrieved from the Scopus database using a title-based search strategy, resulting in a final sample of 53 publications that met pre-defined inclusion criteria. Bibliometric techniques, including publication trend analysis, source and contributor mapping, keyword co-occurrence analysis, and thematic mapping, were conducted using Biblioshiny (R) and VOSViewer. The findings highlight a sustained increase in MHH-related publications after 2015, with research largely concentrated around behavioral, demographic, and hygiene-oriented perspectives. Dominant thematic areas include adolescent-focused studies, health knowledge-attitude-practice (HKAP) frameworks, and sanitation, while themes related to sustainability, workplace contexts, and intersectional considerations remain weakly integrated. Overall, the findings indicate that contemporary MHH research is strongly structured around behavioral and population-focused perspectives, while sustainability, workplace-related contexts, and intersectional dimensions remain comparatively underdeveloped within the current research landscape.
Increasing knowledge about body image dissatisfaction and risk factors during pregnancy will provide opportunities to develop targeted interventions. This study examined body image and associated factors during pregnancy...Increasing knowledge about body image dissatisfaction and risk factors during pregnancy will provide opportunities to develop targeted interventions. This study examined body image and associated factors during pregnancy cross-sectionally. Data were collected from 931 pregnant women using a descriptive form and the Pregnancy Body Image Scale. Analyses used t-tests, ANOVA, Pearson correlation, regression, and path analysis. The study found that advanced age (β = .10), gestational weight gain (β = .17), health problems during pregnancy (β = .12), and low income (β = .16) increased body image dissatisfaction, whereas not paying attention to appearance before pregnancy (β = -.12), spousal support (β = -.09), and planned pregnancy (β = -.07) reduced it. Additionally, low income indirectly increased dissatisfaction by hindering planned pregnancy (β = -.11), while advanced age (β = .15), lack of pre-pregnancy concern for appearance (β = .09), and spousal support (β = .13) indirectly decreased dissatisfaction through promoting planned pregnancy. Based on the study results, it is recommended that midwives and nurses closely monitor and support women at risk of body image dissatisfaction, including those who are older, have low socioeconomic status, lack partner support, experience unplanned pregnancies or health problems, and pay attention to their appearance before pregnancy.
This study aimed to analyze all cause, breast cancer-specific, and other cause age-adjusted mortality rates among Brazilian women with breast cancer, comparing periods before and during the coronavirus disease (COVID-19)...This study aimed to analyze all cause, breast cancer-specific, and other cause age-adjusted mortality rates among Brazilian women with breast cancer, comparing periods before and during the coronavirus disease (COVID-19) pandemic. We analyzed mortality registries data of the Brazilian Unified Health System, from January 2017 to December 2022. Deaths were categorized as breast cancer-specific, breast cancer-contributory, and non-breast cancer mortality. Age-standardized and age-specific crude mortality rates were calculated using the World Health Organization standard population. Temporal trends were analyzed using Joinpoint Trend Analysis software. There were 124,031 deaths in those with breast cancer. Before the pandemic, 58,346 women with breast cancer died, of which 54,284 (93.03 percent) due to the disease. During the pandemic, 65,685 women with breast cancer died, of which 57,734 (87.89 percent) due to the disease. There was a 12.5 percent increase in the number of women dying with a breast cancer diagnosis during the pandemic, the proportion of breast cancer-specific deaths decreased, indicating that the additional mortality burden arose mainly from other causes. The diversion of healthcare resources to manage COVID-19 may have contributed to an increased mortality from other causes. Breast cancer survivors present high risk of mortality in health care crisis, such as the COVID-19 pandemic.
Women Health
· 2025 Oct · PMID 41243592
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Pain during gynecologic exams is prevalent and the quality of provider communication can shape how patients experience and perceive it. This secondary analysis examined provider responses to patients' verbal expressions...Pain during gynecologic exams is prevalent and the quality of provider communication can shape how patients experience and perceive it. This secondary analysis examined provider responses to patients' verbal expressions of pain during initial obstetric physical exams. Audio-recorded and transcribed data from 200 first prenatal visits, randomly selected from a larger National Institutes of Health-funded communication study, was analyzed for instances of pain expression and corresponding provider responses. Logistic regression was used to assess associations between provider and patient characteristics and response types. Fifty providers conducted exams with a diverse patient cohort (mean age 25.4 years; 45.6 percent Black, 38.6 percent White, 15.8 percent Multiracial). Patients vocalized pain in over one-quarter of exams, with providers responding with supportive and non-supportive communication. Providers acknowledged or apologized for pain in 63.2 percent of these encounters and offered positive reinforcement in 33.3 percent. In contrast, pain was referred to as something else in 22.8 percent of exams and ignored in 19.3 percent. Providers were more likely to offer no verbal response when a third-party person was present (OR 5.3, 95 percent CI 1.3-22.4). Findings indicate that pain is frequently expressed and variably addressed even during routine obstetric exams. Educational interventions for gynecologic examination training should emphasize empathetic, trauma-informed communication.
de Meiroz Grillo Barbalho D, Veiga-Junior NN, Cintra Baccaro LF
… +1 more, de Siqueira Guida JP
Women Health
· 2025 Oct · PMID 41222952
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Abortion complications are significant contributors to maternal deaths (MD), particularly in regions with restrictive abortion laws and limited healthcare access. The impact of these causes on the maternal mortality rati...Abortion complications are significant contributors to maternal deaths (MD), particularly in regions with restrictive abortion laws and limited healthcare access. The impact of these causes on the maternal mortality ratios (MMR) in Brazil is scarce. We evaluated the MMR related to abortion in Brazil from 2012-2022, conducting a cross-sectional study using data from the Ministry of Health, analyzing MD related to abortion and calculating the MMR per 100,000 live births (LB). We evaluated the MMR according to age, skin color, and geographic region of living. Among 19,535 MDs, 663 (3.39 percent) were attributed to abortion. Indigenous (PR 3.23; 95 percent CI 1.94-5.36) and black (PR 1.95; 95 percent CI 1.48-2.58) women exhibited higher MMRs. Women aged 40-49 had the highest MMR (5.85 deaths per 100,000 LB), and North region exhibited a significantly higher MMR (PR 1.44; 95 percent CI 1.15-1.81). Abortion accounted for a small proportion of MD in a 10-year analysis of a Brazilian national database; however, the findings highlighted inequalities in the deaths. The indigenous and black women presented higher MMR; the same was observed among older women, and those who lived in North region of the country.
Rasekh Jahroomi A, Mohammadi S, Noorozi Z
… +5 more, Khani S, Ranjbar A, Rahmanian V, Jamali S, Khani A
Women Health
· 2025 Oct · PMID 41213818
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Adenomyosis and endometriosis are chronic gynecological disorders with overlapping mechanisms and symptoms, both linked to impaired sexual health and relationships. This study compared sexual function, sexual quality of...Adenomyosis and endometriosis are chronic gynecological disorders with overlapping mechanisms and symptoms, both linked to impaired sexual health and relationships. This study compared sexual function, sexual quality of life, and relationship satisfaction in affected women and healthy controls. This cross-sectional comparative study (2022-2023) included 90 women in three groups: endometriosis (n = 30), adenomyosis (n = 30), and healthy controls (n = 30), recruited from Jahrom University clinics in Iran. Participants completed the SQOL-F.FSFI, and RAS questionnaires. Data were analyzed with ANOVA and regression (SPSS 25, p < 0.05). Women with endometriosis (21.8 ± 3.8; 95% CI: 20.5-23.2; 19.3 ± 2.9; 95% CI: 18.3-20.4; 42.3 ± 8.9; 95% CI: 39.2-45.5) and adenomyosis (23.2 ± 4.6; 95% CI: 21.6-24.9; 19.3 ± 3.0; 95% CI: 18.2-20.4; 49.7 ± 11.0; 95% CI: 45.8-53.7) had significantly lower scores than controls (26.6 ± 4.8; 95% CI: 24.9-28.3; 22.2 ± 3.5; 95% CI: 20.9-23.4; 51.5 ± 12.3; 95% CI: 47.1-55.9; p < 0.0001). Univariate analysis showed sexual function, desire, and arousal were positive, and pain negative, predictors of sexual quality of life. Regression indicated marriage age and duration were negative, while spouse's age, sexual function, and relationship satisfaction were positive predictors, explaining 36.5% of variance.Endometriosis and adenomyosis significantly reduce sexual function and quality of life. Counseling and supportive care are recommended to address these challenges.
Monterrosa-Castro Á, Chedraui P, Blümel JE
… +14 more, Elizalde-Cremonte A, Espinoza MT, Escalante C, Gómez-Tabares G, Ñañez M, Ojeda E, Rey C, Rodríguez-Vidal D, Rodrigues MAH, Salinas C, Tserotas K, Vallejo MS, Calle A, Dextre M
Women Health
· 2025 Oct · PMID 41165019
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To evaluate the association between severe sleep problems and mild cognitive impairment (MCI) in postmenopausal women, we conducted a sub-analysis of a cross-sectional, multinational investigation between January and Nov...To evaluate the association between severe sleep problems and mild cognitive impairment (MCI) in postmenopausal women, we conducted a sub-analysis of a cross-sectional, multinational investigation between January and November 2023 among postmenopausal women younger than 70 years attending gynecological consultations in nine Latin American countries. MCI was assessed using the Montreal Cognitive Assessment (MoCA) tool, and severe sleep problems were evaluated with two validated instruments: the third question of the Menopause Rating Scale (MRS, score ≥3) and the Jenkins Sleep Scale (JSS, total score ≥12). Two adjusted logistic regression models were used to examine the association between the two measures of severe sleep problems and MCI, adjusting for relevant covariates. The analysis included 1,185 postmenopausal women with a mean age of 56.9 years. Severe sleep problems were significantly more frequent among women with MCI compared to those without MCI, whether assessed by the MRS (28.3 percent vs. 16.6 percent) or the JSS (31.6 percent vs. 18.4 percent; both < .001). In adjusted regression models, severe sleep problems remained independently associated with MCI (MRS: aOR = 1.81, 95 percent CI: 1.26-2.60; JSS: aOR = 1.88, 95 percent CI: 1.31-2.69). Additional factors associated with a higher likelihood of MCI included physical inactivity and greater parity, while ever-use of menopausal hormone therapy and higher educational attainment were associated with a reduced likelihood of MCI. In this sample of postmenopausal Latin American women, severe sleep problems were associated with a higher likelihood of MCI, and factors such as physical inactivity, educational attainment, parity, and ever use of menopausal hormone therapy were also independently related to this condition.
Ghaffari A, Maleki A, Kamali K
… +1 more, Ahmadnia E
Women Health
· 2025 Oct · PMID 41152252
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Respectful maternity care (RMC) plays a crucial role in shaping maternal experiences during childbirth. This study aimed to examine the influence of RMC on maternal self-confidence and mother-infant bonding in primigravi...Respectful maternity care (RMC) plays a crucial role in shaping maternal experiences during childbirth. This study aimed to examine the influence of RMC on maternal self-confidence and mother-infant bonding in primigravida women. A prospective cohort study was conducted on 336 primigravida women admitted to the maternity ward of Ayatollah Mousavi Hospital, Zanjan, Iran, in 2022. Eligible participants were selected using convenience sampling. Data were collected using the RMC Questionnaire, the Lips Maternal Self-Confidence Scale (LMSCS), and the Brockington Postpartum Bonding Questionnaire (PBQ). Maternal self-confidence and RMC were assessed at discharge, and mother-infant bonding was evaluated six weeks postpartum. Statistical analysis was performed using SPSS version 16 at a 95 percent confidence level. The total score of RMC and its dimensions were significantly higher in the group benefiting from RMC, except for the nondiscriminatory care dimension ( = .001). However, the direct relationship between RMC exposure and mother-infant bonding was not significant ( = .258). Promoting a respectful and supportive childbirth environment is essential for enhancing maternal and infant outcomes.
de Souza Andrade E, Dos Santos Prestes AK, Batista Siqueira T
… +2 more, Kremer Ferretti F, Santos MP
Women Health
· 2025 Oct · PMID 41147583
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The climacteric period is associated with physical and psychosocial symptoms that may adversely affect functional capacity. This study aimed to assess physical performance and the severity of climacteric symptoms in wome...The climacteric period is associated with physical and psychosocial symptoms that may adversely affect functional capacity. This study aimed to assess physical performance and the severity of climacteric symptoms in women undergoing the menopausal transition, and to analyze the relationship between symptom intensity and physical performance. A cross-sectional study was conducted with 184 women presenting climacteric symptoms, aged between 40 and 65 years, in the pre-menopause, perimenopause, and post-menopause stages. Menopausal status was determined using the Stage of Reproductive Aging Workshop, and climacteric symptoms were assessed with the Menopause Rating Scale. Physical performance was assessed using the Short Physical Performance Battery, while cognitive function was evaluated through the Montreal Cognitive Assessment instrument. Absolute and relative frequencies, means, and standard deviations were used. Group comparisons were evaluated using the Kruskal-Wallis test, and correlation between variables were assessed using the Spearman correlation test. A significance level of < .05 and a 95 percent confidence interval were considered. Postmenopausal women exhibited lower scores in balance ( = 0,025) and sit-to-stand ( = 0,006) compared to premenopausal women. Overall, 70,1 percent of participants reported severe menopausal symptoms. There were weak but significant correlations between greater symptom intensity and worse gait speed performance (r = 0.18; = 0.014), as well as between somatovegetative symptoms (r = 0.20; = 0.007) reduced balance (r = -0.18; = 0.016) and gait performance ( = 0.20; = 0.007). Advanced menopausal stages are associated with poorer physical performance. Symptom severity additionally impacts physical function, reinforcing the importance of preventive strategies.
Şanli C, Doğan Yüksekol Ö, Ulucan M
… +1 more, Baltaci N
Women Health
· 2025 Oct · PMID 41103055
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HPV is a common sexually transmitted infection strongly associated with cervical cancer. Beyond its physical health implications, an HPV-positive diagnosis often leads to stigma, shame, and social isolation, which remain...HPV is a common sexually transmitted infection strongly associated with cervical cancer. Beyond its physical health implications, an HPV-positive diagnosis often leads to stigma, shame, and social isolation, which remain insufficiently explored in the literature. This study was conducted to determine the levels of stigma and social isolation in HPV positive women. This qualitative study was conducted using a phenomenological research design. A total of 22 women participated in the study. Data were collected through face-to-face interviews conducted in Turkiye. Snowball sampling was employed to recruit participants. The researchers conducted in-depth, individual, open-ended interviews to collect data. Data were collected through semi-structured in-depth interviews with the participants. Qualitative data were examined using content analysis. A total of three main themes and seven subthemes were generated from the analysis. The analysis identified three main themes: emotional burden and coping with HPV, social loneliness and ısolation, and stigmatization and HPV. This study revealed that HPV-positive women experienced negative emotions such as anger and shame, faced social isolation, and encountered stigma from both their social environment and healthcare professionals. The findings highlight the need for psychosocial support and healthcare policies to improve the well-being of HPV-positive women.
Dahir HG, Mouse Duale A, Jama Ibrahim A
… +2 more, Yousuf AM, Hassan Muse A
Women Health
· 2025 Sep · PMID 41082289
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Unmet need for family planning (FP) in Somalia is a critical public health challenge, contributing to unintended pregnancies and maternal mortality. This study investigates factors associated with unmet FP need among mar...Unmet need for family planning (FP) in Somalia is a critical public health challenge, contributing to unintended pregnancies and maternal mortality. This study investigates factors associated with unmet FP need among married women, using data from the 2020 SDHS. We analyzed data from 1,074 married women (15-49 years), categorizing unmet FP need into spacing, limiting, and met need. Multinomial logistic regression was used to examine the associations between sociodemographic factors and these categories, reporting Adjusted Odds Ratios (AORs) with 95% confidence intervals (CI). Older women had significantly lower odds of unmet need for limiting compared to younger women (e.g. AOR 0.04 for 45-49 age group vs. 15-19). Conversely, the desire for more children strongly predicted unmet need for limiting. Women desiring children after two years (AOR 19.75), those undecided (AOR 23.27), and those wanting no more children (AOR 1.76) all showed significantly higher odds of unmet need for limiting compared to those desiring children within two years. The high unmet FP need among married Somali women is primarily linked to desires for delayed or limited childbearing. This underscores the need for culturally sensitive interventions that prioritize women's reproductive intentions and further research to identify specific barriers.
Women Health
· 2025 Sep · PMID 41077920
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This study examines the combined effects of HypnoBirthing education and oxytocin (back) massage on labor experiences and early postpartum outcomes in primiparous women. In this randomized controlled trial, 50 pregnant wo...This study examines the combined effects of HypnoBirthing education and oxytocin (back) massage on labor experiences and early postpartum outcomes in primiparous women. In this randomized controlled trial, 50 pregnant women were allocated to an intervention ( = 25) or control ( = 25) group. The intervention included 12 hours of HypnoBirthing training over four weeks and oxytocin back massage during the final three weeks. Outcomes were assessed with validated instruments - Wijma Delivery Expectancy/Experience Questionnaire Form A/B, Birth Satisfaction Scale - Short Form, Breastfeeding Self-Efficacy Scale - Short Form, and Mother - Infant Attachment Scale - before intervention and one week postpartum. Compared with controls, the intervention group reported lower fear of childbirth (73.0 ± 5.7 vs 102.0 ± 10.5; < .001) and higher birth satisfaction (27.1 ± 3.6 vs 13.5 ± 4.6; < .001), breastfeeding self-efficacy (50.8 ± 7.6 vs 35.4 ± 5.9; < .001), and mother - infant attachment (16.3 ± 2.5 vs 11.8 ± 2.1; < .001). Integrating HypnoBirthing training and oxytocin (back) massage into routine prenatal care may reduce fear of childbirth, improve birth satisfaction, enhance breastfeeding self-efficacy, and promote early mother - infant attachment. The program appears feasible, low-cost, and deliverable by midwives within standard antenatal education. These findings reinforce the value of incorporating such non-pharmacological, supportive techniques into prenatal education and care to promote maternal well-being and early bonding.