The study findings brought out the fact that even in low- risk pregnancy PSA especially ACB is highly prevalent. Nulliparous pregnant mothers reported highest childbirth anxiety calling for the attention of further interventional research to reduce anxiety. Study emphasise routine screening of all pregnant women for pregnancy- specific anxiety to identify and intervene early so as to reduce the adverse labour outcome. A programmed formal childbirth education could be made available to all pregnant women attending in all Government Hospitals in Kerala State India to enrich their childbirth preparation and empower them to cope with challenges of pregnancy and childbirth.