Conclusion
The study highlights that even with good family support and marital harmony pregnant women in Kerala, India reported high prevalence of pregnancy-specific anxiety especially childbirth anx- iety. Nulliparous status, young age and nuclear family status were the identified risk factors of PSA. The high prevalence of pregnancy-specific anxiety could be attributed to low perceived knowledge on childbirth and parenting due to the lack of formal childbirth education in the era of nuclear family norm. This study emphasises routine screening of pregnant women for pregnancy-specific anxiety and provide early preventive measures to reduce pregnancy-specific anxiety which would reduce the adverse pregnancy outcomes. The authors recommend a formal childbirth education for pregnant women in all hospitals in Kerala to enhance childbirth preparation and empower women to cope with the changes and challenges of pregnancy and childbirth.