Midwifery-led continuity-of-care education affects health literacy, empowerment and childbirth fear: a quasi-experimental study

Background According to the World Health Organisation, antenatal care should ensure continuity, respect and evidence-based education. Fear of childbirth (FOC), affecting 20–40% of women globally, contributes to prolonged labour, higher caesarean rates and negative birth experiences. In Türkiye, where midwifery-led support remains limited, this study examined how pregnant women’s health literacy influences empowerment and FOC within antenatal care and evaluated the effectiveness of the midwifery-led continuity-of-care (MLCC) model.Methods A quasi-experimental study with a comparative group design was conducted online between April 2024 and April 2025 using digital maternal communities and antenatal platforms in Türkiye. The intervention consisted of four structured online sessions based on the MLCC model, focusing on pregnancy adaptation, labour preparation, birth preferences and postpartum care. A total of 81 pregnant women participated, with 40 in the intervention group receiving MLCC-based antenatal education and 41 in the control group receiving standard care. Participants self-selected into groups, and data were collected online using validated scales: MHELIP, PRES and W-DEQ (Version A). All analyses were performed using SPSS 25.0 software. Independent samples t-tests and Pearson’s correlations were used for analysis, and multiple regression was performed to identify predictors of empowerment and FOC. All statistical values were verified and reported as mean ± SD with exact p values.Results Pregnant women in the intervention group had significantly higher health literacy and empowerment scores and significantly lower FOC scores than those in the control group (p