Pregnancy-related anxiety is one of the most common psychological challenges during pregnancy and encompasses worries and fears concerning fetal health, childbirth, bodily changes, and the parental role. Research has shown that this type of anxiety is distinct from general anxiety and is associated with adverse outcomes such as preterm birth, low birth weight, impaired child development, and weakened maternal–fetal attachment. Maternal–fetal attachment, as the earliest emotional bond between a mother and her child, plays a significant role in maternal mental health and the child’s emotional development. Although several psychological interventions have demonstrated effectiveness in reducing pregnancy-related anxiety, most have targeted only specific cognitive, emotional, or behavioral aspects of the condition and have not adequately addressed its multidimensional nature.

The present study aims to develop, validate, and evaluate the effectiveness of an integrated cognitive-behavioral and emotion-focused intervention package designed to reduce pregnancy-related anxiety and enhance maternal–fetal attachment. A sequential exploratory mixed-methods design will be employed. In the qualitative phase, a literature review, semi-structured interviews with pregnant women, feasibility assessment, and intervention mapping framework will be used to develop the intervention package. The content validity of the program will then be evaluated by experts. In the quantitative phase, the effectiveness of the intervention will be examined using a multiple-baseline single-case design.

The innovation of this study lies in the development of a culturally adapted and integrated intervention based on the lived experiences of Iranian pregnant women. By simultaneously addressing the cognitive, emotional, and behavioral dimensions of pregnancy-related anxiety, the proposed intervention may contribute to improving maternal mental health and strengthening maternal–fetal attachment.