In pregnant women, non-pharmacological methods such as music, massage, yoga, meditation, relaxation breathing exercises, and acupuncture have been tried to reduce anxiety during childbirth, and there are studies on these in the literature. However, researchers have not come across a study in the literature that evaluates the effect of positive affirmations on perioperative maternal anxiety and breastfeeding together. Researchers aim is to evaluate the relationship between anxiety, sedation, and breastfeeding levels in pregnant women who underwent positive affirmations and music therapy during cesarean section.

The study was designed as a prospective randomized study. Patients were randomly assigned to groups using computer-assisted methods. Clinical study registration was completed after obtaining approval number 2023/234 from the Non-Interventional Ethics Committee of Adnan Menderes University Hospital. Pregnant women undergoing cesarean section were divided into three groups: Group 1 received pre-operative affirmations accompanied by music, Group 2 received only music, and the control group (Group 3) received neither music nor affirmations. After the operation, all three groups were assessed using the State-Trait Anxiety Scale (STAI), Hospital Anxiety and Depression Scale (HADS), and Visual Analog Scale-Anxiety (VAS-A) for anxiety level tests. Patient status index, hormones (prolactin, oxytocin), time to first milk production, and breastfeeding intensity were compared. Breastfeeding intensity was calculated as [weekly number of breastfeeding sessions / (weekly number of breastfeeding sessions + formula feeding sessions)].

Inclusion Criteria:

• Pregnant women aged 18-45 years
• ASA physical status I-II
• Scheduled for elective cesarean section under regional anesthesia
• Ability to understand and complete the anxiety questionnaires
• Provided written informed consent

Exclusion Criteria:

• Refusal to participate in the study
• Hearing impairment preventing music listening
• Psychiatric disorders affecting anxiety assessment
• Emergency cesarean section
• Known endocrine disorders affecting prolactin or oxytocin levels
• İnability to communicate or complete the questionnaires

Only pregnant women scheduled for elective cesarean section are eligible to participate in the study.

Deidentified individual participant data collected during the study, including demographic data, anxiety scores, sedation levels, and breastfeeding outcomes, will be available upon reasonable request from the corresponding investigator after publication of the study results.

Deidentified individual participant data will be available beginning 6 months after publication of the study results and will remain available for 5 years upon reasonable request to the corresponding investigator.

Qualified researchers may request access to deidentified individual participant data for scientific purposes. Access will be granted upon reasonable request to the corresponding investigator and after approval of a research proposal.