Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Daniel McNeil

Committee Member

Shari Steinman

Committee Member

Richard Gross

Committee Member

Bryan Weaver


Fear of pain during pregnancy is an understudied phenomenon with important implications for prenatal and postpartum functioning. The aim of the current study was to understand the role of pregnancy and culture on pain-related fear in Appalachia. Archival datasets, and a new sample of women recruited via Amazon’s Mechanical Turk, were sources of data. Participants completed the Fear of Pain Questionnaire-9 and responded to demographic questions in order to ascertain whether they were pregnant at the time of the study as well as the number and nature of prior pregnancies. In support of hypotheses, results indicated that pregnant women reported lower fear of pain compared to non-pregnant women, and that, among women, living in Appalachia was associated with lower fear of pain relative to living elsewhere in the USA. It was hypothesized that being pregnant and living in Appalachia would interact, yielding the lowest reports of pain-related fear among those women, relative to other groups, however, this interaction was not significant. Additionally, it was hypothesized that nulliparous women would experience higher rates of fear of pain than parous or multiparous women; this effect was significant in fear of severe pain. The results of this study contribute to knowledge about the role of Appalachian culture and perinatal changes in the experience and expression of pain. These findings also provide direction for future research into the mechanisms that protect women from fear of pain, potentially related to how they may be applied to populations outside of Appalachia or non-pregnant women.