The Fear Of Birth Scale (FOBS) is a potentially effective way of measuring FOB in clinical practice and research, but it requires enhancement.  An enhanced version of the FOBS could be used as the primary outcome to measure FOB during pregnancy in an RCT assessing the effectiveness of a suitable intervention, with the Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder assessment (GAD-7) as secondary outcomes to measure depression and anxiety during pregnancy. An intervention to support primiparous women with FOB should be developed, informed by the findings of this study, including components such as psychological education, relaxation, social support, reliable information sources and continuity of carer.