The Non-Stress Test, which is used to evaluate fetal health, is a method that assesses the effects of fetal body movements on the fetal heart rate [1], [2]. This method, as a component of biophysical profiling, is a non-invasive observational tool used to evaluate fetal health from the 32nd week of pregnancy to term, along with ultrasound [3]. The presence of fetal movements and an increase in the fetal heart rate during NST are the most critical features of a reactive test [3]. The frequency of the use of NST is based on clinical evaluations and depends on whether the fetus is at risk of neonatal complications such as intrauterine death or suspected fetal hypoxemia [1], [3], [4]. Although NST is a painless and easy procedure, the requirement of pregnant women to lie down and wait in this position for about 20–30 min causes their anxiety levels to increase [5]. High levels of anxiety lead to an increase in cesarean section rates by affecting test results, leading to misinterpretations, and raising the rates of nonreactive NST [5], [6]. Therefore, the use of non-pharmacological methods has increased in recent years to lower the levels of stress and anxiety observed during NST. In previous studies, it has been determined that music therapy, aromatherapy, virtual reality applications, motivational videos, and nutrition increase the rate of reactive NST [2], [7], [8], [9], [10]. Drawing is a method that is often used to reflect the psychological state and inner world of individuals. The drawing method, which is generally used to evaluate the reflection of children’s inner world [11], [12], [13], is also used for adults [14], [15]. This method aiming to reflect the feelings of adults in varying situations is applicable as a cognitive therapy used to resolve various issues. Peleg et al. (2022) achieved positive outcomes in the course of anorexia nervosa in 5 patients as a result using the drawing method in their treatment [14]. In this study, the effects of pregnant women’s mental visualization of their babies during NST on maternal anxiety and fetal parameters were examined. Nearly all pregnant women have a mental image of their unborn baby. This image in the mother's mind is not a simple visualization. Many emotional and cognitive factors play a role in the creation of this image. The image of the baby that the mother forms in her mind is affected by her own childhood experiences, fantasies, hopes, fears, taboos, cultural beliefs, habits, life challenges, and the meaning she attributes to having a baby [16], [17]. To the best of our knowledge, while there is no incidence of the drawing method used during NST in the relevant literature, there are studies showing that NST results are affected by the anxiety levels of pregnant women [18], [19]. Placental perfusion, which is vital in terms of fetal development and health, is significantly affected by the mother's psychological state. An increase in stress levels during pregnancy can trigger the release of catecholamines, which cause vasoconstriction, affecting uteroplacental blood flow. This can alter physiological parameters such as fetal blood pressure, heart rate, and respiration [9], [20]. Based on this information, this study was conducted to examine the effects of the pregnant woman's mental image of her baby and her drawing of it on maternal anxiety levels and fetal parameters.

H1

Drawing the image of her baby that the pregnant woman visualizes in her mind during NST reduces maternal anxiety.

H2

Drawing the image of her baby that the pregnant woman visualizes in her mind during NST positively affects fetal parameters.