The study investigated the mediator role of death obsession in the relationship between pregnancy-related anxiety and prenatal obsessive-compulsive disorder among pregnant women in the Capricorn district, South Africa. Two hundred and six conveniently selected respondents completed questionnaires individually. Statistically significant associations were found between pregnancy-related anxiety and death obsession, death obsession and prenatal obsessive-compulsive disorder, and pregnancy-related anxiety and prenatal obsessive-compulsive disorder ( ps ⩽ .05). Analysis further showed that death obsession mediates the relationship between pregnancy-related anxiety and both composite scores of a prenatal obsessive-compulsive disorder measure (Obsessive-Compulsive Inventory–Revised) and most of its components. The findings suggest that death obsession is a likely mediator that has to be studied further.

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