Background <p>Birth is one of the most important life events for many women. However, because of problems in the prenatal period and because of the pain, fatigue, and helplessness that many women experience during childbirth, childbirth is often perceived as traumatic. This study was conducted to determine women’s self-efficacy during pregnancy and its relationship to traumatic childbirth perceptions.</p> Methods <p>This descriptive and cross-sectional study was conducted in Elazığ Fethi Sekin City Hospital in Eastern Turkey from November 5, 2019 to September 28, 2020 with 603 pregnant women who met the inclusion criteria and voluntarily agreed to participate. A personal information form, Childbirth Self-Efficacy Inventory-Short Version and Traumatic Childbirth Perception Scale were used for data collection. Percentages, means, analysis of variance (ANOVA), the independent samples t-test, the Mann-Whitney U test, and Kruskal-Wallis and Pearson’s correlation analysis were used to evaluate the data.</p> Results <p>This study’s analyses determined that the mean age of the pregnant women was 30.49 ± 5.53. Of the pregnant women, 49.5% were primary school graduates, and 89.2% were unemployed, 73.3% had a middle economic status, 49.9% were in the 3rd trimester of their pregnancy, 79.6% perceiving childbirth as difficult. The pregnant women scored an average of 230.20 ± 40.56 on the total Childbirth Self-Efficacy Inventory and an average of 78.82 ± 26.40 on the total Traumatic Childbirth Perception Scale. The pregnant women had high levels of traumatic childbirth perceptions, and that there was a significant relationship between their self-efficacy and their traumatic childbirth perceptions (<i>p</i> &lt; 0.001).</p> Conclusions <p>In the study, as the pregnant women’s self-efficacy decreased, their traumatic childbirth perceptions increased.</p>