BACKGROUND: Fear of natural childbirth has become a common concern among women. One of the most important risk factors for fear of childbirth is gestational diabetes. The present study aimed to determine the relationship between self-compassion and fear of childbirth in pregnant women with gestational diabetes. METHOD: This cross-sectional study was conducted on 75 primiparous pregnant women with gestational diabetes referred to health centers in Kermanshah city, Iran in 2023, who were selected through multi-stage random sampling. Data collection was performed from May to October 2023. Data were collected using a demographic form, the Wijma Delivery Expectancy/Experience Questionnaire Version A and the Self-Compassion Scale, and were analyzed using SPSS version 25 with Kruskal Wallis test, ANOVA, Spearman's correlation coefficient, and the multiple linear regression analysis. RESULTS: The mean fear of childbirth score in pregnant women with diabetes was 89.77 ± 32.99. 7 participants (9.3%) had moderate fear (score 38-65), 12 participants (16%) had severe fear (score 66-84), and 47 participants (62.7%) had clinical fear (score 85 or higher) of childbirth. According to the study results, there was a significant negative correlation between the total fear of childbirth score and the total self-compassion score, as well as its subscales including self-kindness, self-judgment, common humanity, isolation, mindfulness, and over-identification. CONCLUSION: The present study demonstrated a significant negative relationship between fear of childbirth and self-compassion. Therefore, specific interventions or training for providers to help women build self-compassion, and culturally tailored interventions are recommended.