Iranian women’s perception on the determinants of birth experience : A qualitative study

Background The prevalence of cesarean birth in Iran is very high. Having a negative childbirth experience is one of the reasons that primiparous women provide to prefer caesarean birth over a vaginal birth. This study is aimed to understand women’s perspective on what determines a positive or negative birth experience for them. Methods This qualitative study is a part a mixed method study that was conducted among primiparous women with a previous vaginal birth experience. The purpose of the main study was to develop a guideline based on Iranian primiparous women’s birth experiences. The quantitative phase of the study was a cross-sectional study where women’s childbirth experiences was measured in a survey via the Childbirth Experience Questionnaire-2. In the qualitative part of the study, women were invited for an in-depth interview via a random stratified sampling method based on their childbirth mean score (women with 10% of the upper bound score which indicated a positive birth experience and 10% of the lower bound indicating negative birth experience, n = 17). Conventional content analysis was used for data analysis. Results We extracted three main themes: (a) “Internal control”, (b) “External control”, and (c) “Support”. Possessing internal control, having a balanced external control to feel cared and feeling supported were the main reasons for women to feel positive about their birth experiences. Whereas, loss of internal control, imbalanced external control and unsupportive environment were related to their negative childbirth experiences. Conclusion Considering that women’s sense of control, the care and support that they receive can influence their childbirth experiences, there is a need for changing maternity policies and practices to highlight the importance of a woman-centred care to create a pleasant, respectful and positive memory for primirparous women who experience normal vaginal births

Consequences of Natural and Man-made Disasters on Pregnancy Outcomes and Complications: A Systematic Review

Introduction: Due to their unique circumstances, pregnant women face a heightened risk of experiencing pregnancy complications during and after catastrophic events. This study aims to investigate the consequences of both natural and man-made disasters on pregnancy outcomes.  Method: This study is a systematic review. Searches were performed until May 31, 2024, in the electronic databases including Medline, Web of Science, Embase, and Scopus. Outcomes such as preterm birth, low birth weight (LBW), small for gestational age (SGA), stillbirth, spontaneous abortion, and pregnancy-related blood pressure complications were studied. Result: The search conducted in the databases yielded 3307 non-duplicate records. After reading the abstracts, 3204 articles were excluded based on inclusion and exclusion criteria. Full texts of 103 article were obtained. However, upon reading the full texts of articles, 13 of them did not meet the inclusion criteria for the study. Consequently, 90 articles were ultimately included. Conclusion: Natural and man-made disasters exert significant influence on adverse pregnancy outcomes. While it is impossible to prevent the incidence of natural disasters and often man-made disasters occur abruptly, the negative consequences of disasters, particularly natural ones, can be mitigated by enhancing prenatal care and avoiding detrimental elements such as smoking and alcohol

The relationship between pregnancy and birth experience with maternal-fetal attachment and mother-child bonding: a descriptive-analytical study

Abstract Background Pregnancy and childbirth experience can be important factors for a pleasant relationship between mother and baby. This study assessed the relationship between the pregnancy and birth experience with maternal-fetal attachment (MFA) and mother-child bonding. Methods A descriptive-analytical study was conducted among 228 pregnant women in Tabriz, Iran February 2022 to March 2023. Using cluster random sampling method, we included 228 women with gestational age 28–36 weeks and followed them up until six weeks postpartum. Data were collected in two stages using the following questionnaires: Pregnancy Experience Scale (hassles and uplifts), Maternal-Fetal Attachment Questionnaire (during the third trimester of pregnancy), Postpartum Bonding Questionnaire, and Childbirth Experience Questionnaire (six weeks postpartum). Data were analyzed using Pearson’s correlation test and general linear model. Results The mean score of MFA was significantly higher among women with feelings of being uplifted during pregnancy [β (95% CI) = 1.14 (0.87 to 1.41); p  0.05). Also, there was no statistically significant relationship between childbirth experience and mother-child bonding (p > 0.05). Conclusion According to the results of this study, pregnancy uplifts have a positive role in improving MFA. Therefore, it is recommended to plan interventions to make pregnancy period a pleasant experience for mothers

Recommendations for improving primiparous women’s childbirth experience: results from a multiphase study in Iran

Background: Women\u27s satisfaction with childbirth experience is considered as one of the quality indicators of the maternity services across the world. However, there is no guideline for improving the experience of childbirth in Iran that is suitable for women with different cultural, economic, and social statuses. The aim of this study is to make recommendations for practice and propose a clinical guideline for improving the experience of women with vaginal births. Methods/design: The study design was a mixed method study with a sequential explanatory approach consisting of three phases. The first phase of the study was a cross-sectional study to identify the predictors of traumatic vaginal childbirth experience among 800 primiparous women from Tabriz health centers who had vaginal birth. Data collection tools in this phase were Childbirth Experience Questionnaire (CEQ) and Support and Control in Birth (SCIB). Both tools were validated for Farsi language. The second phase was a qualitative study with 17 in-depth individual interviews among women who took part in the first phase to better understand their reasons that influenced their childbirth experience either positively or negatively. The third phase of the study was to develop recommendations for a proposed clinical guideline through a Delphi study where maternal health experts were selected and invited to take part in the panel. They first rated the proposed recommendations individually and provided written responses on their own agreement or disagreement with each statement in terms of its impact on childbirth experience, feasibility, acceptability, and cost-effectiveness. After three confirmation rounds, the final conscience was reached by the panel members. Results: The results of the quantitative phase showed that the probability of negative experience of childbirth was increased when physical exercise was not implemented during pregnancy, lacking pain relief options, having fear of childbirth, lacking skin to skin contact with the newborn and being unable to initiate breastfeeding in the first hour after birth (P \u3c 0.05). The analysis of qualitative data revealed 13 major theme categories which were related to women’s sense of internal control, external control and support. In the third phase of the study, culturally appropriate recommendations were made and an evidence-based clinical guideline was proposed. The proposed guideline was based on the combination of the quantitative and qualitative phases, a review of the literature, and the opinions of Iranian experts using the Delphi technique. Conclusion: Given the high prevalence of negative childbirth experience among Iranian primiparous women, the present study may be of great interest for managers, leaders, policymakers, and care providers to improve the quality of the maternity services. However, further studies are required to translate the recommendations into practice and identify enablers and barriers during the implementation of the proposed guideline. To adopt the recommendations at national level, there is a need to further studies to assess the effectiveness of the proposed guideline within different communities across the region and the country

Persian version of the support and control in birth questionnaire among Iranian women

BACKGROUND: Lack of perceived support and control during labor and childbirth is known as an important predictor of post-traumatic stress disorder following childbirth. However, there is no standard scale to measure perceived support and control for Iranian women. This study determined the validity and reliability of the support and control in birth questionnaire for Iranian women. MATERIALS AND METHODS: Support and control in the birth questionnaire were translated into Persian by the forward and backward translation method in 2019. Among a total of 102 healthcare centers in Tabriz, 50 urban and 10 rural centers were selected randomly. Then, 660 women with vaginal childbirth during the postpartum period were extracted by each center and selected randomly. The validity of the Persian version was evaluated in terms of face, content, and construct validity. Internal consistency and reliability were assessed by Cronbach's alpha coefficient and intraclass correlation coefficient, respectively. Exploratory and confirmatory factor analyses were used for evaluating the construct validity of the tool. RESULTS: Cronbach's alpha coefficient (0.95) and intraclass correlation coefficient (0.99) were acceptable. In an exploratory analysis, three factors were extracted and these three factors explained 63.1% of the total variance. Items 14 and 17 were removed from the Persian version due to low factor loading and impact factor values. Confirmatory factor analysis supported the three factors extracted in the exploratory analysis. Confirmatory factor analysis showed suitable indexes of fitness for 31 items. CONCLUSION: Persian version of the support and control in the birth questionnaire is a valid and reliable tool for the Iranian women population

Correlations between primiparous women’s perceived internal control, external control, support and their birth experience

BACKGROUND Perceived control and support can contribute to a positive childbirth experience. However, most studies have not differentiated between perceived internal and external control. OBJECTIVE The present study aimed to assess primiparous women’s perceived internal control, external control, and support, including family and professional support and their association with the childbirth experience. METHODS A cross-sectional study was carried out on 800 primiparous mothers recruited from health centers across Tabriz, Iran, through cluster sampling. The childbirth experience questionnaire (2.0) and the support and control in birth scale were used to measure women’s childbirth experience and their perceived internal and external control and support. Data were collected through an interview during early postpartum and analyzed by independent t-test, one-way ANOVA, Pearson correlation and general linear model. RESULTS The results demonstrated a significant correlation between perceived internal control (r = 0.80, p < .001), external control (r = 0.79, p < .001) and professional support (r = 0.83, p < .001) with childbirth experience. By controlling confounders such as socio-demographic and reproductive variables, internal control [β (95% CI): 0.28 (0.25 to 0.31); p < .001], external control [0.10 (0.06 to 0.14); p < .001], professional support [0.27 (0.23 to 0.30); p < .001], were independent predictors of positive childbirth experience. CONCLUSION These findings point to the importance of perceived internal, external control and professional support and the relationship between healthcare providers, especially midwives, with the women in improving childbirth experience. It is suggested that healthcare providers give support to women and utilize methods that enhance women’s control during labor and childbirth

The Evaluation of Iranian midwifery Ph.D. course based on the CIPP model

Background: A high-quality Ph.D. course requires frequent assessment and identification of deficiencies and limitations. The midwifery Ph.D. course started in 2016 in Iran and since no evaluation has been performed on this program, the present study aimed to evaluate the Iranian midwifery Ph.D. course based on the CIPP model.Method: This descriptive-evaluative research was conducted based on the CIPP model in 2021 in the schools of nursing and midwifery of Tabriz and Ahvaz Universities of medical sciences, Iran. The statistical population included the faculty members of the midwifery Ph.D. program (9 individuals) and midwifery Ph.D. graduates and students (21 individuals). The data collection tools comprised CIPP-based questionnaires exclusively for faculty members and students. Descriptive statistics were employed for data analysis.Results: Most students (81%) and faculty members (77.8%) reported an appropriate general evaluation of the midwifery Ph.D. curriculum. Most faculty members (77.8%) and students (90.8%) reported the indicators of the midwifery Ph.D. curriculum as appropriate in terms of context. More than three forth of faculty members (77.8%) and more than half of the students (57.1%) reported this curriculum as appropriate regarding input. This program was also reported to be appropriate according to 52.4% of students and 66.7% of faculty members in terms of process. Furthermore, a total of 66.7% of participants in both groups reported an appropriate status in terms of output.Conclusion: Midwifery Ph.D. curriculum was reported as an appropriate program. Also, students of this discipline requested greater stress on clinical upskilling for midwifery Ph.D