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This research proposes a framework to guide the development and analysis of digital interventions, namely, through mobile applications, regarding labor and birth. By complying with current scientific evidence, this paper aims to contribute to the safeness and completeness of perinatal health education targeting expectant parents.

A content analysis was conducted on a document containing World Health Organization guidelines for intra-partum, considering the following categories: timeframe, care options, category of recommendation, to create a data set clearly distinguishing between recommendations and non-recommendations. Context-specific and research-context recommendations, details from dosages, measurements and timings, infant care and non-immediate postpartum topics were considered out of the scope of this study.

The results were summarized in a table, ready to be used as a data set, including the following 16 care options ranging from health, well-being and/or rights: respect, communication, companionship, pregnant person’s monitoring, status, fetal monitoring, pain relief, pain management, amenities, labor delay prevention, progress, freedom of choice, facilitation of birth, prevention of postpartum hemorrhage, umbilical cord care and recovery. These were distributed across six timeframes: always, admission, first, second and third stage of labor and immediate postpartum. In addition, recommendations and non-recommendations are displayed in different columns.

This transdisciplinary research intends to contribute to: future research on perinatal education; the creation of digital interventions, namely, m-health ones, targeting expectant parents by providing a framework of content coverage; the endorsement of the rights to Information and to decision-making. Ultimately, when put into practice, the framework can impact self-care through access to perinatal education.

The purpose of this study was to determine the satisfaction of women who underwent normal delivery and cesarean section (or C-section) with maternal care in five state-run hospitals in Northwestern Turkey.

This was a cross-sectional study. The sample consisted of 580 women who underwent normal delivery (ND) and 392 who had a C-section (CS). Data were collected using two maternal satisfaction questionnaires, which participants completed right before they were discharged.

More than half of ND (61.7%) and CS (56.9%) participants were satisfied with maternal care. ND participants who had received antenatal training were more satisfied with maternal care than CS participants who had not received antenatal training. Higher income was a significant predictor for reduced satisfaction with maternal care among CS participants (p = 0.031).

Hospital administrators and decision-makers should meet women's expectations, provide them with comfort, encourage them for skin-to-skin contact and respect their right to privacy in order to increase their satisfaction with maternal care. Pregnant women should also be encouraged to receive antenatal training offered by hospitals before delivery.

The evidence-based results of the study will help hospital administrators to improve healthcare quality and focus on increasing women's satisfaction with maternal care.

To achieve Goal 5 of the MDGs, the Government of Ghana introduced the free maternal health service system to break financial barriers of access to maternal care services. In spite of this, facility‐based deliveries continue to be low due partly to poor quality of antenatal care that prevents pregnant women from giving birth in hospitals. The aim of this study is to examine factors shaping quality of antenatal care in selected public hospitals in the country.

363 expectant mothers were randomly selected for interview. Women who have previously received antenatal care in the health facilities for at least two occasions were interviewed. Multivariate logistic regression model were computed to examine correlates of antenatal care quality.

The odds of reporting quality of antenatal care as good was higher among women aged between 30 and 34 years. Similarly women with junior/senior high education were more likely to report antenatal care quality as good. Distance to the health facilities generally influence women perception of antenatal care quality but the relative odds of reporting quality of care as good attenuated with proximity to the health facility. Five factors (pleasant interaction with providers, privacy during consultation, attentiveness of providers, adequate facilities and availability of drugs) emerged as statistically significant in explaining antenatal care quality after controlling for selected demographic variables.

Results of the study generally demonstrate the need to improve maternal services in public facilities to stimulate utilisation and facility‐based deliveries.

Fear of birth may cause perinatal complication, increased risk of intervention and need for analgesia, delayed mother–infant attachment process and deterioration of spouse relationship. The purpose of this study was to determine the affecting factors and childbirth fears of Turkish pregnant women.

This is a descriptive research type. The sample of this study consisted of 78 pregnant women who met the inclusion criteria and agreed to participate in this study. This study was carried out in a family health center and university hospital in a city in Turkey. Data were collected with Personal Information Form and Wijma Expectancy/Experience Scale-A Version (W-DEQ A).

The mean scores of pregnant women from W-DEQ A version were 75.60 ± 9.48. In 65.4% of pregnant women, fear of severe birth, 20.5% fear of clinical birth and 14.1% of children had a fear of moderate birth. W-DEQ A version, the third trimester, unplanned pregnancies, lack of knowledge of the level of inadequate birth and more than eight pregnancies in pregnancy, the total score of pregnant women was found to be higher (p < 0.05).

The limitation of this study is its small sample size. Further studies with larger sample sizes are needed.

It was determined that one-fifth of the sample group experienced birth fear at the clinical level and childbirth fear level is associated with unplanned pregnancies, lack of knowledge. In antenatal period, the pregnant woman should be encouraged to express her feelings and thoughts about the labor and give information about the labor.

Cognitive and behavioral education programs can be structured to cope with fear of birth for pregnant women at risk.

This research is original. This study presents data on Turkish women. The data can also be used to evaluate intercultural differences.

The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania.

A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs.

Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months.

The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures.

Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

The childbirth process is a complex and vital event that requires careful analysis and improvement. This experience can shape a woman's perspective on motherhood and even affect her mental health. Healthcare providers must prioritize improving the birth experience for women. In this interdisciplinary research, a combination of business process modeling (BPM) and medicine have been used with the aim of realizing an improved delivery experience and increased maternal satisfaction.

The data collection of this study was done by observing 518 childbirth processes and interviewing the chief of labor, chief residents, and midwives in the obstetrics and gynecology department of a hospital in Tehran from October 2022 to February 2023.

The research has been done in four main stages. The first phase is to model the primary process and sub-processes of normal vaginal delivery (NVD). The second phase is validation using expert confirmation and process mining (PM). The third phase is the analysis of the causes of maternal dissatisfaction in labor. The fourth phase of the heuristics redesigning and improving the process, in which for the first time three new categories have been presented including hospital-based, patient-based, and medical technique-based results show BPM intervention effect can be far-reaching in improving patient care and optimizing operational efficiency.

This study is one of only a few to adopt a process-oriented perspective to show how BPM can be used in clinical processes and has specifically examined an essential clinical process, i.e. childbirth.

1. Developing business process management (BMP) applications in a medical special process related to childbirth as interdisciplinary research.

2. A combination of qualitative and quantitative techniques contains engineering software and management approaches for a Case study, Implementation of BPM lifecycle in the women's hospital in Iran, Tehran, for a clinical process, which is called, normal vaginal delivery (NVD) process for fetal expulsion normally.

3. Modeling NVD clinical process and sub-process for the first time by BPMN2.0 notations in visual paradigm (VP) software and Validation of the made model with process mining (PM), by Disco process mining software. This was done through event log collection from HIS at the hospital.

4. Improving the childbirth process by redesigning heuristics and Introducing two new categories special for clinical process improvement for the first time.

5. Clinical process improvement heuristics obtained in this research are not consistent with the previous seven categories presented in previous studies such as Marlon Dumas' book. Therefore, we have introduced two new heuristics to redesign clinical processes compatible with medical centers, including hospital-based, patient-based, and medical technique-based.

6. Providing a framework for clinical process modeling and improvement containing steps and tools.

Developing business process management (BMP) applications in a medical special process related to childbirth as interdisciplinary research.

A combination of qualitative and quantitative techniques contains engineering software and management approaches for a Case study, Implementation of BPM lifecycle in the women's hospital in Iran, Tehran, for a clinical process, which is called, normal vaginal delivery (NVD) process for fetal expulsion normally.

Modeling NVD clinical process and sub-process for the first time by BPMN2.0 notations in visual paradigm (VP) software and Validation of the made model with process mining (PM), by Disco process mining software. This was done through event log collection from HIS at the hospital.

Improving the childbirth process by redesigning heuristics and Introducing two new categories special for clinical process improvement for the first time.

Clinical process improvement heuristics obtained in this research are not consistent with the previous seven categories presented in previous studies such as Marlon Dumas' book. Therefore, we have introduced two new heuristics to redesign clinical processes compatible with medical centers, including hospital-based, patient-based, and medical technique-based.

Providing a framework for clinical process modeling and improvement containing steps and tools.

Obstetric adverse outcomes (AOs) are an important topic and the use of composite measures may favor the understanding of their impact on patient safety. The aim of the present study was to estimate AO frequency and obstetric care quality in low and high-risk maternity hospitals.

A one-year longitudinal follow-up study in two public Brazilian maternity hospitals. The frequency of AOs was measured in 2,880 randomly selected subjects, 1,440 in each institution, consisting of women and their newborn babies. The frequency of 14 AOs was estimated every two weeks for one year, as well as three obstetric care quality indices based on their frequency and severity as follows: the Adverse Outcome Index (AOI), the Weighted Adverse Outcome Score and the Severity Index.

A significant number of mothers and newborns exhibited AOs. The most prevalent maternal AOs were admission to the ICU and postpartum hysterectomy. Regarding newborns, hospitalization for > seven days and neonatal infection were the most common complications. Adverse outcomes were more frequent at the high-risk maternity, however, they were more severe at the low-risk facility. The AOI was stable at the high-risk center but declined after interventions during the follow-up year.

High AO frequency was identified in both mothers and newborns. The results demonstrate the need for public patient safety policies for low-risk maternity hospitals, where AOs were less frequent but more severe.

The purpose of this paper is to develop a psychometric scale – the birth satisfaction scale (BSS) – for assessing women's birth perceptions.

Literature review and transcribed research‐based perceived birth satisfaction and dissatisfaction expression statements were converted into a scored questionnaire.

Three overarching themes were identified: service provision (home assessment, birth environment, support, relationships with health care professionals); personal attributes (ability to cope during labour, feeling in control, childbirth preparation, relationship with baby); and stress experienced during labour (distress, obstetric injuries, receiving sufficient medical care, obstetric intervention, pain, long labour and baby's health).

Women construct their birth experience differently. Views are directed by personal beliefs, reactions, emotions and reflections, which alter in relation to mood, humour, disposition, frame of mind and company kept. Nevertheless, healthcare professionals can use BSS to assess women's birth satisfaction and dissatisfaction. Scores measure their service quality experiences.

Scores provide a global measure of care that women perceived they received during labour.

Finding out more about what causes birth satisfaction and dissatisfaction helps maternity care professionals improve intra‐natal care standards and allocate resources effectively. An attempt has been made to capture birth satisfaction's generalised meaning and incorporate it into an evidence‐based measuring tool.

The purpose of this paper is to examine the association between experiences during childbirth and satisfaction with childbirth services.

A cross‐sectional analytical approach using a structured questionnaire and exit interviews was employed to gather data from 885 women who delivered vaginally in two public hospitals. Data were analysed by generating frequencies and chi‐square which was used in running a binary logistic regression using a stepwise backward elimination approach.

With a response rate of 78.75 percent the key predictor variables of satisfaction with care were: friendliness of staff (OR=15.12, p=0.00); the amount of information provided on the condition and treatment of women (OR=9.3857, p=0.007); the feeling of being treated with respect (OR=3.5581, p=0.023); and the provision of information about channels of complaint about care (OR=50.0839, p=0.000). It is therefore recommended that steps be instituted to improve client‐/health worker interpersonal relationships, to improve the amount and quality of information provided to clients, and also to establish formal structures for complaint management in hospitals.

The study sampled only women with vaginal deliveries, considering the fact that women with caesarean deliveries have different experiences. Thus views of those with caesarean deliveries are excluded.

Several studies have been conducted in Ghana on issues of health service satisfaction and quality, but this is about the first, critically looking at satisfaction with child birth services in Ghana.

The purpose of this paper is to describe what it is like to be a midwife in the professionally isolated and marginalised arena of home birth in Ireland and to explore whether the organisation of home birth services and professional discourse might be undermining the autonomy of home birth midwives.

This paper is drawn from auto-ethnographic field work, with 18 of the 21 self-employed community midwives (SECMs) offering home birth support to women in Ireland from 2006 to 2009. The data presented are derived from field notes of participant observations and from interviews digitally recorded in the field.

Home birth midwives must navigate isolated professional practice and negotiate when and how to interface with mainstream hospital services. The midwives talk of the dilemma of competing discourses about birth. Decisions to transfer to hospital in labour is fraught with concerns about the woman's and the midwife's autonomy. Hospital transfers crystallise midwives’ sense of professional vulnerability.

Maternity services organisation in Ireland commits virtually no resources to community midwifery. Home birth is almost entirely dependent upon a small number of SECMs. Although there is a “national home birth service”, it is not universally and equitably available, even to those deemed eligible. Furthermore, restrictions to the professional indemnification of home birth midwives, effectively criminalises midwives who would attend certain women. Home birth, already a marginal practice, is at real risk of becoming regulated out of existence.

This paper brings new insight into the experiences of midwives practicing at the contested boundaries of contemporary maternity services. It reveals the inappropriateness of a narrowly professional paradigm for midwifery. Disciplinary control of individuals by professions may countermand claimed “service” ideologies.