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Table 4 Themes, categories and perceived strategies to reduce PBT amongst childbearing women

From: Perceived strategies to reduce traumatic childbirth amongst Iranian childbearing women: a qualitative study

Skill-builder knowledge

Responsible caregiving

The alliance of prenatal and antenatal care

Reconstruction of the structures

Birth preparedness

1. Providing realistic information about childbirth

2. Birth adjustment skills training

3. Upgrading the quality of childbirth courses

4. Birth plan preparation

5. Encouraging mothers to take part in childbirth courses*

6. Setting up virtual childbirth courses

7. Reproductive health education to different age groups*

Mothers’ empowerment in maintaining mental health*

1. Self-care for mental health*

2. Promoting Spiritual Health*

Understanding the importance of mental care in maternity services*

1. Enhancing medical education in mental health care*

2. In-service training regarding maternal mental health care*

Support loop

1. Birth companion

2. Caregivers’ supportive behavior

3. Supporting through one to one care

4. Special support in emergency situations

5. Gaining support from mother’ s social networks during pregnancy

6. Providing conditions for support from peers*

Good behavior of the caregivers

1. Good-humored health staff

2. Respectful maternity care

3. Knowledge and prosperity are the cornerstone of good behavior*

Deepening trust

1. Getting familiar with the birth attendant during prenatal period

2. Getting mother’s trust from the first encounter

3. Providing timely information for mother

4. Paying attention to the mother’s needs

Struggle with medicalization of childbirth

1. Early labour assessment

2. Promoting physiologic childbirth*

3. Midwifery-based care

4. Separating maternity and gynecologic care*

Labour pain relief

1. Relaxing through labour massage

2. Listening to the self-selected music during labour

3. Freedom of movement in birth places

4. Accepting the labour pain*

Special services for maternal mental health*

1. Setting standards for mental health care of pregnant women*

2. Special interventions for high-risk mothers*

3. Implementation of prenatal screening program for mental health problems*

Continuity of care

1. Continuity of care by the same midwife(s) from prenatal to postpartum

2. Supporting the private sector of maternity care*

Coordination of prenatal and antenatal caregivers

1. Coordinating the goals of prenatal and childbirth care*

2. National electronic prenatal-care records system*

3. Setting the regional referral system to connect health-centers and hospitals*

4. The clarity of prenatal records for birth attendants

Efficient management*

1. The adoption of new laws*

2. Monitoring the implementation of laws*

3. Financing the personnel*

4. The use of human resources*

5. The appropriateness of the description of tasks with the capacity of labor*

6. Scoring system for health settings*

Rebuilding physical structures*

1. Creating an inviting labour wards*

2. Covering any visible hospital equipment*

  1. * Strategies or categories that were not pre-defined and obtained directly from qualitative study