Table 2 Considerations, intervention as intended and intervention as delivered

Optimal group size (women)

6–8 women

4.2 women/session (range 1–8)

Number and length of sessions

Seven 60-min sessions.

Six-seven 60-min sessions.

Follow-up session after birth with babies?

Not “compulsory”, but suggested and discussed during implementation as optional.

Two groups (of seven) had a follow-up session after birth with their babies.

Time of day for sessions

Weekdays AM

Sessions were scheduled on weekdays (AM), which was considered convenient by participants and midwives, but not optimal for those with daytime jobs or studying.

Partners

To be invited to attend all sessions. However, women had the opportunity to decide otherwise.

Four men attended at least one session.

Most groups (women and midwives together) decided not to invite men.

Content of sessions

Selected topics to be presented (suggested in manual). After that, open for questions and discussion.

Participants encouraged to raise any concerns and identify topics of interest.

Each session started with a presentation of a selected topic. Aids commonly used were pictures, anatomical models and displaying objects. Films on pregnancy and childbirth, some available online in Somali, shown in 1/3 of sessions

Topics “pregnancy”, “birth” and “the newborn baby” were frequently discussed. “Parenthood” and “relationships” less frequent (in 4 of 50 sessions).

Other professionals invited

Child health nurses, physiotherapists etc. optional.

None invited.

Should clinical assessments be integrated in the sessions or not?

No

Clinical assessments were conducted in private adjacent to the sessions by women’s designated midwife, who was not necessarily one of the midwives leading the group.

Interpreting

Interpreter/"cultural broker” assigned to all groups.

A bilingual female interpreter who also facilitated sessions was present in all but a few sessions.

Sessions facilitated by midwives

Preferably two midwives—was believed optimal to facilitate dialogue and good group dynamics.

Half of sessions facilitated by one midwife only. Reasons provided were “few women attending” and a heavy workload. Some midwives (n = 3) preferred to facilitate sessions alone.

Open or closed session groups (i.e. possibility to shift between groups and have fluid starting and end-dates)?

Closed groups, i.e. the same individuals in every session.

Only closed groups – women were assigned to a particular group to give them a better chance of getting to know each other and facilitated the administration for midwives.

Tools to support person-centering in groups

Use of MI techniques in the groups (such as midwives asking open-ended questions and being “reflective in their listening and response”).

MI techniques were used to some extent.