Maternity care priorities for prevention of psychological birth trauma in Iran: A Delphi consensus study

Abstract

Background & Aim: Promoting maternal mental health is achievable through prevention of psychological birth trauma (PBT). This study aimed to investigate experts’ opinion on best strategies in prevention of PBT among childbearing women.

Methods & Materials: This Delphi, systematic interactive research was conducted in Tehran, from July to November 2017. Delphi technique and policy dialogue was used to prioritize pre-defined PBT prevention strategies which had been identified in our previous studies. 13 experts were included in the Delphi. After two rounds, panelists had come to consensus on strategies’ priorities; they rated each strategy. Priority of strategies was set based on scores. Strategies with total mean of ≥9 and interquartile range (IQR) of ≤2 were entered to the next stage. At the last stage of consensus, a 4-hours meeting was held with seven policy makers; four top strategies were selected by consensus of the all members.

Results: From 38 initial strategies, nine with the mean of ≥9 were identified as the top ones. At the policy dialogue meeting, four strategies were selected: continuous support during childbirth, practical childbirth preparation classes, group prenatal care, and preparing individual birth plan in antenatal visit.

Conclusion: According to the experts, top four strategies can be combined in an integrated program. All these services will be provided at Primary Health Care facilities. These strategies are suggested in supporting maternity care in Iran and other developing countries to promote maternal mental and physical health.