Childbirth readiness can reflect women’s childbirth readiness in terms of knowledge, psychological aspects and planning. The purpose of this study was to evaluate childbirth readiness, its related factors and consequences in Iranian pregnant women.

This longitudinal study was the first stage (quantitative stage) of a sequential explanatory mixed-method study. It followed women during late pregnancy (from 37 weeks of gestation) and the postpartum period (4–6 weeks after childbirth) from March to September 2023.

Health centres of Tabriz, Iran.

This study involved 360 pregnant women with a gestational age of 37 weeks and above, selected via cluster sampling. Participants were excluded for high-risk pregnancies, unfavourable incidents in the last 3 months, mental-psychological diseases or a prior caesarean section.

Childbirth readiness and its related factors were assessed using several instruments completed from the 37th week of pregnancy onward, including the Childbirth Readiness Scale, a sociodemographic questionnaire, the Pregnancy Experience Scale and the Wijma Delivery Expectancy/Experience Questionnaire Version A. The consequences of childbirth readiness were then evaluated 4–6 weeks post partum using the Childbirth Experience Questionnaire, the Edinburgh Postnatal Depression Scale and the Postpartum-Specific Anxiety Scale.

The mean (SD) childbirth readiness score was 67.83 (9.41) out of 90. In the adjusted general linear model (GLM), several factors were significantly associated with lower readiness. These included a higher fear of childbirth score (β –0.12, 95% CI –0.16 to –0.08, p

Key factors associated with readiness included fear of childbirth, obstetric history (gravidity, parity, history of abortion and participation in childbirth readiness classes), maternal education, home ownership, husband’s occupation—though several associations showed small effect sizes. After adjustment, readiness did not independently predict childbirth experience or postpartum mental health. The low participation rate in readiness courses highlights a major service gap. Integrating readiness assessment into prenatal care and expanding access to targeted education are recommended to improve outcomes such as birth satisfaction and caesarean rates.

Childbirth can have psychological, social and emotional effects on women and their families. Psychological birth trauma (PBT) is defined as the emotional distress and mental health challenges resulting from negative or distressing experiences during the childbirth process. Labour management plays an important role in the health of women and children. Consequently, the study aims to assess the status of PBT among Iranian women, identify factors influencing it and suggest effective preventive strategies.

This study is a mixed-method research with an explanatory sequential approach. The first phase is quantitative and cross-sectional, involving 300 postpartum women visiting health centres in Tabriz-Iran. In this phase, cluster sampling will be used, and data will be collected using the following questionnaires: Sociodemographic and Obstetric Characteristics, Birth Trauma Scale, PTSD Symptom Scale 1, Perceived Quality of Care Scale, Childbirth Experience Questionnaire version 2.0, Edinburgh Postpartum Depression Scale, Postpartum Specific Anxiety Scale Research Short-Form and the questionnaire on the desire for subsequent pregnancy. The second phase is qualitative, and participants will be selected based on the results of the quantitative phase and extreme cases, using purposive sampling. Data analysis will be performed using qualitative content analysis with a conventional approach. Qualitative data will be collected through in-depth and semi-structured individual interviews with open-ended questions. In the third phase, strategies to prevent childbirth psychological trauma will be designed by integrating the results of the quantitative and qualitative studies, reviewing the literature and gathering expert opinions using a modified Delphi study. Examining PBT and its influencing factors can provide culturally relevant, evidence-based strategies. These strategies can be effective in improving the quality of care for women during childbirth.

This study has received approval from the Ethics Committee of Tabriz University of Medical Sciences in Tabriz, Iran (code number: IR.TBZMED.REC.1402.945). All participants will provide written informed consent before taking part in the study. The outcomes will be shared through articles published in journals, presentations at medical conferences, the validation of a reliable scale for assessing the level of PBT in postpartum women, and the provision of strategies to prevent childbirth psychological trauma. These resources will be valuable for policymakers and healthcare providers.