Women’s experiences of routine care during labor and childbirth and the influence of medicalization: A qualitative study from Iran

Objective: To understand women’s experiences of routine care during labor and childbirth in a medicalized context. Design: Twenty-six in-depth interviews were conducted during the late postpartum period and thematic analysis was applied. Setting: Four public hospitals in Tehran with a high rate of births, providing services to low and middle income families. Participants: Women who had a low risk pregnancies and gave a birth to a healthy baby by normal vaginal delivery. Findings: Two main themes emerged: ‘An ethos of medicalization’ which indicates that women’s perception of childbirth was influenced by the medicalized context of childbirth. And ‘The reality of fostered medicalization’ which illustrates the process by which interventions during labor affected women’s pathway through childbirth, and how the medicalization resulted in a birth experience which often included a preference for Caesarean Section rather than vaginal delivery with multiple interventions. Implications for Practice: Contextual factors such as legal issues, state’s regulations and the organisational framework of maternity services foster medicalized childbirth in Tehran public hospitals. These factors influence the quality of care and should be considered in any intervention for change. The aim should be a high quality birth experience with minimal interventions during normal vaginal delivery. A midwifery model of care combining scientific evidence with empathy may address this need for change.