Women’s Satisfaction with Preconception Care and Childbearing Counseling Services: A Cross-Sectional Study

Background: Women's satisfaction with fertility counseling and preconception care is a critical indicator of the quality and effectiveness of reproductive health services. This study evaluated satisfaction levels and identified key determinants among women of reproductive age attending urban Comprehensive Health Service Centers in Shahroud, Iran, and identified key determinants. Methods: A cross-sectional study was conducted between May and December ۲۰۲۲ among ۳۱۹ eligible women selected through a multistage sampling process from all ۱۰ urban health centers in Shahroud County. Data were collected immediately after each participant’s preconception care session using a validated ۳۵-item satisfaction questionnaire covering two domains: childbearing counseling (۱۱ items, score range ۱۱–۵۵) and preconception care (۲۴ items, score range ۲۴–۱۲۰). Scores were converted to percentages of the maximum possible value and classified into low (< ۵۱%), moderate (۵۱–۷۵%), and high (> ۷۵%) satisfaction categories. All analyses were conducted with SPSS v.۲۲. Results: Mean satisfaction score for counseling was ۲۹.۵۹ ± ۸.۳۴, corresponding to ۵۳.۸% of the maximum possible score (۵۵ points), while mean satisfaction for care was ۵۶.۵۹ ± ۱۵.۶۷, equivalent to ۴۷.۲% of its respective maximum (۱۲۰ points). The overall satisfaction score was ۸۶.۱۸ ± ۲۰.۷۶ (۴۹.۲% of the total possible score), indicating a generally moderate to low quality of services. In the counseling domain, the item "counseling was conducted in the presence of my husband" showed the highest agreement (۳۶.۱% strongly agreed), while "education was sufficient and understandable" had the lowest (۰.۶% strongly agreed). Regarding preconception care, "ease of locating the service site" attracted the highest disagreement (۶۴.۹%), and "midwife’s behavior was polite" scored the lowest for strong agreement (۱.۳%).Deficiencies were most evident in educational content, clarity of communication, explanation of risks such as delayed childbearing (only ۱۹.۴% agreed), and wayfinding. Accessibility via community health workers was a relative strength. Conclusion: Low satisfaction stemmed mainly from poor communication, inadequate education, and structural barriers. Targeted improvements in provider skills, educational materials, privacy, and multidisciplinary access are recommended.

کلیدواژه ها:

Preconception care ، Childbearing counseling ، Reproductive health services ، Quality of health care