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European Journal of Experimental Biology, 2013, 3(6):132-139

ISSN: 2248 9215

CODEN (USA): EJEBAU

Assessing the factors of mothers dissatisfaction with labor and delivery care
procedure in educational and non-educational hospitals in Tabriz
Somayyeh Naghizadeh1, Azita Fathnejad Kazemi1, Mehdi Ebrahimpour2
and Faride Eghdampour1*
1

Department of Midwifery, Tabriz Branch, Islamic Azad University, Tabriz, Iran

2
Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Iran

_____________________________________________________________________________________________
ABSTRACT
This descriptive comparative study is done on 270 childbirth mothers who were admitted in Alzahra, Taleghani and
29 Bahman hospitals in Tabriz. For data collection, a questionnaire was used to measure the factors of mothers
dissatisfaction with physical cares, training and information provided to the mothers, ethical and emotional
supports during labor and delivery. the most important factors of dissatisfaction during labor include lack of
introducing different caretakers and available possibilities and manner of using them, lack of doing actions for
reducing the childbirth pain, lack of explaining about uterine contractions and progress of delivery. The mothers
dissatisfaction during delivery was more than labor. The most important factors of dissatisfaction in delivery were
related to lack of soothing and hugging the mother during labor, not being allowed to choose the midwife among
different caretakers and not gripping the mothers hand during delivery. The mothers dissatisfaction with labor and
delivery care and supports was significantly different among educational and non-educational hospitals (p0.05).
Keywords: Dissatisfaction, Care, Support, Labor, Delivery
_____________________________________________________________________________________________
INTRODUCTION
Delivery is a very important physiological event in a woman's life with deep physical, psychological and emotional
effects on them. This phenomenon is associated with pain, psychological strain, vulnerability, probable physical
effects and death in some rare cases (1). Taking care of mother in delivery with no side effects is the responsibility
of a midwife. She is the only person who is skillful in this regard and has the responsibility of looking after mothers
and babies. The quality of midwifery care is one of the issues, which has major effects on the results of delivery.
The performance and activities of the midwife in this critical situation might not only have different results ranging
from life to death and health to physical damage but also they might considerably affect the psychological and
emotional health of the mother and the baby(2).
Patient satisfaction is a concept that is highly important in medical care (3, 4). Patient satisfaction refers to a
patient's satisfaction with the health care provided (5). Harvey (2002, as cited in Donabedian) believes that
"satisfaction with health care is an important criterion and variable in assessing the quality of medical care" (6).
Patients' satisfaction with the caring services is important since the satisfied patients show different reactions in
comparison to the unsatisfied ones, and the satisfied patients continue the treatment, follow it and invite the others to
use them. Therefore, the satisfied patients not only do not stop using nursing services but they also tend to use it
growingly (5). Moreover, Chunuan (2002) claims that if a woman feels dissatisfied with her delivery experience, she
can hardly communicate with her baby, and a positive labor experience might affect her next delivery and her
opinion about herself as a mother (7). Mackey and Stepans (2006) in their study entitled, Womens evaluation of

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child labor and delivery nurses" indicated that 90 percent of the women labeled their labor and delivery desirable
and 10 percent considered it to be undesirable. They considered the nurses performance to be desirable in the
following aspects: participation (80%), reception (76%), giving information (76%), encouragement (65%), presence
(53%), capability and merit (7%) (8). The recent studies in middle east and developing countries confirmed the
usefulness of women's report in determining the quality of caring services. In Lebanon, they showed that women
who had complete confidence in their doctors and rarely asked questions, considered many routine processes to be
useful, even at times when the researchers considered them to be unnecessary (9).
In a study by Ordibeheshti (1998), the mothers expectations from caretakers were estimated in 20% of cases, were
approximately estimated in 23.8% and were not estimated in 56.2% (10). The study done by Mirmolaei & et.al
(2008) in Tehran University of Medical Sciences showed that most of the mothers were fully satisfied with the
manner of receiving three kinds of support (informational, emotional and physical) (11).
Since it is not possible to improve the quality of patient care services without attending to the patients' ideas and
expectations and considering the fact that midwives are among the main members of the primary health care team
and have major roles in pre-labor and postpartum care, they need to be aware of the factors affecting the patients'
satisfaction (11). Due to the lack of research on determining the factors of mothers dissatisfaction with labor and
delivery care and supports, there needs to do a research in this area, so we decided to do a study entitled as assessing
the factors of mothers dissatisfaction with labor and delivery care and supports in educational and non-educational
hospitals in Tabriz. So, the weak points in care programs will be explored based on the results and therefore we are
reached on one of the important aims of health care systems, that is promoting mothers health and supplying
physical, mental and social welfare by referring the study results to the authorities and preparing suitable strategic
policies.
MATERIALS AND METHODS
The present study is a cross-sectional descriptive analytical research that was conducted in the educational hospitals
of Al-Zahraa (S) and Taleqani and the non-educational hospital of 29 Bahman in Tabriz. To calculate the sample
size, ratio formula was used:

z1 _ P(1 _ p )
2

n=
2
2

At a probability level of 95 %, the sample size was estimated to be 270. The sampling procedure in this study was
based on quota sampling. Since the number of child deliveries in Tabriz hospitals was different, the statistics of
vaginal delivery from each hospital was obtained, so in the first six months of 2009, the number of natural delivery
in Al-Zahraa (S), Taleqani and 29 Bahman hospitals was respectively 2849, 2184 and 1698. In proportion to the
number of birth deliveries in each hospital, the intact sample of the qualified mothers was selected, and respectively
114, 86 and 70 mothers who had referred to Alzahraa (S), Taleqani and 29 Bahman hospitals were selected. The
instruments of data collection in this study included a questionnaire which was prepared by the Newcastle
Satisfaction with Nursing Scale (NSNS) (5), Sylheti questionnaire (12), Labor/delivery evaluation scale (13), Patient
Satisfaction Questionnaire (PSQ), Patient Satisfaction with Health Care Questionnaire (PSHCSQ) (7), Satisfaction
with Intrapartum care, Satisfaction with Antenatal care Scale, Satisfaction with Postnatal care scale (14) and the
questionnaires from the theses of Ordibeheshti (10) and Mirmolaei (15).
The first part of this questionnaire is about personal-social features and the history of previous and present
deliveries, and the second, third and fourth parts of the questionnaire are about the factors of mothers dissatisfaction
with physical cares, training and information provided to the mothers, ethical and emotional supports. The physical
part included 23 questions (12 questions related to labor and 11 questions related to delivery), the information part
included 23 questions (14 questions related to labor and 9 questions related to delivery), the ethical part included 17
questions (9 questions related to labor and 8 questions related to delivery) and the emotional part included 20
questions (9 questions related to labor and 11 questions related to delivery). The questions were arranged as
unsatisfied, no comment and satisfied using Likert three-point scale. In measuring the factors of mothers
dissatisfaction, the unsatisfied ones were assessed to specify the factors of mothers dissatisfaction with labor and
delivery care and supports respectively.
The validity of the questionnaire was established by content validity procedures. To ensure the content validity of
the questionnaire, it was given to 10 members of academic staff at Tabriz University of Medical Sciences. In order
to determine the reliability, the questionnaire was completed by 30 mothers. The reliability in Cronbach's alpha was

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determined to be 0.829. To start the research, having obtained the needed reference letter from the faculty and
having introduced himself to the hospital authorities, the researcher went to postpartum section. After the mother's
state stabilized, the researcher asked permission from her for examining her file in terms of meeting research
conditions including being in the age range of 18 to 35, no background of physical and psychological illnesses
(according to the mothers' self-report), the mother's willingness to take part in the research, no indication of cesarean
section, term pregnancy, having trouble-free pregnancy and being hospitalized 2 hours before the delivery. If the
patient met the needed qualifications, the questionnaire was completed. Before the study, the necessary permits were
obtained from the research committee of Tabriz University of Medical Sciences. Moreover, all cases under study
were informed of the purpose of the study, methodology, optional nature of participation in the study and the
confidentiality of the information. They were also informed that they can leave the study whenever they wanted.
To analyze the data, SPSS software was used. To examine the factors of mothers dissatisfaction, descriptive
statistics was used. To study the relationship between personal-social characteristics and midwives particulars with
the factors of mothers dissatisfaction, ANOVA, correlation tests, and independent T-tests were used. Finally, to
compare the factors of dissatisfaction with educational and non-educational hospitals, independent samples T-test
was used.
RESULTS
The average age of the mothers was 24.964.791. Most of the women (46.7 %) were between the age range of 18 to
23. Seven percent of the mothers had university level education, 35.2 % had senior high school level education, 30.7
% had primary schooling, 22.2 % had junior high school education and 13 people (4.8%) were uneducated. Most of
the subjects (80%) were housewives, 4.8 percent were employed out of home and 15.2 percent were self-employed
home businesses. The average number of surviving children per families under study was 1.490.803; the average
number of dead children per family was 0.040.208, and the average number of abortions was 0.150414. The
majority of the family units under study were nulliparous. Among the mothers 245 cases (90.7 %) had no pain or
problem during the delivery and pregnancy, and 249 cases (92.2%) had previous information or familiarity with the
delivery. The main source of information about mothers was the health personnel (25.6 %), and the least important
source of information (2.2 %) was through the people with whom the patients were in contact.
There was statistically significant relationship between personal-social characteristics and midwifery of the research
units in two kinds of educational and non-educational hospitals (P0. 05).
Studying the factors of dissatisfaction with physical labor cares were done on 12 factors; the most dissatisfaction
with educational and non-educational hospitals were related to lack of doing actions for reducing the childbirth pain
such as back massage, using drugs and etc. (Table No. 1).
Table 1: Causes of maternal dissatisfaction with physical labor cares
Dissatisfaction with physical labor cares
Did actions to reduce childbirth pain (For example, back massage, using drugs and etc.)
Allowed you to walk in the labor room whenever you want
trying the noise in the labor room to be appropriate
changed your Clothing and bed linen when wet and dirty.
satisfy your needs In times of hunger and thirst or they had a convincing answer.
Were trying to make the light, temperature and air flow in the labor room appropriate .
refused to examine repeatedly.
trying to provide the equipments You needed.
Helped you to be in the correct position on the examination table or getting up from it.
advised you In times of need to urinate and defecate.
Controled your Vital signs (blood pressure, respiration, temperature and pulse rate).
monitor The fetal heart rate.
P-value=0/0001

educational
N(%)
168(84)
97(48.5)
88(44)
52(26)
45(22.5)
44(22)
43(21.5)
38(19)
35(17.5)
30(15)
12(6)
2(1)

non-educational
N(%)
57(81.4)
7(10)
29(41.4)
12(17.1)
5(7.1)
6(8.5)
3(4.3)
5(7.1)
11(15.7)
5(7.1)
3(4.3)
1(1.4)

Studying the factors of dissatisfaction with physical cares in delivery room were done on 11 factors; the most
dissatisfaction in educational hospitals was related to the pressure on the abdomen during childbirth and in noneducational hospitals was related to lack of giving blanket during postpartum shivering (Table No. 2).

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Table 2: Causes of maternal dissatisfaction with physical cares in delivery
Dissatisfaction with physical cares in delivery
avoid pressing on the abdomen during childbirth if you do not wish.
helped you in Transferring onto the delivery bed and coming down from it.
helped you during postpartum shivering and gave you a blanket.
After delivery, put you in a comfortable position.
Did health Care immediately after birth.
Before perineal cutting and repair used anesthesia.
Were trying to light, temperature and air flow in the delivery room to be appropriate.
The bleeding was controlled and did the necessary steps to fix the problem.
If the delivery was problematic for any reason, number of actions were taken to address due to solve the problem.
If there was something wrong, like when the baby required resuscitation, efforts were taken to address due to solve the problem.
Did the postdelivery care for your baby.
P-value=0/004

educational
N(%)
51(25.5)
42(21)
35(17.5)
33(16.5)
23(11.5)
21(10.5)
17(8.5)
7(3.5)
6(3)
4(2)
1(0.5)

non-educational
N(%)
6(8.6)
2(2.9)
26(37.1)
4(5.9)
0(0)
5(7.1)
3(4.3)
3(4.3)
1(1.4)
0(0)
0(0)

Studying the factors of dissatisfaction from training and providing required information during labor was done on 14
factors; the most dissatisfaction in educational and non-educational hospitals was related to lack of introducing
different caretakers and lack of explaining their duties (Table No. 3).
Table 3: Causes of maternal dissatisfaction from training and providing required information in labor
Dissatisfaction from training and providing required information in labor
Introduced you different caretakers and explained you their duties.
Showed you Available facilities in the unit and explained how to use it.
Introduced you the washroom, bathroom and labor room.
Described the uterine contractions to you.
Explained you Before doing some care.
Described you about the amount of opening of the cervix.
Gave the description You need about eating and drinking.
Explained you Before uterine examination.
Informed you with the progress of labor and fetal status.
Showed you fetal heart Auscultation device and explained how to use it.
Explained breathing and meditation to reduce labor.
Explained your position during the labor.
If you have any questions, you could simply ask them.
Explained Obstetric or medical terminology in a simple and understandable way.
P-value=0/0001

educational
N(%)
179(89.5)
175(87.5)
153(76.5)
132(66)
129(64.5)
94(47)
77(38.5)
76(38)
68(34)
63(31.5)
54(27)
52(26)
47(23.5)
37(28.5)

non-educational
N(%)
43(61.4)
39(55.7)
17(24.3)
22(31.4)
27(38.6)
22(31.4)
9(12.9)
13(18.5)
8(11.4)
18(25.7)
9(12.9)
12(17.1)
10(14.3)
6(8.6)

Studying the factors of dissatisfaction from training and providing required information in delivery room was done
on 9 factors; the most dissatisfaction in educational and non-educational hospitals was related to lack of training the
stitched cleansing with disinfectants and genital hygiene (Table No. 4).
Table 4: Causes of maternal dissatisfaction from training and providing required information in delivery
dissatisfaction from training and providing required information in delivery
Taught Washing stitched area with Disinfectants and genital hygiene.
Informed you with the baby health Immediately after birth.
Noticed you when removing the placenta.
Notified your companions with the baby and your health and infant sex.
Noticed you about the baby's sex Immediately after birth.
Informed you When attempting to repair a perineal tear or cut.
Noticed of finishing the perineal rupture repair.
Explained pushing during childbirth.
Taught you how to breathe during labor.
P-value=0/0001

educational
N(%)
49(24.5)
46(23)
35(17.5)
27(13.5)
22(11)
21(10.5)
20(10)
10(5)
10(5)

non-educational
N(%)
9(12/8)
8(11/4)
7(10)
0(0)
0(0)
6(8.6)
5(7.1)
0(0)
0(0)

Studying the factors of dissatisfaction from ethical supports during labor was done on 9 factors; the most
dissatisfaction in educational and non-educational hospitals was related to lack of attention to comments and
suggestions in doing care except the urgent ones (Table No. 5).

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Table 5: Causes of maternal dissatisfaction of ethical support in labor
dissatisfaction of ethical support in labor
attention to comments and suggestions in doing care except the urgent ones
Did not blame you for your behavior during labor.
Used respectful words for their requests.
prevent to put you in sight during Care affairs.
Used your name politely.
Knew helping you as their task.
let the other people to observe or examine with your permission.
Not Differentiate between you and other mothers.
Accepted the responsibility for the actions that were taken.
P-value=0/0001

educational
N(%)
120(60)
91(45.5)
78(39)
76(38)
63(31.5)
51(25.5)
31(15.5)
17(8.5)
13(6.5)

non-educational
N(%)
32(45.8)
19(27.2)
11(15.8)
23(32.9)
10(14.3)
10(14.3)
4(5.7)
4(5.7)
1(1.4)

Studying the factors of dissatisfaction from ethical supports in delivery room was done on 8 factors; the most
dissatisfaction in educational and non-educational hospitals was related to lack of introducing different caretakers
(Table No. 6).
Table 6 Causes of maternal dissatisfaction of ethical support in labor
dissatisfaction of ethical support in labor
Introduced themselves to you.
Prevented putting you insight of others.
Refused to blame you for your behavior during childbirth.
Used Simple words and expressions in the description of the delivery process.
Knew helping you as their task
Told you facts about the events that occurred during labor.
Did their best not to harm you and the baby.
Accepted the responsibility for the actions that were taken.
P-value=0/0001

educational
N(%)
179(89.5)
42(21)
39(19.5)
15(7.5)
15(7.5)
13(6.5)
12(6)
10(5)

non-educational
N(%)
44(62.9)
7(10)
12(17.2)
1(1.4)
1(1.4)
0(0)
5(7.1)
1(1.4)

Studying the factors of dissatisfaction from emotional supports during labor was done on 9 factors; the most
dissatisfaction in educational and non-educational hospitals was related to not allowing gripping the hand of mothers
when they have pain (Table No. 7).
Table 7: Causes of maternal dissatisfaction with emotional support during labor
dissatisfaction with emotional support during labor
allowed you to take their hands When you have pain
They understand your situation during labor
Your questions were answered thoroughly and patiently.
Listening carefully to you.
Spoke with a calm and warm tone.
You were allowed to ask questions.
they looked at you or gave attention to you When talking to you.
Admired your cooperation in perform of cares and encouraged to continue cooperation.
Showed composure in dealing with you.
P-value=0/0001

educational
N(%)
152(76)
94(47)
85(42.5)
78(39)
78(39)
76(38)
61(30.5)
53(26.5)
37(18.5)

non-educational
N(%)
52(74.3)
15(21.4)
11(15.7)
10(14.3)
6(8.5)
9(12.8)
7(10)
10(14.3)
4(5.7)

Studying the factors of dissatisfaction from emotional supports in delivery room was done on 11 factors; the most
dissatisfaction in educational and non-educational hospitals was related to lack of soothing and hugging mothers by
different caretakers (Table No. 8).
Table 8: Causes of maternal dissatisfaction with emotional support during delivery
dissatisfaction with emotional support during delivery
They soothed you.
They hugged you.
You could choose Labor factor between labor room carers.
Held your hands.
Allowed to have skin to skin contact with your baby.
Let you shout or cry.
were reassuring you in your infant health and the delivery process.
Let you hug the infant after birth.
Ensured you with their behavior and skills.
Let you put your breasts in baby's mouth after the birth.
Strengthened your safe feeling with their presence.
P-value=0/014

educational
N(%)
193(96.5)
192(96)
178(89)
161(80.5)
64(32)
45(22.5)
33(16.5)
19(9.5)
19(9.5)
18(9)
13(6.5)

non-educational
N(%)
68(97.1)
68(97.1)
63(90)
58(82.9)
10(14.3)
7(10)
2(2.8)
10(14.3)
2(2.8)
17(24.3)
2(2.9)

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The results of study related to personal-social characteristics and midwifery with the factors of dissatisfaction
showed that there was no statistically significant relationship between personal-social characteristics and midwifery
with mothers dissatisfaction from physical cares and emotional supports (p0.05). The dissatisfaction from
receiving required information has significantly statistical relationship with a number of live childbirth (p=0. 009),
pre-familiarity about delivery (p=0. 024) and acquiring the information of subjects regarding the delivery procedure
(p=0. 0001). The dissatisfaction from ethical supports has statistically significant relationship with source of
acquiring information of research center regarding the delivery procedure (p=0. 0001).
For comparing the factors of mothers dissatisfaction with labor and delivery care and supports among educational
and non-educational hospitals in Tabriz, T test was used and the results of the test showed that there was a
statistically significant difference between educational and non-educational hospitals in all 4 areas during labor and
delivery.
DISCUSSION AND CONCLUSION
According to the results of current study, the mothers dissatisfaction from receiving their required information was
high and the most dissatisfaction in labor was related to lack of introducing different caretakers, lack of
introducing ward, bathroom and WC, lack of introducing available possibilities and manner of using them, lack
of explaining about uterine contractions, delivery progress, lack of explaining about different cares respectively
and the dissatisfaction of above ones was more than 50%.
In a study done by Rudman & et.al (2007) showed that 33% of women were unsatisfied with cares of which 7% was
related to receiving information and interfering in their decisions (16). The results of that study are consistent with
the current study and the mothers dissatisfaction from receiving required information was high. In a study done by
Brown & et.al (2007) in Australia, lack of enough information was one of the factors which the mothers mentioned
as a factor of dissatisfaction from labor and delivery caretakers (17).
From among the factors studies for defining the reasons of mothers dissatisfaction from physical labor cares during,
the most factors were related to lack of doing actions for reducing the delivery pain such as back massage, using
drugs and etc., not allowing mothers for walking in delivery room and lack of effort for reducing the noise in
delivery room. The results of Ordibeheshtis study showed that in educational maternity hospital, the physical
expectations of mothers from delivery caretakers were not estimated at 55.77% or it was estimated approximately
(24.29%). In this study, the least expectation estimation was related to the question regarding supplying comfort and
requirements of mother and regarding the setting for mothers comfort (10). The results of this study do not
correspond with the results of current study and mothers dissatisfaction from physical cares was decreased
compared to Ordibeheshtis study. It can be due to increasing the trainings related to physical cares from mothers,
managements more attention to promoting the quality of physical cares and decreasing the shortcomings related to
physical cares.
The results of study done by Mirmolaei & et.al (2003) showed that in Tehran hospitals, 68.75% of units are fully
satisfied with physical supports in labor and delivery room (4).
The most dissatisfaction of mothers from ethical supports in labor was related to lack of attention to comments and
suggestions on doing cares except the urgent ones, blaming mothers due to their behavior during delivery pain
and not using the request kindly or accompanying words such as please. Ordibeheshti showed in his study that
mothers ethical expectations from delivery caretakers were not estimated in most of the cases (59.95%) or was
estimated approximately (23.49%). The least estimation was related to getting permission from mother for doing an
examination by others and kindly explaining the reason and not getting a comment from a mother in urgent cares
(10). The results of Ordibeheshtis study are consistent with current study.
Assessing the factors of mothers dissatisfaction from emotional supports in labor showed that in all studies cases,
the dissatisfaction ranged from 20% to 75% and the most dissatisfaction was due to not allowing the caretakers
gripping the hands of mothers when they have pain.
Mothers dissatisfaction during delivery is less than during labor and it may probably be due to the great number of
caretakers during labor, stress accompanying pain and need to care, support and more attention to mothers which
makes doing proper actions for encouraging the health team for doing support from mothers unavoidable. The most
mothers dissatisfaction during delivery was related to emotional supports and it was related to lack of soothing and
hugging mothers during delivery, not having right for choosing the caretaker among different caretakers, not
gripping the hand of mother during delivery.

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The results of the present study showed that mothers' dissatisfaction with Care and Supports provided by labor and
delivery care takers in educational and non-educational hospitals were statistically significant. Therefore,
satisfaction in labor and delivery period was higher for non-educational hospitals. This lower rate of satisfaction can
be justified due to the greater number of caretakers and students in educational hospitals. In non-educational
hospitals, delivery process care was given by midwives (except for deliveries with side effects).
In a study by Sandin & et.al (2011) in Spain regarding labor cares, 81% of mothers were satisfied with care and
supports during labor and assessed their delivery experience as positive, the results of which are slightly different
with the results of the current study in non-educational hospital and is was completely different with educational
hospitals, the satisfaction of current study in mentioned hospitals are low. This inconsistency can be resulted from
the different expectations of mothers and the type of service provided in different countries (18).
In a study by Sharmi (2007), it became clear that treatment hospitals were more successful than educational
hospitals in terms of gaining the satisfaction of pregnant women in prenatal care. The factor for this lower rate of
satisfaction in educational hospitals is assumed to be the care indexes of educational hospitals (19).
The limitations of the study included mothers' exhaustion with labor and too much attention to herself and the baby
that may cause incorrect reply to questionnaire items. To help remove this problem, the questionnaires were
completed after the stabilization of the mother's state or they were completed by the researcher.
Using the simple sampling method, since all research units which have the requirements of entering the study, was
entered into the study and random sampling was not used due to the great number of requirements for the study, this
convenient sampling method reduces the generalization of results.
Since the findings of this study showed that mothers' dissatisfaction rate in non-educational hospitals in which the
delivery is made by the midwives under the supervision of women's and labor specialists is higher, it is suggested
that in the coming studies, the role of the midwives in attracting the mothers' satisfaction be examined.
Meanwhile, since the current study was done without considering the mothers awareness of care standards, it is
suggested that a study will be done entitled as studying the reasons of mothers dissatisfaction with labor and
delivery caretakers before and after receiving the care standards.
Acknowledgement
I do express my deep appreciation to the head, officials and personnel of the postpartum section of 29Bahman,
Alzahraa (S) and Taleqani hospitals of Tabriz. Moreover, my thanks go to the Vice President for Research of Tabriz
Medical Sciences University for providing the financial grants (code 88/8/5) of the project.
REFERENCES
[1] Page LA. The new midwifery science and sensitivity in practice. London: Churchill Livingstone; 2000: 106.
[2] Fraser DM, Cooper MA. Myles textbook for midwives, London: Churchill Livingstone; 2003: 3-10.
[3] Zolfaghari B, Kabiri P, Oveic Gharan SH. Esfahan Uni Med Sc J 1997; 3 (2): 136-142.
[4] Jafari F, Johari Z, Zayeri F, Ramazankhani A, Sayah Iran Z. Shahed uni science-research J 2006; 14(66): 15-22.
[5] Peterson W. Adolescent mothers `satisfaction with postpartum nursing care: quantitative and qualitative
approaches [dissertation]. Unpublished PhD thesis, Mc master university; 2004.
[6] Harvey S, Rach D, Stainton MC, Jarrell J, Brant R. Midwifery 2002; 18: 260-267.
[7] Chunuan SK. Patient Satisfaction with Health Care Services Received During Intrapartum in One Regional
Hospital in the Southern Part of Thailand. [dissertation]. Unpublished PhD thesis, University Of Kentucky; 2002.
[8] Mackey MC, Flanders Stepans ME. JOGNN 2006; 23(5): 413-420.
[9] Kabakian-Khasholian T, Campbell O, Shediac-Rizkallah M, Ghorayeb F. Social Science & Medicine 2000; 51:
103-113.
[10] Ordibeheshti Khiaban M. [Rate Women`s Expectation of Maternal Care Givers in Education Tabriz Maternity
Hospitals]. [Dissertation]. Un published Master`s thesis, Tabriz Nursing &Midwifery faculty, Iran; 1998.
[11] Mirmolaei S, Khakbazan Z, Kazemnead A, Azari M. Tehran Uni Med Sc J (Hayat) 2007; 13 (2): 31-40.
[12] Daff La, Lamping D,Ahmed LB. International journal quality in health care 2001; 17(3): 215-230.
[13] Robledo IJ. The impact of childbirth preparation and support on labor and birth outcome. [Dissertation].
Unpublished PhD thesis, university of Rhode Island: 1997.
[14] Waldenstrom U, Brown S, Mclachlan H, Forster D, Brennecke S. Birth 2000; 27(3): 156-167
[15] Mirmolaei S, Mehran A, Rahimi Ghasbeh S. Tehran Uni Med Sc J (Hayat) 2004; 9 (17): 41-47.
[16] Rudman A, El-Khouri B, Waldenstrom U. Journal of Advanced Nursing 2007, 59(5), 474487.

138
Pelagia Research Library

Faride Eghdampour et al
Euro. J. Exp. Bio., 2013, 3(6):132-139
_____________________________________________________________________________
[17] Stephanie Brown BA, Lumley J. Birth 2007, 21(1), 13-4.
[18] Sandin A, Kvist L, Berg M, Larsson B. International Journal of Health Care Quality Assurance 2011;
24(1):81-95.
[19] Sharami SH, Zahiri H, Zendedel S. Gilan Uni Med Sc J 2007; 17 (66): 29-37.

139
Pelagia Research Library