Health Provider Perspectives on Barriers to Prenatal Class Attendance in Iran

Abdollahpour, S.; Khadivzadeh, T.; Shafeei, M.; Fargahi, F.; Taheri Hassanabad, R.; Mohsenpour, O.

doi:10.58209/hehp.14.2.367

Health Provider Perspectives on Barriers to Prenatal Class Attendance in Iran

Document Type : Qualitative Research

Authors

S. Abdollahpour ¹

T. Khadivzadeh ²

M. Shafeei ³

F. Fargahi ⁴

R. Taheri Hassanabad ⁴

O. Mohsenpour ⁴

¹ Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

² Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

³ Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

⁴ Health Deputy, Mashhad University of Medical Sciences, Mashhad, Iran

10.58209/hehp.14.2.367

Abstract

Aims: The World Health Organization emphasizes that preparation for childbirth is a key component of antenatal care that reduces maternal mortality and improves birth experiences. Understanding barriers to participation requires resource-based interventions and qualitative inquiry. This study explored health providers’ perspectives on barriers to prenatal class attendance in Iran.
Participants & Methods: This qualitative study included 36 participants who were purposively selected from among class instructors and key informants across 30 health centers from May 2024 to March 2025. Data were collected through semi-structured, in-depth individual interviews using an interview guide. Data were analyzed using conventional content analysis, following Graneheim and Lundman, with attention to the trustworthiness of the findings.
Findings: After data saturation, the analysis yielded 452 codes, which were organized into 94 sub-sub-themes, 10 sub-themes, 4 themes, and 1 main theme. The main theme, “Navigating a Whirlwind of Challenges,” emerged from four themes: Lack of Accessibility, Lack of Acceptability, Negative Feedback, and Lack of Rethinking to Start Over.
Conclusion: Overcoming barriers to prenatal class attendance requires an accessible, evidence-based, and integrated childbirth education program supported by policy, adequate funding, manageable workloads, and ongoing evaluation to empower pregnant women and improve maternal and neonatal health.

Keywords

Iran

Qualitative Research

Prenatal Care

Health Providers

Subjects

Health Care

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