Azita Tiznobaik - PhD of Reproductive Health, Department of Midwifery and Reproductive Health, Member of Maternity and Child Care Research Center, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
Zohreh Khakbazan - Assistant professor , PhD of Reproductive Health, Department of Reproductive Health, School of nursing and midwifery, Tehran University of medical sciences, Tehran, Iran
Mehrnaz Geranmayeh - Assistant professor, PhD of Medical Education, Department of Reproductive Health, School of nursing and midwifery, Tehran University of medical sciences, Tehran, Iran
Ziba Taghizadeh - Associate professor, PhD of Reproductive Health, Department of Reproductive Health, School of nursing and midwifery, Tehran University of medical sciences, Tehran, Iran

Background: Childbirth Satisfaction is a topic of increasing interest and is an essential component of quality of obstetric care. The previous studies showed progress in labor and controlled pain in women who were satisfied with their childbirth experience with respect to maternity services. On the other hand, dissatisfaction with childbirth causes a negative attitude to pregnancy, leading women to request cesarean section in subsequent deliveries. Nowadays, the desire for natural childbirth in the Iranian women is declining while increasing number of cesareans and their complications have become the newest challenge to maternal health. This led to paying more attention to the labor experience and its satisfaction. As satisfaction develops over time and occurs through a complex process involving different factors, this study seeks to identify the above process, contextual, confounding, interactive, and consequential factors. Therefore, the present study is aimed to explain the process of delivery satisfaction in Iranian women and designing a model.Methods: This study was conducted with qualitative methodology and the grounded theory approach in Hamadan. Participants included 26 women who referred to Fatemieh, Atieh and Bou Ali hospitals in Hamadan for childbirth. In addition, 5 medical staff were included as key informants. Semi-structured and in-depth interviews were used to collect data. Inclusion criteria for all the participants in this study were, the ability and willingness to communicate and at least five years of maternity work experience medical staff. The data were analyzed according to Corbin and Strauss's (2008) version in four steps including data analysis for concepts, data analysis for context, and data analysis for process and composition, and class integration. MAXQDA10 software was used for the data analysis.Results: The main concept of this study was “Striving for safe and pleasant labor experience". The main categories of context were "expectation of childbirth, beliefs and childbirth experiences, facilities and services, midwife- woman interactions". The process of forming this study was the categories of "facilitating a safe delivery, adaptation to labor pain and seeking support". The basic model of this study is "safe and pleasant delivery." In fact, women who are satisfied with childbirth consider natural childbirth as the safest way to achieve health for themselves and their babies. This would be a path a way to childbirth satisfaction that essentially depends on their expectations, beliefs and experiences of childbirth. In addition, their adaptation to the pain and support of the delivery process lead to a pleasant experience of childbirth. Psychological recovery due to ignore delivery complications, matching experiences with expectations and a pleasant return to home, along with structural factors, are factors in the formation and satisfaction of a positive mental image of childbirth.Conclusion: Based on the findings of this study, women who are satisfied with childbirth, experience a safe and enjoyable transition with appropriate structures, adaptation to labor pain and seeking support which lead to psychological recovery and satisfaction with childbirth. Therefore, it is necessary to provide appropriate strategies for planning effective interventions to enhance the areas of pleasurable delivery and greater satisfaction of women with natural childbirth, based on the main goals of the country's health system and achieving World Health Organization standards in reducing Cesarean statistics.

Childbirth; Satisfaction; Childbirth satisfaction; Designing a Model