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 key indicator of the quality of reproductive health services. Objectives: This study aimed to assess satisfaction levels and their determinants among women of reproductive age attending urban Comprehensive Health Service Centers in Shahroud, Iran. Methods: A cross-sectional study was conducted from May to December 2022 involving 319 women selected through multistage sampling from all 10 urban health centers in Shahroud County. Data were collected immediately after preconception care visits using a validated 35-item questionnaire covering two domains: childbearing counseling (11 items, score range 11–55) and preconception care (24 items, score range 24–120). Scores were converted to percentages and categorized as low (<51%), moderate (51–75%), or high (>75%) satisfaction. Statistical analysis was performed using SPSS version 22. Results: Mean satisfaction scores were 29.59 (8.34) for childbearing counseling (53.8%) and 56.59 (15.67) for preconception care (47.2%), indicating moderate to low satisfaction overall (total score: 86.18 (20.76), 49.2%). Highest satisfaction in counseling was for “husband’s presence during counseling” (36.1% strongly agreed), and lowest was for “education was sufficient and understandable” (0.6% strongly agreed). In preconception care, the highest disagreement was with “ease of locating the service site” (64.9%), and the lowest strong agreement was for “midwife’s behavior was polite” (1.3%). Key deficiencies included inadequate education, poor communication, unclear risk explanation, and structural barriers. Community health worker accessibility was noted as a relative strength. Conclusion: Low satisfaction primarily stemmed from poor communication, insufficient education, and infrastructural challenges. Enhancing provider communication, educational quality, privacy, and multidisciplinary access is essential.