Association between maternal health literacy and childbirth experience among postpartum women in Northern Iran: a cross-sectional study

While maternal health literacy (MHL) is presumed to facilitate provider communication and active care participation, the specific contributions of its domains to the childbirth experience remain empirically unexplored. This study aimed to determine the association between MHL and childbirth experience among postpartum women. This cross-sectional analytical study was conducted at Al-Zahra Educational and Medical Center, Rasht, Iran, between January and May 2025. A total of 149 postpartum women were selected using convenient sampling within 2 to 12 h of delivery. MHL was assessed using the validated Persian version of the MHL and Pregnancy Outcomes Questionnaire, while childbirth experience was measured using the validated Persian Childbirth Experience Questionnaire (CEQ 2.0). Associations were examined using Spearman’s rank correlation and multiple linear regression after adjusting for these factors. Approximately one-quarter of participants had inadequate MHL. A significant positive correlation was observed between MHL and childbirth experience (Spearman’s ρ = 0.302, p < 0.001). In the fully adjusted regression model, higher auditory-verbal competence was independently associated with more positive childbirth experience (B = 0.466, 95% CI: 0.224–0.708; standardized β = 0.296; p < 0.001). Conversely, the self-management/performance domain was not independently associated after adjustment. Maternal employment (standardized β = -0.180, p = 0.022) and increasing spousal age (standardized β = -0.163, p = 0.037) were independently associated with lower birth experience scores. The final model explained 24% of the variance in the outcome (adjusted R² = 0.24). MHL was positively associated with birth experience among women. Specifically, the auditory-verbal competence domain showed an independent positive association with better birth experiences, even after controlling for demographic and obstetric variables.