the experience of labor and birth , referred to as childbirth , is complex , multidimensional , and subjective , relating to both the outcome and the process that is experienced by an individual woman . birth is a universal experience for women , and many similarities in their birthing are documented in studies of childbearing women living in many countries . the significance of the physical , emotional , and spiritual dimensions of giving birth is universal . a positive birth experience is associated with long - lasting benefits , an affirmative relationship with the baby , and a positive attitude toward motherhood that contributes to the woman 's self - esteem . a negative birth experience may define or alter future pregnancies by affecting a woman 's future reproductive decisions . mentioned that maternal experience may have an impact on their attitudes toward the mode of future birth and on cesarean section rates . many studies have explored women 's experiences of childbirth and have identified that there are many variables that may influence the meaning of childbirth for an individual woman , including maternal age , education , and socioeconomic class . according to lundgren , pregnancy - related factors , complications , expectations , pain , and the form of organization care all influence women 's experience of childbirth . a woman 's previous experience of childbirth may influence her perception of the childbirth experience , for example , first - time mothers were found to be significantly less satisfied with their birth experience and more negative in their description of the baby than were women who had previously given birth . melender showed that negative stories told by others cause anxiety before childbirth and negative birth experiences . a calm , quiet , and caring birthing environment can promote a faster , easier labor and a more positive childbirth experience . the support and care given by midwives and other staff was found to contribute to a woman 's birth experience . over 1,170,000 women give birth in iran every year and more than 95% of births takes place in hospitals . due to iranian religious and cultural values , men do not attend labor and birth . usually , pregnant women accompanied by females arrive in the labor ward and stay with other laboring women in the same room during labor . midwives are the women 's only source of support in labor and birth . in kurdish society , women have to fulfill their familial roles as daughters , wives , and mothers . kurdish women have a certain intrinsic value in that they represent the originators of the next generation . pregnancy and childbirth are generally considered positive life events in the kurdish society , especially when parents have planned and prepared for the beginning of a new life . during pregnancy , women get greater intimacy , closeness , protectiveness , and kindness from their husband and relatives . during their first pregnancy , postnatally , women often stay at home for 40 days to recuperate during which time they rest and are cared for by their family . they are also expected to eat special foods with their meals which are believed to help restore the energy lost by the mother during childbirth . although childbirth is a universal phenomenon , women 's experiences are subjective , personal , and particular ; hence , childbirth is experienced by women in different ways . therefore , the aim of this study was to describe the experience of childbirth of kurdish women giving birth at besat hospital in sanandaj . this study was performed at the governmental besat hospital in sanandaj , a center of kurdistan province in the western part of iran . this hospital is a referral center and there are about 6000 childbirths taking place annually with a cesarean section rate of 42% . this study was approved by the ethics committee of the kurdistan university of medical sciences . inclusion criteria were being an iranian kurdish woman , being nulliparous , and having vaginal childbirth . phenomenology describes the subjective meaning of the lived experience and is particularly appropriate in seeking a rich description of significant life events , such as childbirth , in the voices of the women themselves . descriptions of the mothers experiences in the present study were obtained through in - depth interviews . the sample number was restricted to 15 , as no new data was generated after the 14 interview . when a participant expressed interest in the study and permission to approach was obtained , the participating woman was asked for the contact information the purpose of the study was explained to the participants , followed by recording of demographic and contact information . they were informed that their participation in the study was voluntary and that their names would remain confidential . written consent , which included permission to be interviewed for a second time , was also received . the date of interview was fixed to suit the participant . to give confidentiality , participants were given pseudonyms and their real names were kept confidential by the first researcher . they were reassured that their care would not be affected if they chose not to participate in the study . moreover , they could withdraw from the study at any stage without giving any explanation . the interviews were conducted at the woman 's home and lasted between 80 and 120 min . data collection took place between 2010 and 2011 using semi - structured , audiotaped , face - to - face interviews , which allowed flexibility and made it possible for the researcher to follow the interests and thoughts of the participants . women were interviewed by the first researcher ( rsh ) 612 weeks after they had given birth to their first child . the timing was set to allow maximum time for recovery from birth , while still being close to the experience . can you tell me about the experience of childbirth ?  the women were encouraged to describe all their feelings and experiences . the researcher attempted to convey the attitude ,  teach me ,   tell me about your birth ,  and the women were more than willing to share their perspectives and birth stories . one of the mothers said she did not understand some of the questions ; so , the questions were rephrased to facilitate understanding . careful and subtle probing was done in order to clarify what the participant was attempting to say . the researcher also used validating reflective statements as the participants responded ; therefore , participants knew the researcher understood what they were trying to say . transcription accuracy was checked by a colleague who read randomly chosen transcripts while listening to the audiotape . the analysis was also undertaken with the kurdish transcripts , and only verbatim quotations presented in the writing for publication were translated into english . the researcher has attempted to translate the women 's descriptions to correspond closely with their meaning in kurdish , while making them grammatically correct for english readers . in data analysis for phenomenological enquiry , the researcher aims to uncover and produce an accurate description of the phenomena being studied as experienced by the individual . content analysis of the data including the generation of themes was performed using van manen 's method . data were analyzed concurrently with data collection , and trustworthiness of the data was established by saturation of categories as data were gathered . findings were verified through member checks , with the principal investigator discussing the data collected with the participants to verify that the data accurately described their experiences . the principal investigator ( rsh ) established an audit trail by keeping a journal of impressions associated with data collection and analysis . a draft copy of the findings of the research was given to each participant for verification and to ensure that the participants did not feel that they were identified . the findings are described under the following four themes : feeling empowered , changing life , importance of being supported during labor , and the spiritual dimensions of giving birth . the women 's quotes are used to illustrate the text where appropriate . in the interviews , women continuously described that they were feeling empowered by the experience of becoming a mother . i am capable of doing a delivery and i am capable of being mother .  # 6  i feel i have grown up # 10 for these women , becoming a mother was a pivotal transition that brought changes in their perspectives and priorities . only if you are a mother can you understand how hard it was to give birth to you . i have a lot of strength ; i did nt know i had it . # 12 for these women , pain was an expected part of childbirth and motherhood . one participant said ,  although it is painful , it is also easy because women have been having babies for thousands of years and became mothers .  # 6 the reward of this pain was the joy and happiness most of these women felt when they saw their babies for the first time . a new child becomes a part of the woman 's life and a part of themselves . for these mothers , the moment when they first saw and touched their newborns was the positive and most emotional aspect of giving birth . # 5 the findings of this study show that women can have increased satisfaction with their childbirth when there is increased amount of emotional support .  with this baby , i think we have a strong family relationship , we can care for each other and love each other . # 9 the findings of this study reveal that the women experienced various changes that were associated with their childbirth . these changes included increased patience , understanding , experiences , and feeling more responsible . # 6  i do nt find the right words to express how i felt . # 6 women spoke of how childbirth had brought them closer to both their mothers and spouses . one mother said ,  you are not able to appreciate your parents if you do nt have your own child . having my own child gives me a new understanding of my relationship with my parents . # 3  the child 's development is a result of the parent 's hard work , i realize now . # 1  of course there is certainly a change after giving birth , now my husband and i are much closer . # 6 giving birth provided them with feelings of completeness and changed their view of the world . # 2 one participant mentioned :  things appear in a different perspective now . i feel very differently and the past is viewed very differently now as well . # 9 interaction with midwives was considered an essential part of experience of giving birth . # 11 the experience of not being seen and being ignored in the long first phase of childbirth overshadowed the whole childbirth experience in negative terms for some women . # 7 the environment of labor ward had negative impact on attitudes toward the future pregnancies . i do nt want to have pregnancy at all because i have had bad experience ; the midwives had very bad behavior , they did nt care about me and my baby . # 3 participants mentioned that they needed support of their husband and family during labor and childbirth . they believed that their presence can influence their perception of the childbirth and help them to have an enjoyable experience . i think if my husband or my mother was there , all things were different and i had better experience . # 6 in this study , a strong sense of the spiritual dimensions of giving birth with women 's religious beliefs was identified . these women continuously described the need for reliance on allah as they gave birth and revealed a strong sense of the spiritual dimension of the childbirth experience . # 3  before i went to hospital , i read holy quran and during contraction , i tried to read holy quran by heart . # 7 some women reported taking religious icons with them to keep under their pillows during labor . the findings are described under the following four themes : feeling empowered , changing life , importance of being supported during labor , and the spiritual dimensions of giving birth . in the interviews , women continuously described that they were feeling empowered by the experience of becoming a mother . i am capable of doing a delivery and i am capable of being mother .  # 6  i feel i have grown up # 10 for these women , becoming a mother was a pivotal transition that brought changes in their perspectives and priorities . only if you are a mother can you understand how hard it was to give birth to you . i have a lot of strength ; i did nt know i had it . # 12 for these women , pain was an expected part of childbirth and motherhood . one participant said ,  although it is painful , it is also easy because women have been having babies for thousands of years and became mothers .  # 6 the reward of this pain was the joy and happiness most of these women felt when they saw their babies for the first time . a new child becomes a part of the woman 's life and a part of themselves . for these mothers , the moment when they first saw and touched their newborns was the positive and most emotional aspect of giving birth . # 5 the findings of this study show that women can have increased satisfaction with their childbirth when there is increased amount of emotional support . with this baby , i think we have a strong family relationship , we can care for each other and love each other . the findings of this study reveal that the women experienced various changes that were associated with their childbirth . these changes included increased patience , understanding , experiences , and feeling more responsible . # 6  i do nt find the right words to express how i felt . # 6 women spoke of how childbirth had brought them closer to both their mothers and spouses . one mother said ,  you are not able to appreciate your parents if you do nt have your own child . having my own child gives me a new understanding of my relationship with my parents . # 3  the child 's development is a result of the parent 's hard work , i realize now . # 1  of course there is certainly a change after giving birth , now my husband and i are much closer . # 6 giving birth provided them with feelings of completeness and changed their view of the world . # 2 one participant mentioned :  things appear in a different perspective now . i feel very differently and the past is viewed very differently now as well . # 11 the experience of not being seen and being ignored in the long first phase of childbirth overshadowed the whole childbirth experience in negative terms for some women . # 7 the environment of labor ward had negative impact on attitudes toward the future pregnancies . i do nt want to have pregnancy at all because i have had bad experience ; the midwives had very bad behavior , they did nt care about me and my baby . # 3 participants mentioned that they needed support of their husband and family during labor and childbirth . they believed that their presence can influence their perception of the childbirth and help them to have an enjoyable experience . i think if my husband or my mother was there , all things were different and i had better experience . in this study , a strong sense of the spiritual dimensions of giving birth with women 's religious beliefs was identified . these women continuously described the need for reliance on allah as they gave birth and revealed a strong sense of the spiritual dimension of the childbirth experience . # 3  before i went to hospital , i read holy quran and during contraction , i tried to read holy quran by heart . # 7 some women reported taking religious icons with them to keep under their pillows during labor . a potential limitation of this study is that all participants were kurdish pregnant women in sanandaj ; the findings might have been somewhat different if urban and rural kurdish women from other countries had been included . moreover , it must be taken into consideration that a qualitative study implies interaction between researchers and participants , and that the researcher 's pre - conceptions might influence interpretation of the material . the overall purpose of the present study was to investigate the experience of childbirth among kurdish women giving birth in iran . semi - structured interviews proved a very useful tool for the purpose of data collection in this study . the women were free to talk about the experiences that were important to them personally . in this study about the perspectives of kurdish childbearing women , participants of this study are not representative of all kurdish childbearing women ; there are some lessons which can be learnt . the main finding of this study was that participants described childbirth as the meaning of motherhood . participants believed that childbirth changed their views about themselves and how they were viewed by others . this finding is consistent with previous studies that showed women after childbirth have a sense of self - actualization and self - understanding . the data from the participants interviews affirmed that they found giving birth to be enriched by and to enrich their role in their society . this view is supported by other studies and shows that the midwife is an important source of support . in addition , it has been identified in a number of research studies that effective support during childbirth reduces the need for interventions and , therefore , increases women 's chances of experiencing normal births . the findings of this study suggested that the support of woman 's husband or one of her family members during labor and birth had an important role in the experience of childbirth . although there is an increased amount of literature about the presence of fathers during childbirth , due to iranian religious and cultural values , men do not attend labor and birth . in a study where women in birth clinics were asked to rank their support during birth , the women often ranked the support from the partner higher than the professional support received . maternal experience may have an impact on the attitudes toward the mode of future birth and the cesarean section rates and the maternal role . therefore , it is important for midwives to see beyond the process of labor and understand the importance of a woman 's experience of her birth , because it is this that the women will remember and that will affect their future . furthermore , having an understanding of a woman 's labor and delivery experience allows midwives to continue to improve the quality of maternity care . therefore , all midwives can do something to help change the environment in which they work and to improve the care they offer to women . laboring women who feel safe and who have had the opportunity to build a relationship with their midwife have a positive experience . it is evident that effective support during childbirth is a vital aspect of intrapartum care . it is important for midwives and other health professionals to understand the benefits of giving continuous support to women during childbirth . according to melender , the childbirth experience has the potential to affect positively or negatively a woman 's interaction with her infant . therefore , midwives who have the responsibility of preparing a woman for childbirth or caring for her during childbirth should be aware of all the variables that can influence a woman 's experience of childbirth . this study adds richly descriptive data to the body of literature on kurdish childbearing women . women communicate through telling stories and create meaning as they articulate their feelings about pivotal life events such as childbirth . the findings of this study provide a useful first step toward the identification of aspects of kurdish women 's experience of giving birth .