Examining effect of a companion midwife on Fear of Childbirth and labor Satisfaction,and Subsequent Fertility Intention Among Pregnant Womenreferring to selected hospitals of Shiraz University of Medical Sciences: A randomized clinical trial

To investigate the effect of continuous support provided by a companion midwife, compared with routine maternity care, on fear of childbirth, childbirth satisfaction, and intention for future childbearing among pregnant women attending selected hospitals affiliated with Shiraz University of Medical Sciences.

A randomized, controlled, parallel-group clinical trial. Participants will be allocated to the intervention and control groups using block randomization. Owing to the nature of the intervention, blinding of participants and care providers is not feasible; however, the outcome assessor and data analyst will be blinded to group allocation.

The study will be conducted at Hafez Hospital and Shoushtari Maternity Hospital in Shiraz. Participants will be randomly allocated to two groups. The intervention group will receive companion midwife support from the onset of active labour until childbirth, while the control group will receive routine care. Outcomes will be assessed six weeks postpartum

Participants will be Iranian pregnant women aged 18–40 years with a planned singleton pregnancy, gestational age of 37–42 weeks, spontaneous onset of labour, and cephalic presentation who provide written informed consent. Participants will be excluded if obstetric complications affecting normal labour occur, if they withdraw from the study, or if the questionnaires are completed incompletely.

Intervention group: Routine intrapartum care plus continuous support provided by a companion midwife from the active phase of labour until childbirth. Control group: Routine intrapartum care according to hospital protocol without companion midwife support.

Fear of childbirth, childbirth satisfaction, and intention for future childbearing at six weeks postpartum

A total of 68 eligible nulliparous pregnant women will be enrolled after providing written informed consent and completing the baseline assessment. Participants will be randomly allocated in a 1:1 ratio to either the intervention group (n = 34), receiving continuous support from a companion midwife during labour and childbirth in addition to routine care, or the control group (n = 34), receiving routine maternity care only. Block randomization with a fixed block size of four will be used to ensure balanced allocation between the two study groups throughout the recruitment period. The unit of randomization is the individual participant. No cluster or stratified randomization will be applied. The random allocation sequence will be generated before participant recruitment using a computerized random sequence generator by an independent researcher who is not involved in participant recruitment, intervention delivery, or outcome assessment. Allocation concealment will be ensured using sequentially numbered, opaque, sealed envelopes (SNOSE). After confirming eligibility, obtaining written informed consent, and completing participant enrolment, the corresponding envelope will be opened sequentially to reveal the group assignment. Therefore, the researcher responsible for participant recruitment will remain unaware of the allocation sequence until enrolment has been completed.