Empowering expecting mothers: a qualitative exploration of perceived needs and preferences of pregnant women towards educational resources of perinatal mhealth apps

Abstract

Background

The rapid adoption of mobile health (mHealth) technologies presents an opportunity to enhance prenatal care through tailored educational interventions. However, the success of such applications relies on their alignment with user needs, preferences, and sociocultural contexts. This study aimed to explore the perceived needs and preferences of Iranian pregnant women towards educational resources of perinatal mhealth apps.

Methods

A qualitative content analysis was conducted involving 14 pregnant women, who recruited via purposive sampling from hospitals affiliated with Mashhad University of Medical Sciences and private clinics in Mashhad, Northeast Iran from May to December 2023. Data were collected through semi-structured, in-depth interviews and analyzed using conventional content analysis approach introduced by Elo and Kyngäs (2008). Trustworthiness was ensured through triangulation, member checking, and peer debriefing.

Results

The overarching theme of “Empowering expectant mothers in maternal journey” emerged from a comprehensive analysis revealing three interconnected categories of pregnant women’s perceived needs and preferences towards educational resources of perinatal mhealth apps including (1) ‘Need for Holistic Maternal Well-Being’ which highlights critical needs for mastering stress and strengthening emotional adaptability, Building Daily Routines for Self-Care and Resilience, nutritional wisdom for holistic health as well as harmonizing work-life dynamics (2) ‘Necessity of Proactive Birth Readiness’ that emphasizes the importance of tailored understanding of delivery options, empowered pain management strategies, navigating high-risk pregnancy situations, designing a personalized birth journey and navigating maternity care systems and hospital choices, and (3) ‘Demand for Connected Relationships and Support’ which shows a profound need for enriching maternal-fetal connection, shared parenting journeys and partner collaboration, navigating intimacy and sexual health, building community and peer networks and spiritual growth and reflective practices.

Conclusion

The study reveals that effective mHealth applications must transcend traditional informational approaches, offering holistic, culturally sensitive, and empowerment-oriented educational support. By addressing the multidimensional needs of pregnant women, these technologies can significantly enhance maternal healthcare experiences, promote informed decision-making, and support comprehensive well-being.

Introduction

Pregnancy is a transformative period characterized by profound physiological, psychological, and social changes, necessitating comprehensive and tailored educational support for expectant mothers [1].

In maternal healthcare, assessing learning needs transcends the mere provision of information. It requires a holistic understanding of the knowledge gaps, preferences, and learning styles unique to each individual [2]. These factors are intricately influenced by personal experiences, cultural contexts, socioeconomic conditions, and psychological attributes [3]. Among Iranian pregnant women, these educational needs are deeply rooted in cultural norms and traditions, shaping their perceptions of health and education during pregnancy [4, 5]. A nuanced understanding of these factors is essential to developing educational interventions that align with their expectations and empower them to make informed health decisions [6].

The digitalization of healthcare has revolutionized maternal health globally, with mobile health (mHealth) technologies emerging as a promising solution to address the educational needs of pregnant women [7]. These technologies offer accessible, cost-effective, and personalized approaches to prenatal education, with studies demonstrating their ability to enhance knowledge retention, improve maternal health outcomes, and reduce disparities in healthcare accessibility, particularly in resource-limited settings such as Iran [8, 9].

However, despite the growing adoption of mHealth technologies, a significant gap remains between technological advancements and user-centered design principles, which are critical for effective implementation [10, 11]. Many existing prenatal care applications are designed with a generalized approach, often failing to consider the diverse perceived cultural and educational needs and preferences of pregnant women [12]. This disconnect highlights the necessity of conducting qualitative assessments to identify these unmet needs, ensuring that mHealth solutions are not only innovative but also culturally relevant and user-friendly. As the healthcare landscape increasingly integrates mHealth technologies, there is a unique opportunity to bridge these educational gaps and enhance the delivery of prenatal care through user-centered digital interventions [13, 14].

While some Iranian studies have examined pregnant women’s access to health information and their views on pregnancy self-care apps [15], and more recently have explored pregnant women’s intention to use mHealth apps [16], these works do not explicitly focus on educational resources within perinatal mHealth apps. In related work in the Middle East, studies in Oman have documented antenatal education gaps: pregnant women report insufficient information about labor, birth, postpartum care, and newborn care in standard antenatal services [17]. Similarly, in Egypt, researchers have explored health information-seeking behaviours among pregnant women and identified desires for evidence-based and culturally appropriate educational material [18]. Even with these precedents, to our knowledge no study in Iran—or elsewhere in the region—has qualitatively explored pregnant women’s perceived needs and preferences specifically for educational content delivered via perinatal mHealth apps. To address these challenges, this study aimed to conduct a comprehensive qualitative needs assessment to understand the educational requirements and preferences of Iranian pregnant women regarding educational resources of perinatal mhealth applications.

Methodology

Study design

This study utilized a qualitative content analysis approach, as described by Elo and Kyngäs (2008) [19] to conduct a needs assessment towards educational resources of perinatal mHealth application for pregnant women. This methodology was chosen to enable an in-depth exploration of pregnant women’s educational needs and preferences, allowing themes to emerge naturally from the data without imposing preconceived categories. Qualitative content analysis was particularly suitable for this research, as it provided the flexibility to explore both explicit and implicit conditions influencing the design and implementation of mHealth educational materials for expectant mothers.

Study setting

The research was carried out in various settings, including hospitals affiliated with Mashhad University of Medical Sciences in Mashhad, Northeast Iran and private women’s health specialist clinics. These settings were selected to capture diverse perspectives from different healthcare delivery contexts and socioeconomic environments, ensuring a comprehensive understanding of users’ needs across various healthcare settings.

Participants

Participant recruitment employed a combination of purposeful and snowball sampling strategies to ensure maximum variation in the sample. The study included 14 pregnant women who met specific inclusion criteria, including having at least a high school diploma, prior experience with mobile health applications, a low-risk pregnancy, access to a smartphone, willingness to participate in face-to-face interviews and an electronic literacy score of 50 or higher as measured by a validated instrument. Electronic literacy was assessed using the eHealth Literacy Scale (eHEALS) developed by Norman and Skinner, which has been validated in Persian for Iranian populations with acceptable reliability and construct validity (Cronbach’s α = 0.88) [20]. Individuals with high-risk pregnancies or no familiarity with mobile health apps were excluded from the study. The exclusion of women with high-risk pregnancies was deliberate, as their complex medical conditions, heightened stress levels, and specialized care needs could bias the participants’ focus towards medical complexity rather than typical educational resource needs and preferences of the general pregnant population. The sample size was determined based on data saturation, ensuring the collection of rich, in-depth insights.

Data collection

Data collection was conducted through semi-structured interviews between May and December 2023. The first author, trained in qualitative interviewing techniques, conducted all interviews using a semi-structured interview guide developed through literature review and expert consultation. The guide focused on exploring participants’ perceived needs regarding educational materials of mobile health applications during pregnancy, preferences for educational content delivery, and perceived barriers and facilitators to mobile-based learning. Each interview session lasted approximately 30–45 min and was conducted in a private setting to ensure confidentiality. All interviews were audio-recorded with participant consent and transcribed verbatim immediately following each session. Field notes were maintained throughout the process to capture non-verbal cues and contextual information that might influence data interpretation.

Data analysis

Data analysis was guided by the conventional content analysis approach developed by Elo and Kyngäs (2008) [19]. The process began with preparation, during which audio-recorded interviews were transcribed verbatim and repeatedly read to achieve a deep understanding of the content. In the organization phase, meaning units were extracted through open coding, and similar codes were grouped to form subcategories and categories based on conceptual similarities. An inductive logic was applied throughout the process to allow categories and themes to emerge naturally from the data. The research team conducted multiple rounds of discussion to refine and finalize the coding structure, ensuring consistency and interpretive alignment. Analysis was performed in parallel with data collection to support theoretical sampling and iterative refinement of the interview guide. The process continued until no new concepts emerged, indicating data saturation.

Trustworthiness

To enhance the credibility and rigor of the findings, Lincoln and Guba’s (1985) criteria for trustworthiness were followed [21]. Credibility was ensured by prolonged engagement with participants’ narratives, member validation of interpreted meanings, and peer review by qualitative experts. Dependability was supported by transparent documentation of analytic decisions and the use of a stepwise replication strategy by independent researchers. Confirmability was strengthened through detailed field notes and reflexive memos that tracked analytical decisions over time. Transferability was addressed by providing rich, contextualized descriptions of participants’ characteristics and settings to allow readers to judge relevance to other contexts.

To address positionality, all interviews were conducted by the first author, an Iranian female midwife trained in qualitative research. Her professional background in maternal health likely facilitated rapport and openness with participants, particularly on sensitive topics such as emotional well-being, sexuality, and marital relationships. At the same time, it is acknowledged that her professional identity may have influenced both participant disclosures during data collection and the researcher’s interpretive perspective. To maintain rigor and enhance transparency, this potential influence was mitigated through reflexive journaling, team discussions, and peer debriefing.

Ethical considerations

Ethical approval was obtained from the institutional ethics committee of Mashhad University of Medical Sciences. Participants received detailed oral and written information about the study, including its objectives, voluntary participation, and their right to withdraw at any time without consequence. Informed consent was obtained prior to participation. To safeguard confidentiality, all transcripts were anonymized, and pseudonyms were used throughout the analysis and reporting process. Audio recordings and transcriptions were stored securely and only accessible to the research team.

Results

Characteristics of Participants

The study included a total of 14 pregnant women. The average age of the pregnant participants was 29.5 years (SD = 6.1), ranging from 18 to 40 years. Most of the pregnant women had attained at least a bachelor’s degree, with their gestational age spanning from 18 to 33 weeks and an average of 24.7 weeks (SD = 5.3). Interview durations averaged 60 min (SD = 28.3), and sessions were conducted in varied settings, such as participants’ homes, clinics, and public spaces. Table 1 summarizes the demographic characteristics of the pregnant women participants.

Table 1.

Demographics characteristics of Pregnant Women

Participant Code Number	Age	Education	Duration of Marriage (Year)	Pregnancy History	Gestational Age	Occupation	Interview Duration (Minute)
PC1	28	Bachelor of Literature	8 years	G2 Ab1	25 weeks	Homemaker	45
PC2	31	Bachelor of Medical Records	9 years	PG	27 weeks	Private company employee	90
PC3	34	Master of Psychology	6 years	G3 Ab2	19 weeks	Homemaker	110
PC4	30	Master of Social Sciences	12 years	G3 L2	26 weeks	Homemaker	70
PC5	23	Bachelor of Nursing	3 years	PG	18 weeks	Hospital nurse	40
PC6	35	High School Diploma	10 years	G2 L1	30 weeks	Clothing saleswoman	100
PC7	31	Vocational High School Diploma	12 years	G5 L2 Ab2	20 weeks	Homemaker	40
PC8	24	Associate of Computer Science	3 years	G2 Ab1	26 weeks	Homemaker	35
PC9	21	High School Diploma	5 years	G3 L1 Ab1	29 weeks	Hairdresser	40
PC10	40	Middle School	4 years	G3 L2	33 weeks	Shopkeeper	30
PC11	34	Bachelor of Math Education	6 years	G2 L1	20 weeks	Kindergarten teacher	40
PC12	18	High School Diploma	1 year	PG	19 weeks	Homemaker	35
PC13	28	Associate of English	8 years	G2 L1	31 weeks	Homemaker	60
PC14	29	Bachelor of Tourism	1 year	PG	21 weeks	Private company secretary	45

Note: G Gravidity, Ab Abortion, PG  Primigravida, L Live Birth

Main theme and categories

The overarching theme emerging from the qualitative analysis was “Empowering expectant mothers in maternal journey”. This theme encapsulates the dynamic and multifaceted pregnant women’s perceived needs and preferences towards educational resources of perinatal mhealth apps. The findings were organized into three main categories, Need for Holistic Maternal Well-Being, Necessity of Proactive Birth Readiness and Demand for Connected Relationships and Support. Together, they encompass a total of 14 subcategories that address specific educational and supportive needs for expectant mothers, ranging from holistic care to navigating maternity care systems and fostering intimate relationships and support (Table 2).

Table 2.

Sub-Categories, Categories and Overarching Theme Emerged from The Data Analysis

Subcategory	Category	Main theme
Mastering stress and strengthening emotional adaptability	Need for holistic maternal well-being	Empowering expectant mothers in maternal journey
Building daily routines for self-care and resilience
Nutritional wisdom for holistic health
Harmonizing work-life dynamics
Tailored understanding of delivery options	Necessity of Proactive birth readiness
Empowered pain management strategies
Navigating high-risk pregnancy situations
Designing a personalized birth journey
Navigating maternity care systems and hospital choices
Need for enriching maternal-fetal connection	Demand for Connected Relationships and Support
Shared parenting journeys and partner collaboration
Navigating intimacy and sexual health
Building community and peer networks
Spiritual growth and reflective practices

Category 1: Need for holistic maternal well-being

This category reflects the need for holistic well-being, emphasizing physical, emotional, and nutritional empowerment. The participants articulated the importance of maintaining balance and resilience during pregnancy to ensure a healthy journey for both mother and child.

Subcategory 1.1: Mastering stress and strengthening emotional adaptability

Pregnant women expressed a desire for tools to help manage stress, anxiety, and mood fluctuations effectively, as these emotional challenges often impact their overall well-being. Practical resources like mindfulness techniques, guided meditations, and stress-reduction strategies were identified as critical needs. A pregnant woman explained:

“Sometimes, I feel overwhelmed. It would be great if the app had tips to help calm my nerves or even guided meditations” (PC12).

These views indicate that participants were specifically interested in features such as mindfulness exercises and stress management tips to help them maintain emotional stability during pregnancy.

Subcategory 1.2: Building daily routines for self-care and resilience

Participants emphasized the importance of establishing consistent, practical routines that support both physical well-being and emotional balance throughout pregnancy. Rather than seeking generalized wellness advice, they desired structured guidance tailored to their unique needs as expectant mothers—including safe physical activity, relaxation techniques, mental wellness tools, and daily comfort strategies. This integrated approach reflects a growing awareness among women that self-care is not an indulgence, but a foundation for resilience and maternal health.

One participant shared:

“I need a daily plan that helps me stay physically active and mentally calm—like gentle stretches, reminders to rest, or tips on how to feel good in my own body” (PC8).

Another added:

“It would be great if the app offered ideas for small self-care routines I can do at home—nothing complicated, just things that make me feel better and more in control” (PC3).

Participants emphasized the usefulness of educational content that could guide them in maintaining simple and manageable self-care routines—such as exercise, sleep regulation, and emotional check-ins—to help them feel more comfortable and in control throughout pregnancy.

Subcategory 1.3: Nutritional wisdom for holistic health

Participants emphasized the importance of evidence-based dietary recommendations to support their health and that of their baby. Personalized meal plans and nutritional guidance were among the most requested features. In the voice of one pregnant woman:

“It would be so helpful if the app could give me daily meal plans based on what’s best for me and my baby” (PC1).

Participants expressed that having access to personalized nutritional advice would help them feel more confident in making dietary choices suitable for themselves and their babies.

Subcategory 1.4: Harmonizing work-life dynamics

Participants sought advice on managing work responsibilities alongside pregnancy-related physical and emotional demands. One participant shared:

“I’d like tips on how to stay productive but not overwork myself during pregnancy” (PC6).

Providing guidance on work-life balance can help pregnant women navigate professional challenges while prioritizing their health.

Category 2: Necessity of proactive birth readiness

This category underscores the need for educational resources and tools to help mothers make informed decisions and prepare for childbirth.

Subcategory 2.1: Tailored understanding of delivery options

Expectant mothers expressed the need for comprehensive and accessible information on different delivery options, including their benefits and risks. This knowledge was seen as essential for making empowered decisions about childbirth. One participant remarked:

“I want guidance on how to make a birth plan. It would be great if the app could help me choose what options work best for me.” (PC3).

The participants appreciated having information that would help them better understand and plan for different childbirth options, as it contributed to their sense of preparedness.

Subcategory 2.2: Empowered pain management strategies

Pain management during labor was a significant concern for participants, who sought both psychological preparation and practical techniques to reduce discomfort. One of the women expressed:

“It would be great if the app could suggest pain relief techniques or help me prepare mentally for the pain during labor” (PC7).

Women shared that access to both psychological preparation and pain relief strategies in an app would help them feel less anxious and more prepared for childbirth.

Subcategory 2.3: Navigating high-risk pregnancy situations

Many participants shared concerns about unexpected complications during pregnancy, underlining the need for reliable guidance in high-risk scenarios. Resources offering step-by-step instructions for managing emergencies or understanding symptoms were viewed as essential. According to one woman’s experience:

“I worry about what to do if there’s a complication. It would help to have clear instructions for emergencies” (PC4).

Participants wanted the app to offer clear, step-by-step guidance on what to do during complications, indicating that such features could help them feel more secure during high-risk situations.

Subcategory 2.4: Designing a personalized birth journey

Participants valued tools that could assist them in crafting a personalized birth plan, encompassing preferences for labor, delivery, and postpartum care.

“I want guidance on how to make a birth plan. It would be great if the app could help me choose what options work best for me” (PC13).

Participants expressed interest in tools that would help them outline their birth preferences, suggesting that such features would support them in preparing for their desired birth experience.

Subcategory 2.5: Navigating maternity care systems and hospital choices

In addition to making decisions about birth preferences, many participants emphasized the complexity of choosing a maternity care facility and navigating the broader healthcare system. They expressed a need for clear, trustworthy information about the types of available services, hospital reputations, admission processes, and rights during labor and delivery. Participants explained that understanding differences between hospitals and available maternity services was difficult, and they wished the app would help clarify these options.

One participant shared her confusion and desire for guidance:

“I really don’t know which hospital is best or what services they offer. I wish there was something in the app that could compare them or tell me where to go based on my needs” (PC11).

Some women suggested that including hospital comparisons, directories, or firsthand patient experiences in the app would make it easier for them to choose a facility that met their needs.

Category 3: Demand for connected relationships and support

This category emphasizes the importance of fostering emotional bonds and building a supportive network during pregnancy.

Subcategory 3.1: Need for enriching the maternal-fetal connection

Participants highlighted the significance of activities that enhance the maternal-fetal connection, such as talking, singing, or engaging in interactive activities. A participant reflected on this by saying:

“I’d love suggestions on how to bond with my baby—maybe through talking, singing, or other activities” (PC10).

Participants described those activities like talking or singing to their baby helped them feel emotionally connected, and they wished the app would include suggestions for such bonding moments.

Subcategory 3.2: Shared parenting journeys and partner collaboration

Engaging partners in the pregnancy process was seen as a way to strengthen relationships and share responsibilities. As one expectant mother pointed out:

“If the app had ideas for how my husband could be more involved, it would make this experience more meaningful for both of us” (PC9).

Women expressed a desire for app content that included practical ways their partners could become more involved during pregnancy, which they felt would strengthen their shared experience.

Subcategory 3.3: Navigating intimacy and sexual health

Participants requested culturally sensitive and evidence-based guidance on intimacy during pregnancy to address their personal and religious concerns. In the context of Iranian society, where discussions of sexual health may be considered taboo or private, pregnant women emphasized the need for respectful, discreet, and trustworthy educational content aligned with local norms. One participant explained:

“It would be great if the app could help answer questions about what’s safe during pregnancy” (PC8).

Another added:

“Sometimes, I don’t feel comfortable asking my doctor about sexual issues. I wish the app had explanations that I could read privately and that matched our cultural beliefs” (PC13).

Participants wanted trustworthy and culturally appropriate information on intimacy during pregnancy, noting that such content could help them manage concerns and questions they might not feel comfortable discussing elsewhere.

Subcategory 3.4: Building community and peer networks

The need for community connections, such as online forums or local support groups, was frequently mentioned as a way to reduce isolation and share experiences. In the words of a participant:

“I often feel the need to talk to other mothers who are going through the same experience as me.” (PC14).

Many women shared that connecting with other mothers through forums or groups made them feel less isolated, and they hoped the app would include such community features.

Subcategory 3.5: Spiritual growth and reflective practices

Several participants emphasized the role of spirituality and personal reflection in coping with the emotional and physical demands of pregnancy. They described how spiritual practices such as prayer, meditation, and connecting with a higher power provided a sense of calm, meaning, and inner strength during this transitional phase. Participants also expressed interest in guided reflections or faith-aligned content that could be integrated into a mobile app to support their mental and emotional well-being.

One participant reflected:

“Sometimes when I’m overwhelmed, I just need a moment to pray or read something that calms my heart. If the app had a section with spiritual reminders or reflections, it would really help” (PC6).

Participants expressed a strong interest in having spiritual content—such as prayers, calming reflections, or faith-based messages—integrated into the app to support their emotional well-being during pregnancy.

Discussion

The overarching theme, “Empowering Expectant Mothers in the Maternal Journey,” reflects pregnancy as a deeply interconnected physical, emotional, cultural and social experience. Through three main categories—Need for Holistic Maternal Well-Being, Necessity of Proactive Birth Readiness and Demand for Connected Relationships and Support —the findings emphasize the necessity of designing user-centered, culturally sensitive mHealth platforms that support maternal autonomy, preparedness, and well-being.

The findings of this study underscore the importance of addressing pregnant women’s holistic well-being through educational components in mHealth applications. Participants emphasized managing emotional challenges via mindfulness and guided relaxation, aligning with studies highlighting the value of digital tools in stress regulation and emotional support during pregnancy [22, 23].

Equally, establishing structured self-care routines—including light physical activity, rest, and emotional check-ins—was seen as foundational for resilience, particularly in line with recent research during and after the COVID-19 pandemic [24, 25]. This signals a shift in maternal health behavior toward proactive self-regulation rather than reactive care.

Nutritional empowerment emerged as a major priority, with participants seeking personalized meal plans and evidence-based recommendations. These needs are consistent with prior findings that emphasize the lack of accessible, tailored nutritional counseling in routine prenatal care [26, 27]. mHealth platforms can bridge this gap by delivering culturally sensitive dietary content grounded in maternal nutritional science.

Finally, the concern for harmonizing work-life dynamics reflects a demand for practical strategies to balance employment with pregnancy-related health needs. This is supported by studies on occupational stress and pregnancy, which recommend workplace adjustments and psychosocial support for maintaining maternal well-being [28, 29].

The second category underscores a paradigm shift from traditional, provider-led models of care toward collaborative, informed birth planning. Women expressed a strong desire for tailored information about birth options, including benefits, risks, and procedural choices. This aligns with shared decision-making models that prioritize individual agency in healthcare planning [30, 31]. Participants’ call for educational tools that support birth plan development—aligned with their values and health status—highlights this transformation in maternal roles.

The need for empowered pain management—both psychological and physical—reflects a nuanced understanding of childbirth as a multifaceted experience. Participants sought not only technique-based guidance but also emotional preparedness [32]. This confirms earlier research suggesting that preparation can improve confidence, though evidence on its effect on labor-related anxiety remains mixed [33].

High-risk pregnancy scenarios introduced another layer of complexity. Participants voiced a clear demand for step-by-step guidance, including what signs to monitor and how to respond in emergencies. This aligns with Rubin’s work on maternal identity, emphasizing the importance of informed preparedness over passive worry [34–36].

Designing a personalized birth journey and selecting appropriate maternity care settings further demonstrated women’s desire to actively navigate healthcare systems. The findings resonate with the push toward health system literacy, particularly in low- and middle-income contexts, where information asymmetry is high [35]. Participants requested features such as hospital comparison tools, service directories, and logistical support to facilitate decision-making. Notably, participants perceived these tools as potentially helpful means in supporting maternal autonomy and guiding decision-making during late pregnancy.

The third category emphasizes the central role of relational well-being during pregnancy. Participants described bonding with their unborn child as both a psychological and spiritual process. Activities such as speaking, singing, or visualizing the baby were perceived as emotional bridges that could be enhanced through guided suggestions in mHealth platforms [37].

Partner involvement was another consistent theme. Women advocated for content that actively engages their spouses in prenatal care, transforming the experience into a shared parenting journey [38, 39]. These findings parallel growing literature on partner-inclusive prenatal interventions, which have been shown to reduce maternal stress and improve outcomes [40, 41].

The importance of peer support networks also emerged, especially in collectivist cultures like Iran. Participants desired access to forums, community groups, and shared narratives to normalize their experiences and reduce isolation. This reinforces social support theory, which highlights the buffering effect of peer interaction on psychological well-being [23].

Notably, participants expressed the importance of culturally sensitive guidance on sexual intimacy during pregnancy, a topic often overlooked in public health education. In conservative societies, respectful, evidence-based resources within mHealth tools could help bridge the information gap and address women’s private concerns [42].

Finally, spiritual growth and reflective practices were identified as powerful coping mechanisms. Participants viewed prayer, reflection, and faith-based content as sources of comfort and strength. This finding aligns with prior studies in religious settings, emphasizing the need for spiritually integrated health interventions [43].

The primary aim of this study was to explore pregnant women’s perceived educational needs and preferences regarding perinatal mHealth applications. Consistent with this focus, participants largely concentrated on the educational opportunities offered by such tools and expressed strong enthusiasm for the expansion of these features. Consequently, most of the findings emphasized educational content, modes of delivery, and usability, leading to predominantly positive perspectives on mHealth as an educational resource. Although issues such as privacy or a preference for traditional learning were mentioned, they were peripheral to the study aim and did not emerge as dominant themes. This clarification highlights that the scope of the study is specifically centered on the educational dimension of perinatal mHealth applications.

It is important to acknowledge that the first author, a female researcher with expertise in maternal health and qualitative methodology, conducted all interviews. Her gender and professional background facilitated rapport and openness, particularly on sensitive topics such as sexual health, partner involvement and marital intimacy. At the same time, as researchers embedded within the Iranian cultural context, their perspectives and assumptions may have influenced interpretation, particularly regarding culturally specific norms, practices, and expectations.

It is also important to consider geographic and cultural transferability Iran shares many cultural and religious features with other Muslim-majority countries in the Middle East, where similar family values and faith-based practices influence pregnancy and health behaviors. Therefore, several of our findings—such as the need for structured self-care routines, evidence-based nutritional guidance, partner-inclusive educational content, and practical birth-planning tools—are likely transferable to other local nations in the region, provided that educational content is culturally adapted to local norms and language. Studies from Oman [17], and Saudi Arabia [44] also report comparable gaps in antenatal education and reliance on informal or online sources, underscoring that educational priorities identified in our study resonate beyond Iran while requiring adaptation to local norms.

Strengths and limitations

This study provides valuable insight into the perceived educational needs of pregnant women for perinatal mHealth applications in a culturally specific context. Using a qualitative approach, it captures rich, user-centered perspectives that inform the design of relevant and culturally appropriate educational resources, while also offering findings with transferability. Universal needs such as self-care, nutrition, and birth planning can inform app design globally, whereas culturally grounded aspects—such as spirituality and faith-based guidance—are especially relevant for Muslim-majority and Middle Eastern contexts.

Despite the strengths of this study, several limitations should be acknowledged. First, the sample was skewed toward well-educated, smartphone-literate women, which may limit the applicability of findings to less-educated or digitally inexperienced populations. Second, social desirability bias may have influenced participants’ responses, particularly regarding their enthusiasm for educational mHealth content, as women may have felt compelled to provide favorable answers during face-to-face interviews. Third, our study did not include participants who mistrust, resist, or prefer not to use mHealth apps, which means perspectives highlighting potential barriers to adoption were underrepresented. Additionally, the study focused exclusively on educational needs and did not examine broader technical or functional aspects of mHealth applications.

Implications and future directions

The findings of this study underscore the importance of designing perinatal mHealth applications that are not only culturally tailored but also responsive to the specific educational needs and preferences of pregnant women. These insights can inform the development of content that is personalized, scenario-based, and culturally sensitive, moving beyond generic information delivery to support empowerment, autonomy, and informed decision-making. Developers should involve pregnant women in participatory design processes and consider offline functionalities to address digital disparities. Policymakers and healthcare providers can leverage such tools to improve maternal care accessibility and support.

Future research should focus on validating these findings through the design and usability testing of prototype applications that incorporate the identified educational features. In addition, longitudinal studies are needed to explore how women’s educational needs evolve across different stages of pregnancy and how mHealth interventions can adapt accordingly. Further investigation into the integration of these apps into routine antenatal care and their impact on maternal knowledge, self-efficacy, and health outcomes will be essential. Expanding this research to include diverse cultural and healthcare contexts can also support the development of globally relevant, user-centered mHealth solutions that effectively address the multifaceted needs of pregnant women.

Conclusion

This study provides critical insights into the educational content needs and preferences of Iranian pregnant women regarding perinatal mHealth applications. The findings reveal that expectant mothers seek more than basic informational support—they desire personalized, culturally sensitive, and multidimensional educational resources that address the physical, emotional, cognitive, and relational aspects of pregnancy. The identified categories highlight the importance of designing mHealth platforms that empower users through relevant, actionable, and contextually meaningful content.

By centering the voices of pregnant women, this study provides a nuanced understanding of their perceived needs and preferences regarding the educational components of perinatal mHealth applications. The findings emphasize the importance of promoting self-care, emotional regulation, tailored routines, and culturally sensitive content to support holistic maternal well-being. These insights call for user-centered and context-specific educational strategies in the design of mHealth interventions. Future research should focus on translating these identified needs into actionable app features, followed by usability testing and outcome evaluation in real-world settings. In doing so, mHealth technologies can more effectively respond to the day-to-day realities of pregnancy and contribute to more equitable, supportive, and personalized care.

Abbreviations

mhealth

mobile health

Authors’ contributions

All authors contributed to conceptualization and design of the study. FA prepared the initial draft of the manuscript, and RLR, FT, and FA revised and refined it. RLR conducted a critical review of the manuscript for intellectual content. All authors approved the final manuscript and are collectively responsible for ensuring the accuracy and integrity of the work.

Funding

This research was supported by Mashhad University of Medical Sciences, Mashhad, Iran (Grant Number: 4000201).

Data availability

The datasets generated and analyzed during this study are not publicly accessible to protect participant privacy. However, data can be requested from the corresponding author under reasonable conditions.

Declarations

Ethics approval and consent to participate

The study was conducted in accordance with the ethical guidelines approved by the Ethics Committee of Mashhad University of Medical Sciences, Mashhad, Iran (Ethical Code: IR.MUMS.REC.1400.179). Written informed consent was obtained from all participants, ensuring they were fully aware of their rights, including the option to withdraw at any time without repercussions. Confidentiality and anonymity were upheld by removing identifying information, encrypting data, and restricting access to the research team only.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.