- The limited capability of non-midwifery staff in maternity cares
- Physical weakness of many midwives due to a relatively high age
- Insufficient motivation of many midwives due to low salaries
-Lack of human resources in this area, especially midwives
- Lack of sufficient number of gynecologists in some public health centers
- The large number of duties in MHP
-The high work pressure on midwives, especially during peak hours
- Excessive workload on midwives caused by other health personnel
- The high number of unnecessary questions included in the care system
- A system that is not user-friendly
- Non-compliance of the system with protocols in some professional activities
- The dual role defined for the midwives in the system
- Entering false and unrealistic services into the system
- The low speed of care system
- Creation of false data and statistics due to entering unrealistic cares
- No specific aim to use the produced data in the system
-Inaccessibility of the produced data to the health personnel
- The lack of paper documents
-The lack of alternative paper-forms to be used during system errors and problems
- The absence of a caring midwife at the time of delivery
- Lack of coordination between private and public centers
- The problem of early detection of pregnant mothers in cities
- The poor coordination of hospitals with health centers in referral cases
- Unnecessarily referrals of patients by physicians
- Low tendency of mothers to receive services from public centers
- Unrealistic expectations of mothers from midwives, especially in rural areas
- Using the title “health care provider” for the midwives
- Taking a quantitative approach towards maternity care
- Lack of special examination rooms for the midwives
-A large number of stairs in the buildings and the lack of an elevator
- Poor physical condition of many public centers
- Inadequate number of medical equipment in some private health centers such as weighing scales and barometers
-Using defective equipment such as barometer etc.
- Limited laboratory facilities for pregnancy cares
- Focusing on quantitative evaluation indices and disregarding qualitative ones
- The high number of indices and defined norms for evaluation
-Poor verification of the provided care statistics
- Poor supervision of cares, especially in private health centers
- Inappropriate geographical location of some health centers
