Exploring the childbearing decision-making process in mothers of children with autism spectrum disorder and designing and validation of a childbearing program: A study protocol

Mahla Salarfard; Talat Khadivzadeh; Javad Moghri; Kobra Mirzakhani

doi:10.1186/s12978-025-02142-7

Exploring the childbearing decision-making process in mothers of children with autism spectrum disorder and designing and validation of a childbearing program: A study protocol

Reprod Health. 2025 Oct 1;22(1):178. doi: 10.1186/s12978-025-02142-7.

Authors

Mahla Salarfard¹, Talat Khadivzadeh², Javad Moghri^{3

4}, Kobra Mirzakhani^{5

6}

Affiliations

¹ Student Research Committee, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
² Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
³ Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
⁴ Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
⁵ Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. Mirzakhanik@mums.ac.ir.
⁶ Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Mirzakhanik@mums.ac.ir.

Abstract

Background: One of the most important demographic challenges in the world over the last three decades has been the significant decline in fertility rates. Fertility decision making is one of the major events in a couple's life and can be a complex process, especially for families who have a child with a history of a multifactorial disease, such as autism spectrum disorder. Therefore, the present study will be aim to discover the childbearing decision-making process in mothers of children with autism spectrum disorder and design and validate a childbearing program for this mothers.

Methods: The present study will be conducted in three phases. In the first stage, a qualitative research will be conducted using the Strauss and Corbin grounded theory approach. In this study, the main participants are mothers who have at least one autistic child, who meet the inclusion criteria for the study. In the first phase, sampling will be done with purposive and theoretical method. The date will be gathered through semi-structured in-depth interviews, field notes, and observations of individual interactions. The Strauss and Corbin 2015 approach will be used to analyze the data. MAXQDA 2020 software will be used for managing the process of data analysis. In the second phase of the present study, a program using a logic model will be designed to support decision-making regarding childbearing among mothers of children with autism. Finally, validation of the developed program will be achieved by using the nominal group technique with a panel of experts during the third phase.

Discussion: In this research, as a result of the needs, challenges and problems of mothers of children with autism spectrum disorder in the context of their decision to have children, a supportive program will be presented using a logical model that is suitable for policy makers, planners and service providers to be implemented in the socio-cultural context of the study.

Keywords: Autism spectrum disorder; Decision making; Fertility; Grounded theory; Logic model; Nominal group technique.

MeSH terms

Adult
Autism Spectrum Disorder* / psychology
Child
Decision Making*
Family Planning Services*
Female
Humans
Mothers* / psychology
Pregnancy
Qualitative Research
Research Design