Exploring Factors Influencing Pregnant Women’s Perceptions and Attitudes Towards Midwifery Care in Romania: Implications for Maternal Health Education Strategies

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Authors,

Thank you so much for this interesting and timely research article. I have read through and I appreciate the quality of the writing as reflected in this article. However, there are a few issues that you need to attend to for the article to be better and more scientifically sound.

-Kindly delete..."
 Public health is important for everyone, and .." in the first line of introduction and let the sentence begin with the tone of the title for example...."maternity services hold a unique....."

-Line 44-53, there is a need to contextualize information in this section by citing the relevant authors.

-The authors must contextualize and acknowledge author/s whose arguments they are using in lines 79-121. Otherwise, the way it is presented here depicts serious plagiarism. This applies to the larger chunk of information in the introduction section. Kindly, revise,

-line 141, argument that midwives are strong advocates for vaginal birth, according to who?

-line 152, instead of research let it read 'the aim of this article"

-In the methods, the authors indicate that the questionnaire could not be submitted until all the questions are responded to. However, in the results section, they indicate that 18 participants were excluded due to incomplete responses. Revisit this for clarity.

-In the discussion section, the statement 'in the recent year' in line 239 is vague as it does not bring out specificity clearly.

-what context are the authors referring to about Some women who reported not receiving additional information about age-related risks in lines 245-247?

-The authors need to advance their argument in lines 264-267. Rather than mentioning that the results are supported by previous studies. What does the statistical significance mean in terms of the main objective of this article?

-Lines 280-283 can be moved to the recommendations section. Authors need to create a sub-section for this.

-there are two short paragraphs in lines 296-300, they are not discussions but rather sound like findings. The authors should consider merging the two and discuss them.

-In the conclusion section, the authors need to summarize the key findings from this study rather than repeating key themes. Moreover, they need to mention who should do what exactly for instance, line 338..........." promoting healthier and more woman- and child-centered perinatal care.."

-References are current and to the point.

-I will be happy to read an improved version of this manuscript.

Good luck

Comments on the Quality of English Language

Averagely good.

Author Response

Authors’ response to reviewer’s 1 comments

We are grateful to the reviewer for the careful evaluation of our manuscript and for the constructive suggestions; all of them helped us to further improve the quality of our manuscript.

            We appreciate the thorough work of the reviewer and all the comments. We believe that we could fix his suggestions. We performed a minor English spell check that reviewer said is required.

We performed an extensive reworking the introduction, research design, the methods, results, and the conclusions of the manuscript. All modifications are included in the revised manuscript in highlights.

Comments and Suggestions for Authors

Dear Authors,

Thank you so much for this interesting and timely research article. I have read through and I appreciate the quality of the writing as reflected in this article. However, there are a few issues that you need to attend to for the article to be better and more scientifically sound.

Thank you for your kind words.

-Kindly delete..."

 Public health is important for everyone, and .." in the first line of introduction and let the sentence begin with the tone of the title for example...."maternity services hold a unique....."

Answer: We deleted the suggested phrase.

-Line 44-53, there is a need to contextualize information in this section by citing the relevant authors.

Answer: we cited the relevant authors as the reviewer so kindly suggested.

-The authors must contextualize and acknowledge author/s whose arguments they are using in lines 79-121. Otherwise, the way it is presented here depicts serious plagiarism. This applies to the larger chunk of information in the introduction section. Kindly, revise,

Answers: we cited the relevant authors as the reviewer so kindly suggested.

-line 141, argument that midwives are strong advocates for vaginal birth, according to who?

Answers: we cited the relevant authors as the reviewer so kindly suggested.

-line 152, instead of research let it read 'the aim of this article"

Answers: The suggested modification has been made.

-In the methods, the authors indicate that the questionnaire could not be submitted until all the questions are responded to. However, in the results section, they indicate that 18 participants were excluded due to incomplete responses. Revisit this for clarity.

Answers: We have reviewed and corrected it.

-In the discussion section, the statement 'in the recent year' in line 239 is vague as it does not bring out specificity clearly.

Answers: We have reviewed and corrected it

-what context are the authors referring to about Some women who reported not receiving additional information about age-related risks in lines 245-247?

Answers: The sentence refers to information from other studies. We have made the clarification suggested in the article.

-The authors need to advance their argument in lines 264-267. Rather than mentioning that the results are supported by previous studies. What does the statistical significance mean in terms of the main objective of this article?

Answers: We have made the clarification suggested in the article.

-Lines 280-283 can be moved to the recommendations section. Authors need to create a sub-section for this.

Answers: We have made the suggested modification.

-there are two short paragraphs in lines 296-300, they are not discussions but rather sound like findings. The authors should consider merging the two and discuss them.

Answers: We have made the suggested modification.

-In the conclusion section, the authors need to summarize the key findings from this study rather than repeating key themes. Moreover, they need to mention who should do what exactly for instance, line 338..........." promoting healthier and more woman- and child-centered perinatal care.."

Answers: We have reformulated the conclusions according to the suggestions

-References are current and to the point.

-I will be happy to read an improved version of this manuscript.

Thank you!

Reviewer 2 Report

Comments and Suggestions for Authors

Please see attached file.

Comments for author File: Comments.pdf

Author Response

Authors’ response to reviewer’s 2 comments

We are grateful to the reviewer for the careful evaluation of our manuscript and for the constructive suggestions; all of them helped us to further improve the quality of our manuscript.

            We appreciate the thorough work of the reviewer and all the comments. We believe that we could fix his suggestions. We performed an English spell check of the manuscript.

We performed an extensive reworking the introduction, research design, the methods, results, and the conclusions of the manuscript. All modifications are included in the revised manuscript in highlights.

Thank you for opportunity to reviewing the original paper:

Exploring Factors Influencing Pregnant Women's Perceptions and Attitudes Towards

Midwifery Care: Implications for Maternal Health Education Strategies

We thank you for your input!

My detailed comments to the authors:

Title

Exploring Factors Influencing Pregnant Women's Perceptions and Attitudes Towards

Midwifery Care in Romania: Implications for Maternal Health Education Strategies

Answer:  We change the title as suggested.

Abstract

The aim of the study should be mentioned.

Answer:   We added the purpose of the study as suggested.

The method used in the project should be mentioned.

Answer:   We added the method used in the project as suggested.

There are few technical errors – punctuation and spacing (in whole text).

 Answer:   We have corrected the technical errors

Keywords: 

I suggest to adding midwifery care

Answer:   We added the midwifery care as suggested.

Introduction

Line 51 – please explain of TORCH abbreviation

Answer:   We have explained the meaning of TORCH abbreviation

Line 152 – the aim of the study should be clearly stated:

The aim of this research is to identify specific variables that affect the perceptions and

attitudes of pregnant women towards care provided by midwives.

This knowledge could contribute the development of more effective education and information

strategies within maternal health services.

Answer:    We change the aim as suggested.

Material and Methods

In this section is mish mash and it should be ordered as follow:

Method – inclusion/exclusion criteria – detailed survey description – the course of the study –

statistical methods

Answer:   We have rearranged the method as you suggested

Lines 206-219 should be transfer to the section Survey Questionnaire

Answer:  We have transferred the paragraph as you suggested

Results

In my opinion would be good to add in this section additional table showing data from 3 main

question mentioned in lines: 206-219.

Answer:  We added the table as you suggested

Conclusions

Line 335 - The main factors as ….,  influencing women's decisions regarding perinatal

Line 344 - reducing unnecessary medically unreasonable cesareans.

Answer:  We rewrote the conclusions as you suggested

Thank you!

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Authors

Thank you for addressing the review comments comprehensively. Looking forward to reading this article.

All the best in other processes.