Maternal Mental and Physical Health in Birth Decision-Making: A Systematic Qualitative Review from Tamil Nadu, India Short Running Title: “Maternal Health and Birth Decisions in Tamil Nadu.”

Maternal mental health Psychological safety Birth decision-making Autonomy Tamil Nadu Qualitative synthesis

Authors

  • Meera Mohan PhD Scholar, Center of Psychology and Behavioral Sciences, Shoolini University, Solan, Himachal Pradesh, India, Assistant Professor, KLH University, Hyderabad, India,
  • Dr. Nisha Kumari Associate Professor, Centre of Psychology and Behavioral Sciences, Shoolini University, Solan, Himachal Pradesh, India
  • Sumit Singh Centre of Psychology and Behavioral Sciences, Shoolini University, Solan, Himachal Pradesh, India
November 2, 2025
November 3, 2025

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Background: This review explores how maternal mental and physical health interact to shape childbirth decision-making in Tamil Nadu, India.

Methods: Following PRISMA 2020 guidelines, qualitative studies published from 2015 to 2025 were reviewed using the PEOS framework. Sixteen studies involving approximately 825 participants were synthesised through thematic analysis.

Results: Six major themes emerged: perceived medical necessity, fear and trauma, autonomy, recovery concerns, family support, and institutional trust. Findings highlight that women’s psychological safety often outweighs clinical advice in birth decisions.
Conclusion: Maternal decision-making reflects an ongoing negotiation between physical health and emotional control. Integrating trauma-informed, person-centered care in Tamil Nadu’s maternal programmes is recommended.