Background: To meet the Millennium Development Goal #5 of a 75% reduction in maternal mortality by 2015, international organizations recommend that all women give birth assisted by a skilled birth attendant. However, less than half of all Tanzanian women give birth with a skilled birth attendant, and Tanzania's healthcare provider shortage, especially in rural areas, makes it challenging for hospitals to provide individualized high-quality childbirth support which may make it difficult to attract more women to hospitals for delivery. Unfortunately, few studies have focused on the perceptions of mothers who gave birth in a hospital. To improve quality of childbirth support with limited resources, this study describes mothers' perceptions of childbirth support at a hospital in rural Tanzania.

Methods: A purposive sample of 28 mothers was interviewed within 24 hours after delivery at a hospital. Semi-structured qualitative interviews were conducted with an interpreter. Interviews were audio-recorded, transcribed, and translated into English. The English transcripts were coded and reviewed repeatedly; two major themes emerged.

Results: The two themes were: (1) Women described "help" as professional assistance that safeguards life-threatening childbirth; (2) Family support is complementary to professional support in a hospital birth. In the first theme, most mothers appreciated technological support, whereas some mothers preferred no technological support unless there was a complication. A few mothers said they received inadequate support due to very busy staff. In the second theme, most mothers described the importance of physical and informational support of family. Others also valued presence of family for their feelings of security and affection; however, family was often outside the room when a mother was delivering.

Conclusions: Results suggest that mothers who come to the hospital for birth appreciate having skilled attendants to safeguard themselves and their infants, as is appropriate given Tanzania's high maternal mortality ratio (578 per 100,000 compared to the global rate of 229 and a European rate of 7). Mothers would also like to have family present. Increased inclusion of family members should be instituted to better meet mothers' needs and to potentially mitigate some aspects of staff burden.