Influencing factors in choosing delivery method

Iranian primiparous women’s perspective

Authors

  • Sepideh Gareh Sheikhlou Department of Obstetrics and Gynecology, Dezful University of Medical Sciences, Dezful, Iran

Keywords:

Primiparous Women, Cesarean Section, Vaginal Delivery, Influencing Factors

Abstract

Background: Studies on the primiparous mothers’ decision on delivery method are limited. 

Aim: The aim of his study was to determine the factors that influence the choice of delivery method by Iranian primiparous women.

Methods: This cross-sectional study was conducted in April through September 2014. Participants were 460 primiparous women in 8 hospitals of 4 cities in Iran. Finally, 230 cesarean section and 230 vaginal delivery women were selected. Inclusion criteria were being primiparous, and having no contraindication for vaginal delivery. Study tool was a researcher-developed questionnaire that its validity and reliability were proved. Data were gathered by direct interview and analyzed by SPSS version 16. 

Results: Average age of the participants was 23 years. Factors that correlated with the choice of Cesarean section were upper education, high socioeconomic level, tendency of husband, living with the husband’s family, insistence of the physician, receiving maternal care in personal offices, fear of delivery pain, low knowledge of the mother, high age of marriage and pregnancy, history of abortion, and lack of family support. More than 60% of the participants had little knowledge about the delivery methods. Satisfaction with cesarean section was 70% and with the vaginal delivery was 77%. Half of the cesareans were performed on the insistence of the physician.

Conclusion: Considering the factors identified in this study, can enforce the intention of mothers to have vaginal delivery by improving their knowledge and perception about this delivery method.

References

David H, Norman J. Gynecology illustrated. 5, editor. London: Churchill Livingstone Co; 2000.

Malcolm S, Ian M. Essential obstetrics and Gynecology. edition T, editor: Churchill LivingstoneCo; 1998.

Cunningham F, Leveno K, Bloom S, Fauser J, Zwirner M. Williams Obstetrics. 22, editor. New York:

Graw-Hill; 2005.

Betran AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, et al. Rates of caesarean section:

analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007;21(2):98-113. PMID:

, DOI: 10.1111/j.1365-3016.2007.00786.x

Hart D, Norman J, Callander R, Govan A. Gynaecology illustrated. 5th, editor. London: Churchill

Livingstone; 2000.

Hopkins K. Are Brazilian women really choosing to deliver by Cesarean. Soc Sci Med. 2000;51(5):725-40.

DOI: 10.1016/S0277-9536(99)00480-3, PMID: 10975232

Murray S. Relation between private health insurance and high rates of caesarean section in Chile:

qualitative and quantitative study. BMJ. 2000;321(7275):1501-5. PMID: 11118176, PMCID: PMC27552

Mohammaditabar S, Kiani A, Heydari M. The survey on tendencies of primiparous women for selecting

the mode of delivery. J Babol Univ Med Sci. 2009;11(50):54-9.

Torkzahrani S. Commentary: childbirth education in Iran. J Perinat Educ. 2008;17(3):51-4. PMID:

, PMCID: PMC2517184 DOI: 10.1624/105812408X329601

shareferad G, fathean Z, Terane M, Mahake B. The Survey of pregnant women views about delivery and

cesarian According Behavioral intention model. Elam Uni Med Sc J. 2007;15(1):19-23.

Azami-aghdash S, Ghojazadeh M, Dehdilani N, Mohammadi M, Asl amin abad R. Prevalence and Causes

of Cesarean Section in Iran: Systematic Review and Meta-Analysis. Iranian J Publ Health. 2014;43(5):545- 55. PMID: 26060756, PMCID: PMC4449402

Ananth CV, Vintzileos AM. Trends in cesarean delivery at preterm gestation and association with perinatal

mortality. Am J Obstet Gynecol. 2011;204(6):31. PMID: 21457916, DOI: 10.1016/j.ajog.2011.01.062

Cheng YW, Eden KB, Marshall N, Pereira L, Caughey AB, Guise JM. Delivery after prior cesarean:

maternal morbidity and mortality. Clin Perinatol. 2011;38(2):297-309. PMID: 21645797, PMCID:

PMC3428794 DOI: 10.1016/j.clp.2011.03.012

Huang X, Lei J, Tan H, Walker M, Zhou J, Wen SW. Cesarean delivery for first pregnancy and neonatal

morbidity and mortality in second pregnancy. Eur J Obstet Gynecol Reprod Biol. 2011;158(2):204-8.

PMID: 21641102, DOI: 10.1016/j.ejogrb.2011.05.006

Cunningham F. Williams Obstetrics. 22, editor: Golban Publications; 2005.

Arjmandi B, Farzin M. Assessment of the Level of the Pregnant Womens Knowledge Towards the

Advantages and Disadvantages of Normal Vaginal Delivery and Cesarean Section, Tehran(2005). J Iran

Univ Medl Sci. 2007;14(55).

Monari F, Mario S, Facchinetti F, Basevi V. Obstetricians’ and midwives’ attitudes toward cesarean

section. Birth. 2008;35(2):129-35. PMID: 18507584, DOI: 10.1111/j.1523-536X.2008.00226.x

Bahrie M, Latifnejad R, Abdollahian E, Esmaili H. Effect of midwife’s psycologiy & physical &

Educational supportive in duration of labor stages and lobor pain force. J Sabzevar Univ Medl Sci

;11(1):23-4.

Asghar M, Parivash A, Fatemeh R, Arezoo A, Hossein A. Investigating the Choice of Delivery Method

Type and Its Related Factors in Pregnant Women in Maragheh. Knowledge & Health. 2009;4(1):36-9.

Alavije Z, Shahry P, Kalhory M, Haghighizadeh M, Sharifirad G, Khorsandi M. Identification of factors

related to elective cesarean labor: a theory-based study. Daneshvar (medicine) Shahed University.

;96:1-11.

Sharghi A, Kamran A, Sharifirad G. Factors Influencing Delivery Method Selection in Primiparous

Pregnant Women Referred to Health Centers in Ardabil, Iran. J Health Syst Res. 2011;7(3):364-72.

Alimohamadian M, Shariat M, Mahmoodi M, Ramezanzadeh F. The survey of impact of pregnant women's

request in selected cesarean. Payesh. 2003;2:133-9.

Behague D, Victora C, Barros F. Consumer demand for caesarean sections in Brazil: informed decision

making, patient choice, or social inequality? A population based birth cohort study linking ethnographic

and epidemiological methods. BMJ. 2002;324(7343):942-5. PMID: 11964338, PMCID: PMC102326

SHareat M, Majlasei F, Azarei S, Mahmodei M. Cesarean section rate and its determinants in maternity

hospitals in Tehran. Payesh. 2002;1(3):5-10.

Faraji Dor Khaneh R, Zahiri S, Farjad B. Knowledge and Attitudes of pregnant women to normal delivery

methods. J Guilan Univ Med Sci. 2003;12(46):69-75.

Signorelli C, Cattaruzza M, Osborn J. Risk factors for caesarean section in Italy: results of a multicentre

study. Public Health. 1995;109(3):191-9. DOI: 10.1016/S0033-3506(05)80052-6, PMID: 7597132

Menacker F, Declercq E, Mac M. Cesarean delivery: background, trends, and epidemiology. Semin

Perinatol. 2006;30(5):235-41. PMID: 17011392, DOI: 10.1053/j.semperi.2006.07.002

Anderson E. Health and disease prevention. Nursing Outlook. 1996;10(5):1105-252.

Graham W, Hundley V, McCheyne A, Hall M, Gurney E, Milne J. An investigation of women's

involvement in the decision to deliver by caesarean section. Br J Obstet Gynaecol. 1999;106(3):213-20.

PMID: 10426639

Published

2022-01-18

Issue

Section

Articles