Implementation of Targeted Education to Promote Normal Vaginal Delivery: A Randomized Controlled Trial

Document Type : Original Article

Authors

1 M.Sc. Student of Health Education, Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Instructor, Department of Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Associate Professor, Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Introduction: It is widely reported that the complications of Caesarean-section (C- section) delivery are much more than the normal vaginal delivery (NVD) in Iran. The purpose of this study was to determine the effect of targeted education on the mode of delivery in pregnant women.
Methods: A randomized controlled trial was conducted among 72 primiparous women at their 20-25 weeks of gestational age in Isfahan, Iran, during 2015. The sample was randomized into two groups of 36 people. A pre-test was performed using a questionnaire on knowledge, attitude, perceived self-efficacy, perceived social support, and intention to choose the delivery mode. The experimental group (including the women and their spouses) received specialized educational messages in a form of a computer file based on their scores obtained from each part of the pre-test data. At 37 weeks of pregnancy, post-test was administered to both study groups using the questionnaire and the mode of delivery was recorded in the questionnaire after the birth. The analysis of data was conducted using SPSS through the Chi-square test, independent t-test، and paired t-test.
Results: Before the intervention, no significant difference was observed in terms of the studied variables between two the groups (P=0.71). However, the mean score in the experimental group was higher than that of the control group after the intervention (P<0.001). The definite decision to choose NVD in the experimental group also increased from 30.6% to 58.3% which was significantly more than that of the control group (P=0.03). The frequency of NVD was significantly higher in the experimental group, compared to the control group (P=0.04).
Conclusion: The utilization of targeted educational messages through computer based on knowledge, self-efficacy, attitude, and perceived social support could result in NVD selection. Therefore, it is suggested to provide new strategies to offer educational messages, such as targeting education in community health centers.

Keywords

References

  1. Zgheib SM, Kacim M, Kostev K. Prevalence of and risk factors associated with cesarean section in Lebanon - A retrospective study based on a sample of 29,270 women. Women Birth 2017; 30(6):e265-71.
  2. Betran AP, Torloni MR, Zhang JJ, Gulmezoglu AM; WHO Working Group on Caesarean Section. WHO statement on caesarean section rates. BJOG 2016; 123(5):667-70.
  3. Olieman RM, Siemonsma F, Bartens MA, Garthus-Niegel S, Scheele F, Honig A. The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review. BMC Pregnancy Childbirth 2017; 17(1):195.
  4. Hassani L, Aghamolaei T, Ghanbarnejad A, Dadipoor S. The effect of an instructional program based on health belief model in decreasing cesarean rate among primiparous pregnant mothers. J Educ Health Promot 2016; 5:1.
  5. 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. Iran J Public Health 2014; 43(5):545-55.
  6. Darsareh F, Aghamolaei T, Rajaei M, Madani A. Determinants of caesarean birth on maternal demand in the Islamic Republic of Iran: a review. East Mediterr Health J 2017; 23(6):441-8.
  7. Darsareh F, Aghamolaei T, Rajaei M, Madani A, Zare S. The differences between pregnant women who request elective caesarean and those who plan for vaginal birth based on Health Belief Model. Women Birth 2016; 29(6):e126-32.
  8. Fenwick J, Toohill J, Creedy DK, Smith J, Gamble J. Sources, responses and moderators of childbirth fear in Australian women: a qualitative investigation. Midwifery 2015; 31(1):239-46.
  9. Sercekus P, Okumus H. Fears associated with childbirth among nulliparous women in Turkey. Midwifery 2009; 25(2):155-62.
  10. Keshavarz Z, Ghazanfarian A, Simbar M, Shakeri N. Effect of educational intervention based on theory of planned behavior (TPB) in selecting mode of delivery. Iran J Obstet Gynecol Infertil 2016; 19(27):1-7. (Persian).
  11. Ghotbi F, Akbari Sene A, Azargashb E, Shiva F, Mohtadi M, Zadehmodares S, et al. Women's knowledge and attitude towards mode of delivery and frequency of cesarean section on mother's request in six public and private hospitals in Tehran, Iran, 2012. J Obstet Gynaecol Res 2014; 40(5):1257-66.
  12. Matinnia N, Haghighi M, Jahangard L, Ibrahim FB, Rahman HA, Ghaleiha A, et al. Further evidence of psychological factors underlying choice of elective cesarean delivery (ECD) by primigravidae. Braz J Psychiatr 2018; 40(1):83-8.
  13. Zamani-Alavijeh F, Araban M, Hassanzadeh A, Makhouli K. Contributing factors of pregnant women's beliefs towards mode of delivery: a cross-sectional study from Iran. Matern Health Neonatol Perinatol 2018; 4:9.
  14. Moasheri BN, Sharifzadeh G, Soltanzadeh V, Khosravi Givshad Z, Rakhshany Zabol F. Relationship between fear of pain, fear of delivery and attitude towards cesarean section with preferred mode of delivery among pregnant women. Iran J Obstet Gynecol Infertil 2016; 18(179):8-16. (Persian).
  15. Wang E. Requests for cesarean deliveries: the politics of labor pain and pain relief in Shanghai, China. Soc Sci Med 2017; 173:1-8.
  16. Abedian Z, Navaee M, Jaafari Sani H, Arani A, Ebrahimzadeh S. Comparing the effect of two teaching methods, role playing and lecture on primigravida women’s knowledge, attitude and performance according to delivery mode. Iran J Obstet Gynecol Infertil 2012; 15(1):26-34. (Persian).
  17. Kennedy HP, Doig E, Tillman S, Strauss A, Williams B, Pettker C, et al. Perspectives on promoting hospital primary vaginal birth: a qualitative study. Birth 2016; 43(4):336-45.
  18. Hawkins RP, Kreuter M, Resnicow K, Fishbein M, Dijkstra A. Understanding tailoring in communicating about health. Health Educ Res 2008; 23(3):454-66.
  19. Sayakhot P, Carolan-Olah M, Steele C. Use of a web-based educational intervention to improve knowledge of healthy diet and lifestyle in women with gestational diabetes mellitus compared to standard clinic-based education. BMC Pregnancy Childbirth 2016; 16(1):208.
  20. Park EJ, Mcdaniel A, Jung MS. Computerized tailoring of health information. Comput Inform Nurs 2009; 27(1):34-43.
  21. Lumluk T, Kovavisarach E. Effect of antenatal education for better self-correct diagnosis of true labor: a randomized control study. J Med Assoc Thai 2011; 94(7):772-7.
  22. Khaledi GH, Mostafavi F, Eslami AA, Afza HR, Akbar H. Evaluation of the effect of perceived social support on promoting self-care behaviors of heart failure patients referred to the Cardiovascular Research Center of Isfahan. Iran Red Crescent Med J 2015; 17(6):e22525.
  23. Fathian Z, Sharifirad GR, Hasanzadeh A, Fathian Z. Study of the effects of behavioral intention model education on reducing the cesarean rate among pregnant women of Khomeiny-Shahr, Isfahan, in 2006. Zahedan J Res Med Sci 2007; 9(2):123-31. (Persain).
  24. Zamani-Alavijeh F, Shahry P, Kalhori M, Araban M. Pregnant women's preferences for mode of delivery questionnaire: psychometric properties. J Educ Health Promot 2017; 6:20.
  25. Masoumi SZ, Kazemi F, Oshvandi K, Jalali M, Esmaeili-Vardanjani A, Rafiei H. Effect of training preparation for childbirth on fear of normal vaginal delivery and choosing the type of delivery among pregnant women in Hamadan, Iran: a randomized controlled trial. J Family Reprod Health 2016; 10(3):115-21.
  26. Bates SB, Riedy CA. Changing knowledge and beliefs through an oral health pregnancy message. J Public Health Dent 2012; 72(2):104-11.
  27. Bitew Y, Awoke W, Chekol S. Birth preparedness and complication readiness practice and associated factors among pregnant women, Northwest Ethiopia. Int Sch Res Notices 2016; 2016:8727365.
  28. Alhaidari T, Amso N, Jawad TM, Alnakkash U, Khazaal F, Alnaaimi A, et al. Feasibility and acceptability of text messaging to support antenatal healthcare in Iraqi pregnant women: a pilot study. J Perinat Med 2018; 46(1):67-74.
  29. Salomonsson B, Alehagen S, Wijma K. Swedish midwives' views on severe fear of childbirth. Sex Reprod Healthc 2011; 2(4):153-9.
  30. Tilden EL, Emeis CL, Caughey AB, Weinstein SR, Futernick SB, Lee CS. The influence of group versus individual prenatal care on phase of labor at hospital admission. J Midwifery Womens Health 2016; 61(4):427-34.
  31. Tsai YJ, Hsu YY, Hou TW, Chang CH. Effects of a web-based antenatal care system on maternal stress and self-efficacy during pregnancy: a study in Taiwan. J Midwifery Womens Health 2018; 63(2):205-13.
  32. Munro S, Hui A, Salmons V, Solomon C, Gemmell E, Torabi N, et al. SmartMom Text messaging for prenatal education: a qualitative focus group study to explore Canadian women's perceptions. JMIR Public Health Surveill 2017; 3(1):e7.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 21, Issue 10
December 2018
Pages 66-74

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