Assessing pregnant women's beliefs, behavioral intention and predictive factors for cesarean section in Hamadan

Document Type : Original Article

Authors

1 Assistant professor, Research Center for Health Sciences, Faculty of Health, Hamadan University of Medical Sciences, Hamadan, Iran.

2 Associate Professor of Health Education, School of Public Health& Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Professor of Vital Statistics, School of Public Health, Hamadan, Hamadan University of Medical Sciences, Iran.

4 PhD student in Health Education, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Abstract

Introduction: Cesarean section delivery is more dangerous than normal delivery for mother and neonate. In many cases wrong beliefs, norms, and unawareness persuade and determine mode of delivery. The aim of this study was to determine women's beliefs, behavioral intention, and predictive factors for requesting cesarean section.
 
Methods: This descriptive-analytical study was performed on 346 pregnant women referred to Hamedan health centers and obstetrics clinic. Samples were randomly selected and data related to the demographic variables, beliefs and behavioral intention toward delivery method, and predictors of willingness to select cesarean method were collected using questionnaire and interview. Data were analyzed by SPSS version 11.
 
Results: Willingness to perform an elective cesarean section was 50.2% versus 44.2% for normal delivery. Main reasons to perform a cesarean section were: Obstetricians' suggestion (49.4%, n=86) and having painless delivery (36%, n=63). Logistic regression revealed that, previous cesarean, tube ligation after cesarean section, planned delivery, spouse' willingness and safety of neonatal were determinant factors in cesarean section (p<0.05). Rising mothers’ literacy, employment, increase in age, and first pregnancy increased the requests for cesarean section in pregnant women (p<0.05).
 
Conclusion: By identifying, modifying and improving women's beliefs to normal vaginal delivery and also providing standard conditions for normal delivery could reduce rate of non-medical causes of cesarean section. Providing educational and counseling services for families by health centers and mass media is suggested.

Keywords

References

1. Shariat M, Majlesi F. Ceasarean section in maternity hospitals in Tehran, Iran. Payesh, J Iran Inst Health Sci Res
2002; 1(3):5-10. (Full Text in Persian)
2. Nuttall C. Caesarean section controversy. The caesarean culture of Brazil (letter). BMJ 2000;320(7241):1074
3. Tita AT, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW,et al. Timing of Elective Repeat Cesarean
Delivery at Term and Neonatal Outcomes. N Engl J Med 2009;360 (2):111-120
4. Lothian AJ.The cesarean catastrophe, J Perinat Educ 2006;15(1):42-5.
5. Belizán JM, Althabe F, Barros FC, Alexander S. Rates and implications of cesarean sections in Latin America:
ecological study. BMJ 1999; 319:1397-400.
6. Murray SF. Relation between private health insurance and high rates of cesarean section in Chile: quantitative and
qualitative study. BMJ 2000;321:1501-5.
7. Mohammadpourasl A, Rostami F, Torabi S. Prevalence of cesarean section and its demographic correlates in
Tabriz. Med J Tabriz Univ Med Sci 2006;28(3):101-5. (Full Text in Persian)
8. Alimohammadian M, Shariat M, Mahmoudi M, Ramezanzadeh F. The influence of maternal request on the
elective cesarean section rate in maternity hospitals in Tehran. Payesh, J Iran Inst Health Sci Res 2003; 2(2):133-9.
(Full Text in Persian)
9. Hajian K. The trend of cesarean section in public and private centers of 1994-99 J Shaheed Beheshti Univ Med Sci
Health Serv 2002;26(3):175-179. (Full Text in Persian)
10. Allahverdipour A, Moeini B, Dehghani F. Comparative assessment of persuasive beliefs among Hamedan and
Tabriz pregnant women for choosing cesarean delivery. Accomplished research project at Research Vice Presidency,
Hamedan University of Medical Sciences, Winter 2008. Unpublished. (Full Text in Persian)
11. Little M, Lyerly A, Mitchell L,Kuppermann M. Mode of delivery: Toward responsible inclusion of patient
preferences. Obstet Gynecol 2008;112(4):913–18
12. Aali B.SH.,Motamedi B. The survey of knowledge and attitude of pregnant women to the type of delivery
(vaginal versus abdominal). Iran J Obstet Gynecol Infertil 2000-2001; 3(5-6):43-50. (Full Text in Persian)
13. Aram S, Allameh Z, Zamani M, Yadgar N. Assessing prevalence of the type of delivering in pregnant women in
Isfahan. Iran J Obstet Gynecol Infertil 2001;4(7-8):74-9. (Full Text in Persian)
14. Bettes BA, Coleman VH, Zinberg S, Spong CY, Portnoy B, DeVoto E, et al. Cesarean delivery on maternal
request: obstetrician-gynecologists' knowledge, perception, and practice patterns. Obstet Gynecol 2007;109(1):57-66.
15. Walker R, Turnbull D, Wilkinson C. Increasing cesarean section rate: Exploring the role of the culture in an
Australian community. Birth 2004;31(2):117-122
16. Penna L, Arulkumaran S. Cesarean section for non-medical reasons. Int J Gynaecol Obstet 2003; 82(3):399-409.
17.Garmaroudi G, Eftekhar H, Batebi A. Ceaserean section and related factors in Tehran ,Iran.Payesh :Journal of the
Iranian Institute for Health Sciences Research 2002;1(2):45-49. (Full Text in Persian)
18. Fisher J, Smith A, Astbury J. Private health insurance and a healthy personality: new risk factors for obstetric
intervention. J Psychosom Obstet Gynaecol 1995;16:1-9.
19. Quadros LG. Cesarean section controversy. Brazilian obstetricians are pressured to perform cesarean sections.
BMJ 2000;320:1073.
20.Lei H,Wen SW, Walker M. Determinants of cesarean delivery among women hospitalized for childbirth in a
remote population in China. J Obstet Gynaecol Can 2003;25(11):937-43.
21.Lavender T, Hofmeyr GJ, Neilson JP, Kingdon C, Gyte GML. Cesarean section for non-medical reasons at term.
Cochrane Database Syst Rev. 2006;19;3:CD004660.
22. Moradan S. Evaluation of selection of rout of delivery and its causes in patients referring to medical centers of
Semnan. Iran J Obstet Gynecol Infertil 2005; 7(2):44-49. (Full Text in Persian)
23. Christilaw JE. Cesarean section by choice: constructing a reproductive rights framework for the debate. Int J
Gynaecol Obstet 2006; 94(3):262-8.
24. Mossialos E, Allin S, Karras K, Davaki K. An investigation of cesarean sections in three Greek hospitals: the
impact of financial incentives and convenience.Eur J Public Health 2005;15(3):288-95.
25. Kwee A, Cohlen BJ, Kanhai HH, Bruinse HW, Visser GH. Cesarean section on request: a survey in the
Netherlands. Eur J Gynaecol Obstet Reprod Biol 2004; 113(2):186-90.

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