Effect of educational interventions based on theory of planned behavior [TPB] in selecting delivery mode among pregnant women referred to Rasht health centers

In recent years, most developed countries have aimed at reducing the cesarean rate through education and other interventions. In our country, however, despite all efforts, the cesarean rate remains very high. The aim of this study was to determine the effects of educational intervention based on the Theory of Planned Behavior [TPB] on choosing delivery mode in pregnant women, who were referred to the Rasht Health Centers. This quasi-experimental study included 72 pregnant women referred to various Health Centers in Rasht in the spring and summer of 2010. After a pre-test by using a valid and reliable questionnaire for both groups, specific training was provided for the intervention group based on the Theory of Planned Behavior. At the end of the pregnancies, post-test were performed in both groups and the results were analyzed by SPSS-13 software. The results indicate that there were significant differences in the mean knowledge, evaluations of behavioral outcome, attitude [P =0.000], perceived behavioral control, subjective norms, and behavioral intention [P < 0.05] among pregnant women in the test group compared with the control. There was a significant difference in behavior between the two groups [P < 0.05]. The results show that maternal educations in the field for persuasion of normal delivery had been effective. Therefore, we recommend implementing training programs based on Theory of Planned Behavior, in order to persuade pregnant women for normal delivery and decreasing the rate of the cesarean section

[Women's attitudes toward elective delivery mode based on the theory of planned behavior]

Cesarean section [CS] delivery is more risky than normal vaginal one for both mothers and neonates. However, due to various reasons, the rate of CS is rising unfortunately. Unawareness and unfounded attitudes are among the more common reasons for this increasing rate of CS. To survey women's attitudes toward elective delivery mode based on the Theory of Planned Behavior [TPB] in Rasht, northern Iran. This descriptive-analytical study was carried out with 207 women referred to health centers in Rasht, using cluster sampling, in winter 2010. Questionnaires were used to collect the respective data which were analyzed by SPSS-13. Findings showed that 43% of the women have had normal vaginal delivery, 36.2% caesarean section for medical reasons and 20.7% elective cesarean section. In the elective cesarean section group, the mean scores of knowledge, attitude, evaluation result and perceived behavioral control were 42.56, 55.87, 60.33 and 47.28, respectively. The tendency of more than 70% of the women was CS absolutely while the two other groups favored normal delivery. All the three groups support the physician as the best source to consult for the selection of delivery mode. As demonstrated, the mean scores of knowledge, attitude, evaluation result and perceived behavioral control for the women with elective cesarean section were lower than the corresponding scores for the two other groups. Since the majority of the women in the study were primiparous, appropriate strategies including training programs for pregnant women and young girls based on behavioral theories and models such as TPB, and counseling with families, arranged by health centers and the mass media can be suggested