Psychological predictors of intention to deliver vaginally through the extended parallel process model: a mixed-method approach in pregnant iranian women

Despite the fact that cesarean delivery does not offer significant health benefits for either mother or newborn, there has been a noticeable upward trend in elective cesarean births in Iran, over the last two decades. This study aims to examine whether knowledge, perception of health threats, efficacy, and personal beliefs act as psychological predictors towards the intention of women to have a normal vaginal delivery. The mixed-method approach was used as quantitative and qualitative design. Simultaneously, 290 pregnant women who visited prenatal clinics participated in the study. Quantitative and qualitative data were collected using a structured questionnaire based on Witte's Extended Parallel Process Model, and four focus groups, respectively. Women perceived lower personal risk but higher levels of efficacy. Perceived self-efficacy, severity, and response efficacy emerged as significant predictors of intention to experience vaginal birth. The participants' insufficient knowledge and misconceptions about birth methods were prevalent. Major themes were identified and divided into negative and positive beliefs about vaginal birth. This educational model is useful for understanding women's intention to undergo a vaginal birth, especially when it is combined with a qualitative approach. Maternal care providers should acknowledge their clients' beliefs and intended childbirth methods prior to offering medical intervention.

Attitude of pregnant women, midwives, obstetricians and anesthesiologists toward mode of delivery: a qualitative study

To investigate the attitudes toward mode of delivery of pregnant women, midwives, obstetricians and anesthesiologists who participate in childbirth in Shahrood, Iran. This was a qualitative research with tri-angulations data collection strategy. The study sample was consisted of primiparous and multiparous women, midwives, obstetricians and anesthesiologists. A total of 18 women who seek prenatal care from Fatemiyeh obstetrics clinics during pregnancy, were asked to participate in 3 focus group discussions. 8 midwives in labour ward and clinic were interviewed individually. All of physicians were participate in study by Delphi method for data collection purpose. All interviews and discussions were tape recorded. The main themes were categorized into two main categories: [causes of intention to cesarean] and [causes of intention to vaginal delivery]. The main reason for intention to use cesarean was fear of pain due to vaginal delivery and the main reason for intention to use vaginal birth was fear of post cesarean pain and its morbidity. Other reasons that raise the cesarean section rate in Shahrood included, fear of legal complaints after vaginal birth complications fear of sexual disorders after vaginal birth, existing conflicts between midwives duties and obstetricians and negative attitudes. The results clearly show that although most of women and health providers do not consider cesarean section as the first option for delivery, but some essential obstacles remain as major reasons for increasing cesarean rate