ASSESSING OF PREGNANT WOMEN TOWARD VAGINAL DELIVERY AND CESAREAN SECTION BASED ON BEHAVIOURAL INTENTION MODEL

Main Article Content

Dr. Hani Baloch
Dr Yamina Ishtiaq
Dr Kausar Parveen
Dr Ayesha Basharat
Dr Sadia Kanwal
Ulfat Naseem
Dr Gulnaz
Sana Mukhtiar

Keywords

C-section, Vaginal delivery, Patients, Factors, Influencing

Abstract

Introduction: The decision-making process surrounding childbirth method, whether vaginal delivery or cesarean section, is a complex interplay of medical, psychological, and sociocultural factors.


Objectives: The main objective of the study is to find the behavior of pregnant women toward vaginal delivery and cesarean section based on behavioural intention model.


Material and methods: This quantitative study was conducted at Bolan Medical Complex Hospital Quetta March 2022 to March 2023. Data was collected from 220 pregnant women.Data collection involved structured interviews conducted with pregnant women in their third trimester of pregnancy. Participants were recruited from antenatal clinics in various healthcare facilities, following the application of inclusion and exclusion criteria. Prior to data collection, informed consent was obtained from each participant.


Results: Data were collected from 220 pregnant females.Mean age of participants was 28.01±3.5 years. There were 120 (54.5%) females was in primigravida group and 100 (45.5%) was in multigravida. 150 (68.2%) adopt vaginal delivery and 70 (31.8%) adopt C-section.Attitudes exhibited the strongest predictive power, with a beta coefficient of 0.45 and a highly significant p-value of <0.001, followed by subjective norms (β = 0.32, p = 0.002) and perceived behavioral control (β = 0.28, p = 0.005). Collectively, these predictors accounted for 65% of the variance in pregnant women's intentions toward childbirth methods, as indicated by the R-squared value.


Conclusion: It is concluded that pregnant women exhibit strong positive attitudes toward natural childbirth, while expressing reservations about cesarean section (CS). These findings highlight the importance of patient-centered care in prenatal settings, where healthcare providers should prioritize addressing women's preferences and concerns.


 

Abstract 131 | PDF Downloads 32

References

1. Naghibi, S.A., Khazaee-Pool, M. &Moosazadeh, M. The Iranian version of theory-based intention for cesarean section (IR-TBICS) scale: development and first evaluation. BMC Pregnancy Childbirth 21, 5 (2021). https://doi.org/10.1186/s12884-020-03498-3
2. Siabani, S., Jamshidi, K. &Mohammadi, M.M. Attitude of pregnant women towards Normal delivery and factors driving use of caesarian section in Iran (2016). BioPsychoSocial Med 13, 8 (2019). https://doi.org/10.1186/s13030-019-0149-0
3. Shams-Ghahfarokhi, Z., &Khalajabadi-Farahani, F. (2016). Intention for Cesarean Section Versus Vaginal Delivery Among Pregnant Women in Isfahan: Correlates and Determinants. Journal of Reproduction & Infertility, 17(4), 230-239. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5124342/
4. Kanani, S., Allahverdipour, H., &AsghariJafarabadi, M. (2015). Modeling the Intention to Choose Natural Vaginal Delivery: Using Reasoned Action and Social Cognitive Theories. Health Promotion Perspectives, 5(1), 24-33. https://doi.org/10.15171/hpp.2015.004
5. Sun, N., Yin, X., Qiu, L., Yang, Q., Shi, X., Chang, J., ... & Gong, Y. (2020). Factors associated with Chinese pregnant women’s preference for a cesarean section based on the theory of planned behaviour. Tropical Medicine & International Health, 25(2), 209-215.
6. Zare, Z., MohaddesHakak, H. R., Yaghobi, Z., TavakoliQuchani, H., Joveini, H., & Hosseini, S. H. (2021). The impact of an educational intervention based on theory of planned behavior on selecting mode of delivery in primigravidae women with intention of elective cesarean section. Journal of Midwifery and Reproductive Health, 9(2), 2652-2660.
7. Naghibi, S. A., Khazaee-Pool, M., &Moosazadeh, M. (2021). The Iranian version of theory-based intention for cesarean section (IR-TBICS) scale: development and first evaluation. BMC Pregnancy and Childbirth, 21, 1-11.
8. Zamani-Alavijeh, F., Shahry, P., Kalhory, M., Haghighizadeh, M. H., Sharifirad, G. R., &Khorsandi, M. (2020). Identification of factors related to elective cesarean labor: a theory-based study. Daneshvar Medicine, 19(5), 1-10.
9. Kashfi SM, KhaniJeihooni A, BabaeiHeydarabadi A, Ashrafi Hafez A, Rezaianzadeh A, Shahidi F. Effect of behavioral intention model-based education on decrease the rate of caesarean delivery among pregnant women. Journal of Paramedical Sciences. 2014;5:16–23.
10. Firoozi, M., Asgharipour, N., &Shakeri, M. T. (2020). Impact of Motivational Interviewing on Women's Knowledge, Attitude and Intention to Choose Vaginal Birth after Caesarean Section: A Randomized Clinical Trial. Journal of Midwifery & Reproductive Health, 8(1).
11. Ghaffari, M., Afshari, A., Rakhshanderou, S., &Armoon, B. (2020). Using theory of planned behavior for prediction of delivery mode among pregnant women: a theory-based cross-sectional research. International journal of adolescent medicine and health, 32(2), 20170106.
12. Attarian, S., Feyzi, Z., Jamali, J., &Firoozi, M. (2021). Influence of Individual Consulting based on Fogg's Behavior Model on Choosing Vaginal Birth after Caesarean. Health Education and Health Promotion, 9(4), 437-443.
13. Majlesi, M., Montazeri, A., Rakhshani, F., Nouri-Khashe-Heiran, E., & Akbari, N. (2020). ‘No to unnecessary caesarean sections’: Evaluation of a mass-media campaign on women’s knowledge, attitude and intention for mode of delivery. PLoS One, 15(8), e0235688.
14. Soheili, B., Mirzaei, A., Sayehmiri, K., Montazeri, A., Araban, M., &Ghazanfari, Z. (2021). A randomized controlled trial of a theory-based health education on prevention of elective cesareans in Iran. Health Education and Health Promotion, 9(1), 61-66.
15. Shakiba, M., Navaee, M., &Hassanzei, Y. (2020). The effect of motivational interviewing on attitude and practice about type of delivery in primigravid women requesting elective cesarean section referring to comprehensive health services centers. Journal of education and health promotion, 9.
16. Shirzad, M., Shakibazadeh, E., Rahimi Foroushani, A., Abedini, M., Poursharifi, H., &Babaei, S. (2020). Effect of “motivational interviewing” and “information, motivation, and behavioral skills” counseling interventions on choosing the mode of delivery in pregnant women: a study protocol for a randomized controlled trial. Trials, 21, 1-10.
17. Keedle, H., Peters, L., Schmied, V., Burns, E., Keedle, W., & Dahlen, H. G. (2020). Women’s experiences of planning a vaginal birth after caesarean in different models of maternity care in Australia. BMC pregnancy and childbirth, 20, 1-15.
18. Soh, Y. X., Razak, N. K. B. A., Cheng, L. J., & Ying, L. A. U. (2020). Determinants of childbirth self-efficacy among multi-ethnic pregnant women in Singapore: A structural equation modelling approach. Midwifery, 87, 102716.
19. IbiciAkça, E., & Aksoy Derya, Y. (2022). Effects of tele-education given based on the health belief model on mode of delivery tendencies in pregnant women. Journal of reproductive and infant psychology, 1-19.
20. Deng, R., Tang, X., Liu, J., Gao, Y., & Zhong, X. (2021). Cesarean delivery on maternal request and its influencing factors in Chongqing, China. BMC pregnancy and childbirth, 21(1), 384.