Determinants of intention for cesarean section vs. normal delivery among pregnant women in Isfahan

The rate of cesarean section (CS) in Iran accounts as the 2nd highest rate in the world, and this rate in Isfahan is the highest rate in the country. This paper aims to assess correlates and determinants of intention for cesarean section versus normal vaginal delivery among pregnant women in Isfahan. A survey was conducted among 400 pregnant women aged 15 to 49 years. Pregnant women with gestational age of 24-40 weeks who attended to labor clinics of nine hospitals in Isfahan were recruited using non probability sampling during June and July 2014. Multivariate analysis identified selected factors as determinants of intention for CS. These are “the role of physician”, “subjective norms” and “body Image” upon control of education, income and number of ideal fertility. Moreover, path analysis showed that “attitude towards cesarean section” and “individualism” imparts their influence on CS decision through subjective norm. Accordingly, voluntary cesarean section is a complex decision which is shaped by various factors and comprehensive interventions is suggested to discourage cesarean section. These interventions need to encompass changes in physicians’ role, social norms, body image and correcting misperceptions among women during prenatal educational courses.