Development a tailored intervention to promote normal vaginal delivery among primigravida women: a formative research

Although performing cesarean section in specific condition can save life of mother and neonate, but has considerable complications. Reducing cesarean among primigravida is one of the best strategies to reduce cesarean. Therefore, this study was performed with aim to develop a tailored intervention to promote normal vaginal delivery (NVD) among primigravida women.
This formative research was done to develop an intervention based on assessment tools pattern and social marketing response to reduce cesarean section among primigravida women in Boyer-Ahmad city in 2015. The qualitative data were collected through individual interviews and focused group discussions. The quantitative data were collected by a questionnaire based on the constructs of Theory of Planned Behavior. Data was analyzed by SPSS software (version 16). The qualitative data were analyzed by content analysis method as manual and the quantitative data by routine descriptive statistics, logistic regression, Chi-Square and Mann-Whitney tests.
In qualitative part, the most important barriers for selecting NVD were: maternity being unpleasant, fear, other's recommendations, and negative experiences of referring to maternity and low level of knowledge among women. The main interventions recommended for increasing NVD were: education, counseling, making the process of NVD more pleasant. In the quantitative survey, we found that 25.2% of the women were intended to do cesarean. In quantitative part, 39 women (25.2%) had intention to perform cesarean section. The median and interquartile range of attitude was 18±4, subjective norms 16.5±3, and perceived control behavior 16±3. Attitude, subjective norms, place of residence, and the spouse's job were the main predictors in selecting the mode of delivery.
To design an effective tailored intervention to promote NVD among primigravida women, their wants and needs should be considered. Education, offering telephone counseling, and implement of brief interventions by physicians and midwives in health centers are the main elements of the tailored intervention.