Factors related to the decision making process of primigravid women about mode of delivery: A theory-based study

The rate of cesarean section in Iran is three times higher than standard and attention to the factors affecting decision making process of women to choose mode of delivery helps to recognize the causes of its high rate. This study was performed with aim to investigate the factors affecting decision making process of women to choose mode of delivery based on the Health Belief Model (HBM).
This cross-sectional study was performed on 321 primigravid women who had normal and healthy pregnancy with gestational age of higher than 26 weeks in Gonabad from June 2014 to April 2017. Data collection tools included the questionnaire of personal and reproduction characteristics, the questionnaire of awareness about the advantages and disadvantages of vaginal delivery and cesarean section, the questionnaire of assessing HBM, and the questionnaire of choosing the mode of delivery. Data was analyzed by SPSS software (version16). P 238 women (74.1%) had selected vaginal delivery and 83 (25.9%) cesarean. Among the HBM constructs, two groups were significantly different in terms of perceived susceptibility (p= 0.023) and perceived benefits (p= 0.001), but there was no significant difference between two groups in terms of knowledge, perceived severity and perceived barriers (p>0.05). Two groups were not significantly different in terms of age, education and occupation of pregnant women (p> 0.05), but a significant difference was found between those who had selected vaginal delivery and those who had selected cesarean in terms of sources of information about delivery mode (p= 0.008).
The main findings of this study showed a relationship between perceived susceptibility and perceived benefits with intended mode of delivery. This finding can be used in designing educational programs for pregnant women with more emphasis on significant structures of HBM.