Challenges and strategies of “promotion of vaginal delivery instruction” from the perspective of Obstetricians and Gynecologists

The Increase of unnecessary caesarean sections has become one of the serious concerns in some health systems. One of the seven packages of the healthcare reform plan that was sent to all Iranian medical universities in 2014 was the "Promoting Natural Delivery," emphasized the need to reduce cesarean delivery and promote more natural delivery. The present study aimed to assess gynecologists’ perspective on the Health Section Evolution Plan in Iran.

The research method was qualitative and a half-structured interview was conducted in 2015 to collect information. Participants in the study included gynecologists and Obstetricians of Isfahan University of Medical Sciences. The purposeful and snowball sampling method was used to select the participants and continued until saturation. The interviewees were selected from among the hospitals teaching. 11 people were interviewed. Thematic analysis method was used for data analysis.

In this study, after analyzing the content of the interviews, four main themes that included making the “natural childbirth franchise free”, “reducing C-section rate”, “Motivating service providers(experts)", and “Improving natural childbirth facilities standards”, and 5 sub themes that included the “Not giving attention to culture”  , “Obligatory Increase for natural delivery rate”, “Not giving attention to Law reform at the natural childbirth”, “An unacceptable Tariff  Payment System” and “Payment delays on new tariffs”.

Promotion of natural childbirth instruction has somewhat realized; however it has significant shortages and limitations. It is possible to solve a lot of problems by increasing the number of normal births by developing legal guidelines for responding to possible problems, and then seeking legal protection from professionals.