Reasons for Elective Cesarean Section amongst Pregnant Women; A Qualitative Study (original) (raw)
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Reproductive Health
Background Cesarean section (CS) rates have been increasing globally. Iran has one of the highest CS rates in the world (47.9%). This review was conducted to assess the prevalence of and reasons for women’s, family members’, and health professionals’ preferences for CS in Iran. Methods and findings In this mixed-methods systematic review, we searched MEDLINE/PubMed, Embase, CINAHL, POPLINE, PsycINFO, Global Health Library, Google scholar; as well as Iranian scientific databases including SID, and Magiran from 1 January 1990 to 8th October 2019. Primary quantitative, qualitative, and mixed-methods studies that had been conducted in Iran with Persian or English languages were included. Meta-analysis of quantitative studies was conducted by extracting data from 65 cross-sectional, longitudinal, and baseline measurements of interventional studies. For meta-synthesis, we used 26 qualitative studies with designs such as ethnography, phenomenology, case studies, and grounded theory. The Re...
Salient beliefs towards vaginal delivery in pregnant women: A qualitative study from Iran
Reproductive Health, 2015
Background: Childbirth by cesarean section has increased at an alarming rate over the past few years in Iran. The present study was designed to explore pregnant women's beliefs about the mode of delivery in order to provide some suggestions for future interventions to increase vaginal delivery. Methods: This was a qualitative study framed by the Theory of Planned Behavior conducted in Tehran, Iran in 2013. Pregnant women attending public hospitals were recruited. The data were collected via in-depth interviews and focus group discussions. Interviews were conducted in a semi-structured manner. All interviews were tape recorded and transcribed verbatim. A content analysis approach was used to explore the data. Results: In all 36 pregnant women participated in the study. The mean age of women was 27.8 (SD = 4.5) years. In general, women preferred vaginal delivery. During interviews and focus group discussions several themes emerged related to the pain associated with vaginal delivery, fears of childbirth, related health concerns, and the role of decision makers. The findings were grouped into three main themes namely: behavioral beliefs (negative and positive beliefs towards outcomes of vaginal delivery), normative beliefs (injunctive norms and descriptive norms), and control beliefs (internal and external barriers). Conclusion: Despite the fact that there were positive beliefs regarding vaginal delivery, participants indicated concerns related to loss of control and fear. It is essential that health care providers realize the psychological needs of women during pregnancy and the need for continuous support during childbirth. This type of support may improve their self-control during labor, and decrease fear of childbirth.
Knowledge and Attitude of Pregnant Women toward Elective Cesarean Section in Saudi Arabia
Open Journal of Nursing
Background: The rate of deliveries by cesarean section (CS) is increasing worldwide. An elective cesarean section (ECS) is a cesarean section carried with or without a medical reason, in some cases choice by pregnant women. The number of women demanding for delivery by elective cesarean section is increasing in Saudi Arabia. Although CS is the commonest major surgery performed in Obstetrics throughout the world; there are still concerns about the knowledge and attitude of Saudi Pregnant women towards it. Methods: The design of this study was a quantitative, descriptive, and cross-sectional design. The study sample consisted of 206 pregnant women attending antenatal clinic during the third trimester, selected by convenience sampling method from Maternity and Children Hospital in Jeddah City in Saudi Arabia. Structured interview questionnaire was used in this study. Different statistical procedures were used for data analysis including percentages, mean, and mean percentages. Content validity and reliability were done. Results: The majorities (78.2%) of the pregnant women have adequate level of knowledge about ECS, 14.6% of them have moderate knowledge, and only 7.3% have inadequate knowledge. Also, 137 (66.5%) of pregnant women have negative attitude toward ECS, while 58 (28.2%) have positive attitude. Conclusion and recommendations: The study concluded that there was a good level of knowledge among pregnant women about ECS in most of the instrument questions in general; except in some areas such as the bad consequences of CS. On the other hand, the majority of the pregnant women had negative attitude toward ECS. Health care provider such as doctors, nurses and midwives should provide adequate knowledge to the pregnant women about consequence of cesarean section on the mother and child.
The preference of Iranian women to have normal vaginal or cesarean deliveries
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2013
The cesarean section (C-section) has higher risk compared to normal vaginal delivery (NVD). The aim of this population-based study was to evaluate the frequency of mothers' tendency toward the mode of delivery and the factors that can affect this inclination. This cross-sectional study was conducted from August 2011 to June 2012 in Fars Province, Iran, and comprised mothers in their 20(th) to 30(th) weeks of pregnancy. A questionnaire was designed to include, sociodemographic information, maternal knowledge, main sources of knowledge, attitude of the mother, husband, parents, close friends, and gynecologist, regarding the route of delivery, convenience factors, and barriers to choosing NVD, and mother's preference for the route of delivery. Of 6921 participants, 2197 (31.7%) preferred C-section and 4308 (62.2%) favored NVD while 416 (6%) had no idea regarding the preferred route of delivery. Score of knowledge in 904 (13.1%) participants was zero, and 1261 women (18.2%) achi...
2018
The aim of the study was to assess the relation of knowledge score for cesarean disadvantages and selecting the mode of delivery. In this cross-sectional study, we studied 192 women who referred to obstetrics and gynaecology clinics in Jahrom, Iran. All women and their fetus were healthy without any problems and were in the third trimester of first pregnancy. We used a questionnaire including demographic situations and eighteen questions about disadvantages of cesarean section. The data recorded with using SPSS version 15 and analyzed by chisquare, independent t-test and one-way ANOVA test. Mean knowledge score was lower among mothers that intend to do cesarean section than those selected vaginal deliveries (10.82 ± 4.46 vs. 12.50 ± 4.08, respectively) that there was significantly different (P= 0.025). The most common reason for choosing cesarean section was fear of vaginal delivery (n= 24, 61.6%). The mean knowledge score was higher women who selected cesarean section in comparison...
Causes of Cesarean Section from Perspectives of Obstetricians and Midwives: A Qualitative Study
Journal of Postgraduate Medical Institute, 2020
Objective: To investigate the causes of cesarean section from the perspective of midwives and obstetricians. Methodology: This qualitative study was carried out using conceptual content analysis method. In this study, participants were selected via purposive sampling method and this process continued until data saturation. Accordingly, 12 midwives and 7 obstetricians were enrolled into the study. A semi-structured individual interview was conducted with each participant. Data analysis was performed by Cheevakumjon method and conceptual content analysis was used to extract the concepts. After reading the text of the data, key sentences and concepts were derived and finally categorized. Results: Total of three themes, "attitudes of obstetricians and midwives", "social-supportive factors" and "resources" were identified. The identified categories included; attitudes of obstetricians and midwives (negative attitudes toward vaginal birth, positive attitudes towards cesarean section), social-supportive factors (hospitals, community, midwives and obstetricians, negative experiences, authorities' support for the medical team and resources), financial factors, human resource, facilities and equipment, and educational factors. Conclusion: Normal vaginal delivery conditions can be provided for pregnant women by increasing the access of all pregnant women to free health services, appropriate equipment, availability of midwives and obstetricians and existence of International standards on patient-to-physician ratio.
Development of Strategies to Reduce Cesarean Delivery Rates in Iran 2012–2014: A Mixed Methods Study
International Journal of Preventive Medicine, 2014
Background: With the change in population policy from birth control toward encouraging birth and population growth in Iran, repeated cesarean deliveries as a main reason of cesarean section are associated with more potential adverse consequences. The aim of this research was to explore effective strategies to reduce cesarean delivery rates in Iran. Methods: A mixed methodological study was designed and implemented. First, using a qualitative approach, concepts and influencing factors of increased cesarean delivery were explored. Based on the findings of this phase of the study, a questionnaire including the proposed strategies to reduce cesarean delivery was developed. Then in a quantitative phase, the questionnaire was assessed by key informants from across the country and evaluated to obtain more effective strategies to reduce cesarean delivery. Ten participants in the qualitative study included policy makers from the Ministry of Health, obstetricians, midwives and anthropologists...
BioPsychoSocial Medicine, 2019
Background: Normal delivery is a natural and physiological process with numerous benefits for mother and baby. Giving birth by Caesarean Section (CS) should be limited to the cases in which normal delivery is not possible. The purpose of the study was to determine the attitudes of pregnant women towards Normal Delivery and factors driving the use of Caesarian Section in Kermanshah, Iran. Methods: This analytical-descriptive study was conducted on 410 pregnant women referred to the PHC centers in Kermanshah in western Iran. They had been selected through a multi-stage sampling method, including clustering, randomized, and proportional sampling, from among all eligible women. Data was collected using a questionnaire standardized by previous studies. The level of 0.05 was considered significance association, whenever applied. Results: The mean and standard deviation for participant age was 27.65 ± 5.37 years. The median score for participant attitude was 60.7 ± 9.5 (range from 22 to 85). Generally, 21.5% had a negative attitude toward normal delivery and preferred CS. Participant attitude was negatively correlated with a pregnant woman's age, lower age, and a more positive attitude towards vaginal childbirth. The attitude of women with a history of normal delivery was 63 ± 9 and for those with a history of CS was 56.7 ± 9.3, significantly different. Conclusion: Most women had a positive attitude towards normal delivery, particularly those who had experienced normal delivery in their previous childbirth. Although only a quarter of the participants had a negative attitude toward normal delivery, this figure still was of utmost significance, therefore educational interventions, specifically encouraging women with history of normal delivery to consult their peers, are recommended.
International journal of community based nursing and midwifery, 2015
Cesarean section (C-section) in the North of Iran accounts for 70% of childbirths, which is higher than the national average of 55%. Understanding women's perceptions towards modes of delivery in different cultures can pave the way for promoting programs and policies in support of vaginal delivery. We aimed to investigate women's perceptions towards modes of delivery in the North of Iran. Using a focused ethnographic approach and purposive sampling, 12 pregnant women, 10 women with childbirth experience, nine non-pregnant women, seven midwives, and seven gynecologists were selected from hospitals, healthcare centers, and clinics of Tonekabon and Chaloos, Mazandaran, Iran, during 2012-2014. Data were collected through in-depth interviews and participant observation. Data analysis was performed using thematic analysis using MAXqda software. Two major themes emerged from the data including: "vaginal delivery, a facilitator of women's physical and mental health promotio...