Persuading Iranian Women toward Normal Vaginal Delivery: Using Pictorial Perception of the Labour Process

Abstract

BACKGROUND:Pictorial education could provide an innovative approach for health educators which help to increase health-related information, the attention of individuals, comprehension, and recall.AIM:The purpose of this study was to determine the effect of pictorial perception of labour process by persuading Iranian women toward normal vaginal delivery.MATERIALS AND METHODS:The pre and post non-randomized trial with control group carried out on non-probability sample consisted of 76 pregnant women during the third trimester of pregnancy in the four urban health care centres in Pars-Abad city, Iran, during 2014. Demographic, knowledge, attitude, subjective norms, outcome expectations, self-efficacy, and intention to do normal vaginal delivery variables were measured by using self-administered questionnaire and via the self-report method. Data analysis was performed using SPSS-21 software by Independent t-test, repeated measure, paired T-test, ANOVA, chi-square, Cochran’s Q, and McNemar test. Manipulation included a pictorial education program to persuade pregnant women toward selecting normal vaginal delivery.RESULTS:The results showed significant improvement in mean scores of knowledge, attitudes, self-efficacy and behavioural intention of labour after manipulation in the intervention group (P < 0.001). It was found about 60% changes for intending to choose normal vaginal delivery, and 27/06% of women in the intervention group reported normal vaginal delivery versus the control group. And 10/81% of women did a cesarean section because of medical reasons during of delivery. Reduction of cesarean section was evident. Additionally, the annual rate of cesarean section decreased about 7% in comparison to the previous year.CONCLUSION:Pictorial education could be effective on the intention of women to choose natural vaginal delivery among pregnant women, and it can be used as an effective training technique for developing health literacy, enhancing self-efficacy and decision-making power of women in the delivery.

Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in Iran: a mixed-methods systematic review

“…While 5.46% of nulliparous women preferred a CS (95% CI 5.38%–5.50%; χ 2 = 1117.39; df = 28 [p < 0.00001]; I 2 = 97%) [ 43 , 48 – 51 , 53 , 54 , 57 , 61 , 63 , 67 – 70 , 74 , 76 , 83 , 86 , 89 – 96 , 103 , 105 , 106 , 108 ], this proportion was 53.05% for multiparous women (95% CI 51.66%–51.44%; χ 2 = 144.70; df = 2 [p < 0.00001]; I 2 = 99%) [ 48 , 88 , 92 ]. However, 35 studies did not specify whether the participants were nullipara or multipara, and the proportion of preference for CS in this group of women was 2.06% (95% CI; 2.05–2.08%; χ2 = 2133.04; df = 34 [p < 0.00001]; I 2 = 98%) [ 44 – 48 , 52 , 55 , 56 , 58 – 60 , 62 , 64 , 65 , 71 – 75 , 77 – 79 , 82 , 84 , 85 , 87 , 93 , 97 – 102 , 107 ].…”

“…For women in early and mid-pregnancy, 5.94% preferred CS (95% CI 5.86–5.99%; χ 2 = 194.59; df = 11 [p < 0.00001]; I 2 = 94%) [ 46 , 49 , 50 , 55 , 61 , 68 – 70 , 72 , 85 , 102 – 104 ]. Among women who were in the third trimester (late pregnancy), this proportion was 3.81% (95% CI 3.74%–3.83%; χ 2 = 549.67; df = 23[p < 0.00001]; I 2 = 96%) [ 43 , 44 , 46 , 48 , 49 , 51 , 53 – 57 , 62 , 64 , 72 , 76 , 77 , 83 , 90 , 92 , 93 , 95 , 96 , 105 ]. Preference for CS in studies that did not specify gestational age of women was 3.7% (95% CI 3.76–3.81%; χ 2 = 2865.90; df = 31 [p < 0.00001]; I 2 = 99%) [ 45 , 47 , 52 , 58 – 60 , 63 , 65 , 67 , 71 , 73 – 75 , 78 , 79 , 82 , 84 , 86 – 89 , 94 , 97 – 101 , 106 – 108 ].…”

An educational programme based on salutogenesis theory on childbirth fear and delivery method among nulliparous women: A mixed methods research protocol

“…Although the recommended rate of caesarean section by the World Health Organization is 10%–15%, Iran recorded one of the highest rates of caesarean section in 2017 (50.77%) (Ardakani et al, 2020; Çankaya & Şimşek, 2021; Firoozi, Tara, Ahanchian, & Roudsari, 2020). Hence, this can have short‐term and long‐term consequences for the mother and her child, including uterine infection, fever, bleeding, anaesthesia complications, urinary system damage during surgery, intestinal damage, venous thrombosis, higher expenditure, thromboembolism, postpartum depression, increased need for blood transfusion, placenta prevail, foetal distress syndrome and adverse effects on the infant's immune system (Firoozi et al, 2020; Kananikandeh, 2018; Mortazavi, 2017).…”