Why do primigravidae request caesarean section in a normal pregnancy? A qualitative study in Iran

Faisal, Ibrahim; Matinnia, Nasrin; Hejar, A R; Khodakarami, Z.

doi:10.1016/j.midw.2013.08.011

Cited by 81 publications

(104 citation statements)

References 57 publications

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“…So the women who watch video about normal delivery (definition, advantages, pharmacological and non-pharmacological method to reduce labor pain, preparation to delivery and comfort measures to relieve labor pain regarding mood of delivery) and information about cesarean delivery and it's complications) will reduce fears of labor and preferences of elective caesarean section. This study findings are supported by [32], they studied 40 requested women for primary elective CS in Egypt, reported that majority of women changed their decision to normal vaginal delivery and delivered actually by vaginal deliver after childbirth counseling [31] Consistent with this findings, a blind clinical trial involving 67 primiparous women conducted in Iran, studied the effect of role play education on primiparous' fear of normal delivery and decision for mode of delivery, founded that majority of lecture group and all role play group choose vaginal birth to be their mood of delivery after educational interventions [36 and 37]. Non-pharmacological methods including education by lecture video are one of the most effective ways to cope with fear and providing accurate information to the pregnant women.…”

Section: Discussionsupporting

confidence: 84%

Effect of Healthy Instructions on Reducing Pregnant Women’s Fear of Normal Delivery and Preferences for Cesarean Delivery

Khedr¹

2017

AJNS

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Abstract:Childbirth is physiological process that needs no intervention. Cesarean delivery should only conduct when normal delivery is contraindicated to protect mothers and infant's health. Nowadays, a Cesarean Section has become a culture for escaping pain. Therefore this study aimed to evaluate the effect of healthy instructions on reducing pregnant women's fear of normal delivery and preferences for cesarean delivery. A quasi-experimental design was used. A purposive sample of 64 pregnant women was selected and divided randomly into two equal groups, 32 in each group. The study was carried out at Antenatal clinics of Obstetrics and Gynecology Center of Mansoura City. Three tools were utilized for data collection; an interviewing questionnaire and Childbirth Attitudes, Childbirth Fear Associated Factors Questionnaires to assess degree of women's fear of normal delivery and preferences for cesarean delivery. Level of fear was assessed pre and post healthy instructions. The study findings revealed that both groups were significantly different regarding the fear of normal delivery after intervention. It was obvious that before intervention more than half of both groups had preference for Cesarean Section while after intervention, vaginal delivery was the first preference of both groups. This study concluded that, healthy instructions by video and lecture educational methods were effective in making a decision on normal delivery, lessening the fear of normal labor, and diminished the incidence of elective cesarean delivery. The present study recommended to apply healthy instructions by video and lecture educational methods for raising their awareness to distinguish among normal delivery and cesarean section on large number of pregnant women for reducing fear from normal delivery and preferences for cesarean delivery.

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Section: Discussionsupporting

confidence: 84%

Effect of Healthy Instructions on Reducing Pregnant Women’s Fear of Normal Delivery and Preferences for Cesarean Delivery

Khedr¹

2017

AJNS

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“…Psychological factors, especially fear of vaginal birth and its associated pain, are related to the demand for caesarean birth (23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Anxiety and fear of childbirth have consistently been associated with maternal request for elective caesarean section (33)(34)(35)(36).…”

Section: Maternal Factorsmentioning

confidence: 99%

“…Another important factor is negative past experiences -both with regard to pregnancy and childbirth -and this is currently considered to be one of the main causes of fear of childbirth that might lead to elective caesarean section (12,23,28,40). Women who have had a negative previous birth experience continue to feel fear in subsequent births, especially in relation to labour pain.…”

Section: Maternal Factorsmentioning

confidence: 99%

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Determinants of caesarian birth on maternal demand in the Islamic Republic of Iran: a review

Darsareh

Aghamolaei

Rajaei

et al. 2017

East Mediterr Health J

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Analyse des déterminants des naissances par césarienne sur demande de la mère en République islamique d'IranRÉSUMÉ Le phénomène des naissances par césarienne sur demande fait l'objet de discussions, notamment parce qu'une première césarienne est hautement prédictive d'autres césariennes lors des naissances suivantes. L'identification des raisons d'un accouchement par césarienne sur demande est importante de façon à planifier des interventions efficaces. À ce titre, la présente analyse fait état, sur la base d'études menées en République islamique d'Iran, des facteurs impliqués dans la tendance qu'ont les femmes de recourir à un accouchement par césarienne. Plusieurs mots clés incluant « naissance par césarienne », « accouchement », « causes », « demande/ exigence de la mère », ainsi que « choix de la patiente » ont été utilisés pour effectuer des recherches dans Medline, PubMed, Ovid, Scientific Information Database, Magiran, Google et Google Scholar. La recherche a été menée à partir d'articles en persan et en anglais, sans limitation de temps. À l'aide d'une analyse de contenu, les facteurs influençant le recours à une césarienne ont été divisés en trois catégories : les facteurs liés à la mère, les facteurs sociaux, et ceux liés aux dispensateurs de soins. Eu égard à la prévalence élevée de césariennes, il est important de concevoir et de mettre en oeuvre des programmes et des interventions efficaces prenant en compte les raisons principales qui conduisent les femmes à opter pour une césarienne non nécessaire. ABSTRACT The phenomenon of caesarean birth on demand has gained attention, particularly as a first caesarean birth appears to be strongly predictive of subsequent caesareans. Identification of reasons behind caesarean birth on demand is important for planning effective interventions. Therefore, this review reports the factors involved in the tendency of women to undergo caesarean birth, based on studies in the Islamic Republic of Iran. Several keywords including caesarean delivery, childbirth, causes, maternal request/demand, and patient choice were used to search Medline, PubMed, Ovid, Scientific Information Database, Magiran, Google and Google Scholar. The search was conducted on Persian and English language articles, with no time limitation. Using content analysis, the factors influencing caesarean section were divided into 3 categories: maternal, social and healthcare giver. According to the high prevalence of caesarean section, it is important to design and implement effective programmes and interventions with consideration of the key reasons that lead women to opt for unnecessary caesarean section.

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“…A study of 376 women by Aksoy et al showed that an extreme fear of childbirth is a factor linked to an increased rate of cesarean section (OR 4.22, 95% CI: 2.91-6.11) (Aksoy et al, 2014). A qualitative study conducted by Faisal et al in Iran on 14 nulliparous women who requested elective cesarean section without any medical reason showed that the main reasons for requesting cesarean section were extreme fear of childbirth, complications after normal vaginal delivery, and sexual dysfunction (Faisal et al, 2014). In a study of 1,635 nulliparous and multiparous women, Nieminen et al showed that there was an association between fear of childbirth and preference for cesarean section among nulliparous women (OR 11.79,) and multiparous women (OR 8.32, (Nieminen et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

The Validity and Reliability of Persian Version of Wijma Delivery Expectancy/Experience Questionnaire (Version A) among Iranian Nulliparous Women

Abedi

Hazeghi

Afshari

et al. 2016

GJHS

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Extreme fear of childbirth may interfere with normal process of labor and increase the rate of cesarean section. The aim of this study was to evaluate validity and reliability of a Persian version of Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) among nulliparous women. In this cross-sectional study, 200 nulliparous women of reproductive age were recruited. The original form of the W-DEQ was received from corresponding author (Garthus-Niegel). This questionnaire was translated into Persian language and back-translated to English by three experts in reproductive health and psychiatry who were fluent in Persian and English. Two questionnaires namely the Beck Anxiety Inventory (BAI) and the Depression Anxiety Stress Scale (DASS) were used to check the convergent and divergent validity. Confirmatory factor analysis was used to assess the construct validity, while the Pearson correlation coefficient was used to assess the convergent and divergent validity of the W-DEQ. Reliability was measured using Cronbach's coefficient alpha. Factor analysis yielded nine factors that explained 70.06% of the total variation. Cronbach's alpha was 0.64 and the convergent validity with the BAI questionnaire was (r=0.402) and the divergent validity of W-DEQ with the DASS questionnaire was (r=0.349). The Persian W-DEQ has a good validity and reliability for measuring the fear of delivery in Iranian women of reproductive age. Using this questionnaire for nulliparous women is recommended.

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Why do primigravidae request caesarean section in a normal pregnancy? A qualitative study in Iran

Cited by 81 publications

References 57 publications

Effect of Healthy Instructions on Reducing Pregnant Women’s Fear of Normal Delivery and Preferences for Cesarean Delivery

Effect of Healthy Instructions on Reducing Pregnant Women’s Fear of Normal Delivery and Preferences for Cesarean Delivery

Determinants of caesarian birth on maternal demand in the Islamic Republic of Iran: a review

The Validity and Reliability of Persian Version of Wijma Delivery Expectancy/Experience Questionnaire (Version A) among Iranian Nulliparous Women

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