Factors Influencing the Choice of Delivery Based Health Belief Model in Nulliparous Pregnant Women referred to Health Centers in Islamshahr 2013

Abstract

Abstract: Introduction: Unfortunately, today only to save the lives of mothers and babies not be delivered by cesarean section and cesarean has become a means to escape from the pain. In recent years, demand has increased for elective cesarean section. Based on this study, the factors’ affecting the choice of the type of delivery in pregnant women was based on the health belief model. Method: This cross- sectional study of 208 Primiparous pregnant women demand elective cesarean section and vaginal delivery, presenting to health center in Islamshahr was conducted. Sampling method was random. The data from the maternal health belief questionnaire and Decisional conflict scale to through interviews were collected. To determine the effect of the independent variables (demographic characteristics and structure of the model) on the dependent variable (choice of delivery), the chi- square test, Mann- Whitney and t-test was used and for predict the effects of the demographic characteristics and structural of the model on the select the type of delivery was used multivariate logistic regression analysis. Results: 47% and 53% of participants, respectively, elective cesarean section and vaginal delivery were chosen for their delivery. Chance of choosing cesarean in the age group under 20 years(OR:0/3; 95% CI: 0/1 to 0/8) and 25-20 years (0/2; 0/1 to 0/6) was significantly lower than mothers in the age group 25 years and more. Chance of choosing cesarean among mothers who were cared by a gynecologist was about 7 times mothers were cared by midwives(7/1; 3/03 to 16/9). The chance of choosing ceaseran mothers who perceived threat, perceived self- efficacy and perceived role of the doctor were respectively 2.5 times(2/5; 1/7 to 3/4), 2.9 times(2/9; 1/8 to 4/5) and 1.4 times(1/4; 1/1 to 1/7) was higher, but mothers who perceived higher anxiety scores had lower odds(0/6; 0/4 to 1/0) to choose cesarean section. Between The roles of motherhood and choice of delivery there was no significant correlation(P=0/532). Conclusion: With regard ro the impact of health belief model structures to choose the type of delivery, it seems that good planning for the mother’s education based on health belief model structurs, reduce anxiety and perceived threat and increase mother’s self- efficacy, Can play an important role in reducing elective cesarean section.