Effectiveness of Information Counseling on Decision-Making Delivery Method in Primiparous Women Referred to Healthcare Centers of Tabriz-Iran

Abstract

BACKGROUND: The rate of cesarean delivery in Iran is four times higher than the standard defined by the World Health Organization. OBJECTIVE: Information counseling is a method for providing accurate information and helping to make evidence-based decision-making. This research was conducted to determine the effect of information counseling on the decision making process of delivery. METHODS: This was a before and after clinical trial in which 120 pregnant women in the 28thweek of the pregnancy with no indication of cesarean sections (CS) were included. Pros and cons of vaginal and cesarean modes of delivery were presented by training sessions.Women's’ preferential delivery mode were measured by a pre- and post- questionnaires and follow-up. Data were analyzed by SPSS16using t-test. RESULTS: The findings showed that the main indicators for determining the type of delivery, including awareness of delivery, decision for delivery mode, understanding the risks of delivery mode and self-efficacy, were significantly associated with educational intervention and counseling (P<0.01). In the pre-intervention phase, 66.7% of women had normal delivery and 33.3% of cesarean section. After intervention, with a significant increase in the choice of normal delivery, 78.4% for natural delivery and 15.3% of cesarean section were considered as the best option for delivery. Follow-up results after educational intervention showed that 44.2% of participants in this study performed normal delivery and 50% cesarean section. 8.5% were excluded from the study for certain reasons. After review, it was found that encouraging physicians to cesarean section was the main and primary cause of cesarean. CONCLUSION: The implementation of information counseling has most likely a great effect on encouraging women to change their decision patterns and self-making decision for VD maternity and reducing the CD. But in practice, some factors, especially the constant recommendation of physicians to CD as a programmable and convenient delivery, undermine the role of these interventions.