ARTICLE INFO

Article Type

Original Research

Authors

Kanani   S. (1*)
Allahverdipour   H. (2)






(1*) Department of Health Education and Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
(2) Department of Health Education and Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran

Correspondence

Article History

Received:  July  27, 2014
Accepted:  December 3, 2014
ePublished:  December 10, 2014

BRIEF TEXT


… [1-19].The person's belief in his/her ability to perform the behavior successfully, i.e., “self-efficacy” is important in adopting a behavior [20-21].

Self-efficacy consists of self-assessment of one`s ability to cope with stressful situations and to do necessary reactions, especially during labor and delivery pain, and it plays an important role in choosing the type of delivery [22]. A study by Dilen et al. shows that self-efficacy is a decisive factor in choosing the type of delivery [23].

This study aimed at determining the influence of self-efficacy in choosing the type of delivery and labor time in pregnant women.

This research is descriptive-sectional.

The study was conducted in spring, 2014, among women in their first and second time pregnancy who were covered by health centers of Pars-Abad city in their third trimester of pregnancy.

Among 3 health stations and 4 health centers of Pars-Abad, 2 stations and 3 health centers were selected randomly, and then a total number of 200 women who were in their first and second time pregnancy along their third trimester (provided having normal delivery the first time were studies through sampling), aged from 18 to 35, having had neither frequent abortions nor contraindications of normal delivery, willing to participate in the research were entered the study through simple sampling. Those women who did not consent to participate in the study, or had indications for cesarean (multiple birth, small pelvis, diabetes and high blood pressure) were excluded from the study.

Data was collected using a combination of research-made questionnaire by Khorsandi et al. [22] containing demographic characteristics (age, education, spouse's education, job, spouse`s job, intentional or unintentional pregnancy, planned location for delivery, insurance, having supplementary insurance and household income), self-efficacy of choosing normal delivery (5 items), self-efficacy of labor time (18 questions) and choosing the type of delivery (2 items) by self-reporting. The content validity of the questionnaires was achieved using the pilot study in which the opinions of 10 professors and experts in the field of health education, health promotion, and obstetricians were applied, and the necessary modifications were deployed. To determine the reliability of the questionnaires, 50 pregnant women participated in the primary study and the internal correlation coefficient of self-efficacy for choosing the normal delivery, labor time, and the type of delivery was 0.85, 0.95, and 0.9 respectively. All the questions related to both of the scales of choosing the normal delivery self-efficacy and labor time self-efficacy were completed based on 5-point Likert Scale ranged from “absolutely uncertain” (zero point) to “absolutely certain” (five points). Statistical analysis In order to analyze the data obtained from questionnaires, SPSS 21 software was deployed and after reviewing and confirming the normal distribution of the data, to compare the relationship between demographic variables and choosing the type of delivery in either of two groups of mothers in their first and second time pregnancy, Chi-square test and Fisher's test were used; to compare the self-efficacy of choosing the normal delivery and self-efficacy of labor time, and to compare self-efficacy of labor time and selection of the type of delivery for mothers in their first and second time pregnancy, independent t-test was used.

The mean age of pregnant women was 25.19 ± 4.48 and the mean age of their husbands was 29.60± 4.71. 74.6 % of women in their first time pregnancy aged from 18 to 26, and 61.3 % of women in their second time pregnancy aged from 27-35. A significant difference was observed between spouse's educations as well as supplementary insurance status and choosing the type of delivery for women in their first time pregnancy. The significant difference was only found between job variable and selecting the type of delivery for mothers in their second time pregnancy (p<05/0;Table 1). Both types of self-efficacy of choosing the normal delivery and labor time had a meaningful relationship with the number of delivery (first or second time) (p<0.001); the mean scores of choosing the normal delivery self-efficacy and labor time self-efficacy for women in their second time pregnancy were higher than women in their first time pregnancy (Table 2).There was a significant difference between choosing the type of delivery and both kinds of self-efficacy for selecting the normal delivery and labor time in both groups of women (p<0.001); the mean scores of self-efficacy for choosing the normal delivery and labor time were lower in women who had selected the cesarean in both groups (Table 3).

Dilek et al. have expressed the self-efficacy of choosing the type of delivery as the decisive factor in selecting the type of delivery and normal delivery [9, 23]; Lowe study on women in their first time pregnancy and Khorsanadi et al. study on women in their first time pregnancy and women who give birth to more than one child in one labor, illustrate the influence of self-efficacy of labor time on choosing the type of delivery [22, 24], which are in line with the findings of this study. Choosing the type of delivery in both groups of women in their first and second time pregnancy was not related to other reviewed demographic variables such as age, mother`s education, husband`s occupation and household income; although some studies reveal the unaffectedness of these variables on preferred type of delivery for women [11-29]. However, the relationship between age, education and financial conditions with choosing the type of delivery was observed in both groups of mothers in other studies whichwere consistent with the results of this research [26, 30]. … [31-33].

Noticing the relieving procedures of labor pain to enhance the self-efficacy, particularly for women in their first time pregnancy should be put forward within educational interventions in order to increase normal delivery.

Self-reporting method for completing the questionnaires was considered as one of the limitations of this study which probably leads to recall bias. Furthermore, samples were selected non-randomly which does not let the findings to be generalized to other populations.

Self-efficacy of choosing the type of delivery and self-efficacy of labor time are crucial factors in choosing the type and number of delivery for women in their first and second time pregnancy.

The authors are sincerely grateful to all officials and personnel of all concerned health centers and pregnant women participating in the study.

The personal interests of the authors are not associated with the results of this study.

The study was done after making the necessary arrangements with the Department of Health Network in Pars-Abad city and acquiring the written consent of the subjects, assuring them of the confidentiality of information.

Non-declared

TABLES and CHARTS

Show attach file


CITIATION LINKS

[1]Darvishi E, Mortazavi SS, Nedjat S, Holakouie-Naieni K. [Experiences of women and gynecologists on the choice of delivery method: A Qualitative Research]. Journal of Health Systems Research.2012; 8(1):59-68. (Persian)
[2]Lobel M, DeLuca RS. Psychosocial sequelae of cesarean delivery: Review and analysis of their causes and implications. Soc Sci Med.2007; 64(11): 2272-84.
[3]Karim F, Ghazi A, Ali T, Aslam R, Afreen U, Farhat R. Trends and Determinants of Caesarean section. Journal of Surgery Pakistan.2011; 16(1):22-7.
[4]Runmei M, Terence TL, Yonghu S, Hong X, Yuqin T, Bailuan L, et al. Practice audits to reduce caesareans in a tertiary referral hospital in south-western China. Bull World Health Organ.2012; 90(7):488-94.
[5]Deline J, Varnes-Epstein L, Dresang LT, Gideonsen M, Lynch L, Frey JJ. Low primary cesarean rate and high VBAC rate with good outcomes in an Amish birthing center. Ann Fam Med.2012; 10(6):530-7.
[6]Tita AT, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med.2009; 360(2):111-20.
[7]Lin HC, Xirasagar S. Institutional factors in cesarean delivery rates: policy and research implications. Obstet Gynecol.2004; 103(1):128-36.
[8]Khani-Jeihooni A, Shahidi F, Kashfi SM. [Effectiveness of educational program based on the theory of rea-soned action to decrease the rate of cesarean delivery among pregnant women in Fasa, southern Iran]. Journal of Education and Community Health.2014; 1(1):62-71. (Persian)
[9]Hajian S, Shariati M, Najmabadi KM, Yunesian M, Ajami ME. Psychological predictors of intention to deliver vaginally through the extended parallel process model: a mixed-method approach in pregnant Iranian women. Oman Med J.2013; 28(6):395-403.
[10]Sharghi A, Kamran A, Sharifirad GR. [Assessing the factors influencing delivery method selection in primiparous pregnant women referred to health centers in Ardabil, 2010]. Hormozgan Medical Journal.2011; 15(3):234-42. (Persian)
[11]Kashfi SM, Khani jeihooni A, Babaei Heydarabadi A, Ashrafi Hafez A, Rezaianzadeh A, Shahidi F. Effect of behavioral intention model-based education on decrease the rate of caesarean delivery among pregnantwomen. Journal of Paramedical Sciences .2014; 5(1):16-23.
[12]Movahed M, Enayat H, Ghaffarinasab E, Alborzi S, Mozafari R. [Related factors to choose cesarean rather than normal delivery among shirazian pregnant women]. Journal of Fasa University of Medical Sciences.2012; 2(6):278-83. (Persian)
[13]Rowlands IJ, Redshaw M. Mode of birth and women's psychological and physical wellbeing in the postnatal period. BMC Pregnancy Childbirth.2012; 12:138.
[14]Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, et al. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet.2006; 367(9525):1819-29.
[15]Naseh N, Khazaie T, Kianfar S, Dehghan R, Yoosefi S. [Prevalence of cesarean and its complications in women referring to Vali-e-Asr Hospital]. Modern Care Journal.2010; 7(1):12-8. (Persian)
[16]Stoll K, Fairbrother N, Carty E, Jordan N, Miceli C, Vostrcil Y, et al. "It's all the rage these days": University students' attitudes toward vaginal and cesarean birth. Birth.2009; 36(2):133-40.
[17]Tanglakmankhong K, Perrin NA, Lowe NK. Childbirth self-efficacy inventory and childbirth attitudes ques-tionnaire: psychometric properties of Thai language versions. J Adv Nurs.2011; 67(1):193-203.
[18]Nieminen K, Stephansson O, Ryding LE. Women’s fear of childbirth and preference for cesarean section cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand.2009; 88(7):807-13.
[19]Salomonsson B, Bertero C, Alehagen S. Self-efficacy in pregnant women with severe fear of childbirth. J Obstet Gynecol Neonatal Nurs.2013; 42(2):191-202.
[20]Ghaffari M, Afshari A. Application of health belief model for predicting delivery method among pregnant women of Semirom: a cross-sectional research. World Appl Sci J.2013; 22(4):494-99.
[21]Sexton TL, Tuckman BW. Self-beliefs and behavior: The role of self-efficacy and outcome expectation over time. Pers Individ Dif.1991; 12(7):725-36.
[22]Khorsandi M, Ghofranipour F, Heydarnia A, Faghihzade S, Akbarzade A, Vafaei M. [Survey of perceived self-efficacy in pregnant women]. Journal of Medical Council of Islamic Republic of IRAN.2008; 26(1):89-95. (Persian)
[23]Dilks FM, Beal JA. Role of self-efficacy in birth choice. J Perinat Neonatal Nurs.1997; 11(1):1-9.
[24]Lowe NK. Self-efficacy for labor and childbirth fears in nulliparous pregnant women. J Psychosom Obstet Gynaecol.2000; 21(4):219-24.
[25]Lowe NK. Self-efficacy for labor and childbirth fears in nulliparous pregnant women. J Psychosom Obstet Gynaecol.2000; 21(4):219-24.
[26]Moeini B, Allahverdipour H, Mahjoub H, Bashirian S. [Assessing pregnant women's beliefs, behavioral intention and predictive factors for cesarean section in Hamadan]. Journal of Obstetrics Gynecology and Infertility of Iran.2011; 14(3):37-44. (Persian)
[27]Baghianimoghadam MH, Baghianimoghadam M, Jozi F, Hatamzadah N, Mehrabbik A, Hashemifard F, et al. [The relationship between HBM constructs and intended delivery method]. The Journal of Toloo-e-Behdasht.2014; 12(4):105-16. (Persian)
[28]Chong ES, Mongelli M. Attitudes of Singapore women toward cesarean and vaginal deliveries. Int J Gynaecol Obstet.2003; 80(2):189-94.
[29]Sharifirad GR, Fathian Z, Tirani M, Mahaki B. [Study on Behavioral Intention Model (BIM) to the attitude of pregnant women towards normal delivery and cesarean section in province of Esfahan-Khomeiny Shahr-1385]. Journal of Ilam University of Medical Sciences.2007; 15(1):19-24. (Persian)
[30]Fathian Z, Sharifirad GR, Hasanzadeh A, Fathian Z. [Study of the effects of Behavioral Intention Model education on reducing the cesarean rate among pregnant women of Khomeiny-Shahr, Isfahan, in 2006]. Zahedan Journal of Research in Medical Sciences.2007; 9(2):123-31. (Persian)
[31]Cai WW, Marks JS, Chen CH, Zhuang YX, Morris L, Harris JR. Increased Cesarean Section Rates and Emerging Patterns of Health Insurance in Shanghai, China. Am J Public Health.1998; 88(5):777-80.
[32]Boyd NG, Vozikis GS. The influence of self-efficacy on the development of entrepreneurial intentions and actions. Entrepreneurship theory and practice.1994; 18:63-77.
[33]Gibbins J, Thomson AM. Women's expectations and experiences of childbirth. Midwifery.2001; 17(4):302-13.
[34]Lowe NK. Maternal confidence for labor: development of the childbirth self-efficacy Inventory. Res Nurs Health.1993; 16(2):141-49.