J Biomed. 2016 September; 1(3):e7346.
Published online 2016 September 28.
doi: 10.17795/jmb-7346.
Research Article
Effect, for the Preferred Mode of Delivery, on Pregnant Women and
Their Husbands of a Preparing Program on the Advantages of Vaginal
Delivery
Forough Mortazavi,
1
Vahideh Moghaddam Hosseini,
2,3
Yaser Tabarraie,
4
and Tahereh Towfighian
5,*
1
Department of Education Development Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
2
School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
3
PhD Student, Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pecs, Hungary
4
MSc in Biostatistics, Department of Biostatistics and Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
5
MSc in Nursing, Department of Education Development Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
*
Corresponding author: Tahereh Towfighian, MSc in Nursing, Department of Education Development Center, Sabzevar University of Medical Sciences, Sabzevar, Iran. Tel:
+51-44446070, Fax: +51-44445684, E-mail: tofighiyan260@yahoo.com
Received 2016 May 30; Revised 2016 August 15; Accepted 2016 August 30.
Abstract
Background: Despite evidence indicating the effective role of husbands in family planning programs, their role in decision making
about the mode of delivery has been ignored.
Objectives: The aim of this study is to investigate the effects of implementing a preparing program for pregnant women who prefer
cesarean section and their husbands, on their preferred mode of delivery.
Methods: In this before-after clinical trial, 101 pregnant women and their husbands, referred to Sabzevar health clinics affiliated
to Sabzevar University of Medical Sciences, were selected. The inclusion criteria were having a singleton pregnancy and women’s
preference to giving birth by cesarean section. Women who had to give birth by caesarean due to having a previous caesarean or
whose husbands were reluctant to participate in the study, were excluded. In a visit to the health clinics, a midwife discussed benefits
of vaginal delivery for mother and baby, risks of caesarean, and cases in which caesareans are lifesaving. Outcomes were husband’s
opinion about the mode of delivery and woman’s decision about the mode of delivery, both after the intervention and one month
later. Data analyses were performed using SPSS version 18. Wilcoxon matched-pairs signed rank test was used to compare husbands’
opinions about the mode of delivery before and after the intervention.
Results: About 60% of women were primiparas. Just after the intervention and one month later, 66.3% and 72.3% of women pre-
ferred vaginal delivery, respectively. About 58% and 72% of husbands preferred vaginal delivery before and after the intervention,
respectively. Wilcoxon test showed that there was no significant difference in choice of vaginal delivery by husbands before and
after the intervention (P = 0.147).
Conclusions: A preparing program for couples can influence women’s preferred mode of delivery. Future research should compare
such a program for couples and for pregnant women alone.
Keywords: Caesarean, Vaginal Delivery, Pregnant Women, Patient Participation, Spouses
1. Background
Caesarean, which is defined as the termination of preg-
nancy by a surgical method, is a lifesaving procedure when
a mother or her baby is at risk. In western countries, the
rate of caesarean increased in 80th and 90th. The rate of
caesarean in 1970 was 4.5% and reached 32% in 2007 (1).
Thereafter, programs for decreasing the rate of cesareans
were implemented. In Iran, the rate of cesareans during
the past two decades has increased consistently. According
to the world health organization (WHO) report in 2010, the
rate of caesarean in Iran was 42% and Iran was the second
country in the world after Brazil in which caesarean was
most prevalent (2). Results of the across-the-world WHO
survey in 2005 showed that the increased rate of caesarean
was accompanied by the increased rate of maternal and
neonatal mortality and morbidity as well as increased in-
fant hospitalization in neonatal intensive care units (NICU)
(3). Therefore, the WHO introduced a justified caesarean
rate as 10% - 15% (4). Recent opinions about women’s rights
for choosing the mode of delivery caused an increased rate
of cesareans in the world on maternal request (5). The rate
of caesarean on maternal request in the US has increased
by 50% since 2000. In 2003, 2.5% of births were performed
on maternal request in the US (1). In Iran, the rate of cae-
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