Document Type : Original Article


1 Fertility and Infertility Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences

2 Mother and Child Welfare Research Center, Faculty of Public Health, Hormozgan University of Medical Sciences

3 Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran


BACKGROUND: Mortality and disability rates were reported to be respectively 2‑3 and 5‑10 times
higher in C‑sections compared to Vaginal delivery.
OBJECTIVES: This study was aimed to explore the factors involved in selecting the birth type among
primiparous women.
METHODS: The present cross‑sectional research was conducted on 220 primiparous women,
who visited the health‑care centers of Bandar Abbas. They were recruited in their first trimester of
pregnancy with a simple randomized clustering method. Data were collected in a researcher‑designed
questionnaire. Its validity was confirmed by a panel of experts and reliability was tested and approved
through the test–retest method. Mean, standard deviation, independent sample t‑test, and Chi‑squared
tests for data analysis were done by SPSS 16. P < 0.05 was considered statistically significant.
RESULTS: The mean age of the participants was 27.40 ± 6.07 years. The main barriers to the choice
of vaginal delivery were the fear of pain and fear of vaginal area tears and ruptures, fear of injury to
fetus, and doctor’s recommendation. A statistically significant correlation was observed between the
age, education, employment, income, awareness, and the reasons for preferring surgical childbirth.
CONCLUSIONS: To reduce the rate of unnecessary cesarean sections (C‑section), the following
recommendations are suggested: Reducing fear of pain in expectant mothers, modifying wrong
beliefs about the culture of natural childbirth, increasing awareness of fewer adverse effects of
vaginal delivery including the vaginal tears if the mother abides by all midwife(s) instructions during
the delivery procedure, providing educational courses for the necessary movements during the
delivery, decreasing surgeons’ payment for C‑section, and increasing payment for natural childbirth
and implementing barriers for optional delivery to reduce the C‑section.


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