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Pourrasmi Mamaghani A, Abdekhoda M, Bastani Alamdari P, Mohammadi M. The Effectiveness of Information Counseling on Decision-Making about Delivery Method in Primiparous Women Referred to Healthcare Centers of Tabriz-Iran. J Res Dev Nurs Midw. 2020; 17
URL: http://nmj.goums.ac.ir/article-1-1257-en.html
1- Department of Medical Library and Information Sciences, School of Health Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
2- Department of Medical Library and Information Sciences, School of Health Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran , abdekhodam@tbzmed.ac.ir
3- Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
4- Golestan University of Medical Science, Iran
Abstract:   (1418 Views)
Background: The rate of cesarean delivery in Iran is four times higher than the standard defined by the World Health Organization. Information counseling is a method for providing accurate information and helping primiparous women to make evidence-based decisions. This research was conducted to determine the effect of information counseling on 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) and a health record were included. Sample size was calculated using cluster sampling and the formula n= (〖(Z_(α⁄(2- Z_(β  ) )) )^2 δ〗^2  )/d^2  . The sample size was approximately 63 individuals. To correct the effect of cluster sampling, the calculated sample volume was multiplied by a factor of 1.4. To further validate the data, the number reached 120. Data gathering tool was a questionnaire designed based on reviewing previous studies and considering the purpose of the study whose validity and reliability were measured. The questionnaires were given to the women in two stages at week 28 and week 36. The interventions were in the form of packages containing brochures and information booklet on the benefits and disadvantages of natural childbirth and cesarean section in addition to training sessions taught by a midwifery specialist. 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. After data collection, the analysis was performed at two levels of descriptive and inferential statistics. Finally, data were analyzed by SPSS16using t-test.
Results: The findings showed that the main indicators for determining the type of delivery, including awareness about delivery, making 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% had cesarean section. After intervention, with a significant increase in choosing normal delivery, 78.4% chose natural childbirth and 15.3% chose cesarean section 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 reviewing the results, it was found that encouraging physicians’ team to cesarean section was the main and primary cause of cesarean.
Conclusions: The implementation of information counseling has a great effect on encouraging women to change their decision patterns and self-making decision for VD maternity and reducing CD. However, in practice, certain factors, especially the constant recommendation of physicians’ team to CD as a programmable and convenient delivery, undermine the role of these interventions.
Type of Study: Original Article | Subject: Psychology and Psychiatry

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