حیات (Mar 2004)
Reasons of choosing Cesarean section as the delivery method by the pregnant women referred to healthtreatment centers in Rasht
Abstract
Introduction: Cesarean section (CS) is more dangerous than normal delivery for mothers and neonates. Rates of CS in our country are very high, especially in Guilan province (57.6% in urban areas). The claim that a major reason for these high rates is maternal request, hidden behind of the routine medical diagnoses, was the basis of present study. Materials and Methods: A total of 210 pregnant women in Rasht who were at 36-40 weeks of pregnancy and had chosen CS as their delivery method without previous history of CS or any medical reason were included in this study. Cluster sampling was performed at health-treatment centers of Rasht. Data were collected by interview and a questionnaire was completed by the investigators. Statistical analyzing was performed by descriptive and analytic methods (Chi square and Fisher exact test). Results: The majority of participants (68.6%) had moderate knowledge about benefits and harms of CS and most had taken their information from relatives and friends. The majority of women (71.4%) had moderate attitude toward CS. More than 50% of the mothers had chosen CS for following reasons, in decreasing order of frequency: child's health, fear of pain, stress and anxiety, prevention of genital tears, fear of vaginal exams, prevention of deformity and relaxation of genitalia and shortening of delivery time. There was a significant relation between some of the demographic factors or obstetrical history, level of knowledge and kind of attitude with some of the reasons of choosing CS; for example, age, level of knowledge (both p<0.05) and kind of attitude (p=0) with fear of pain. Conclusion: Reasons for choosing CS by the medically low risk mothers are not medically acceptable and midwives and the other health workers can successfully explain this to mothers. They can also support pregnant women informationally, emotionally and socially in different ways such as holding childbirth preparation classes. In this way they can influence women's decision about method of delivery and promote mothers' and neonates' health by decreasing CS rates.
