The effect of motivational interviewing on self-efficacy and decision-making about type of delivery in primigravid women: A randomized clinical trial

Abstract

Background: Childbirth self-efficacy is one of the most important factors affecting pregnant women's decision about the type of delivery. Low childbirth self-efficacy can lead to unnecessary cesarean sections (CS). Objective: This study aimed to examine the effectiveness of motivational interviewing (MI) on self-efficacy and the decision about the type of delivery in primigravid women requesting elective CS. Methods: A randomized controlled trial was conducted on 120 primigravid women at 28–31 weeks of gestation. The participants were selected through multistage sampling and randomly assigned into an intervention and a control group, each 60. The intervention group received four 90-min sessions of MI, whereas the control group received routine prenatal care. The Childbirth Self-Efficacy Inventory, and the Decision-Making Checklist were used to collect data before and 4 weeks after the intervention. Chi-square, independent-samples t-test, and paired t-test were used for data analysis. Results: The mean baseline childbirth self-efficacy score was 63.68 ± 18.91 in the intervention group and 71.58 ± 25.66 in the control group (P = 0.57). The mean score increased significantly in the intervention group at the end of the study (P = 0.001), whereas it decreased significantly in the control group (P = 0.003). Although all women preferred CS at baseline, 91.7% of the intervention group and 28.3% of the control group applied for normal delivery at the end of the study (P < 0.001). Conclusions: MI can increase childbirth self-efficacy and can be used by midwives and other health-care providers to encourage pregnant women to choose normal delivery.

Keywords

• cesarean section
• decision-making introduction
• motivational interviewing
• self-efficacy