Attitudes of Primary Pregnant Women Toward Preference of Birth Method in Dezful, Iran: A Cross-Sectional Study

  • Mahnaz Nosratabadi Department of Midwifery, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
  • Nasrin Sarabi Department of Nursing, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
  • Leila Masoudiyekta Department of Nursing, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
  • Zahra Abbaspoor Department of Midwifery, Reproductive health promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Aziz Kassani Department of Community Medicine. School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
Keywords: Attitude, Pregnant Women, Delivery, Cesarean Section


Introduction: Choosing the birth method is a major issue for pregnant women that is affected by multifaceted physiological, psychological and socio-cultural factors.

Aim(s): The aim research was performed to explore factors influencing pregnant women’s attitude toward birth method.

Methods: This is a cross-sectional study on 220 healthy nulliparous pregnant women with uncomplicated pregnancies without any contraindication for vaginal birth in Medical Centers of Dezful, in the south west of Iran. Data collection tool was a questionnaire for factors affecting the choice of delivery method. Differences in attitude were compared between two groups of natural vaginal delivery preference and cesarean delivery preference. Statistical analysis was performed with SPSS Version 16.0 statistic software package. Descriptive statistics were used to report percentages, mean, and standard deviation, and t-test, chi-square were applied to analyze the data.

Results: During the study period, 206 primary pregnant women were examined to determine the attitudinal influencing factors the birth method preference. 131 women (64%) chose the natural delivery method and 71 women (36%) chose the cesarean delivery method. In addition, the results showed a statistically significant difference between the two groups regarding the general attitude of the participants towards natural delivery (164.43 in the normal vaginal delivery (NVD) group versus 134.50 in the cesarean section (CS) group (p < 0.001)).

Conclusion: There is a direct relationship between the attitude of pregnant women towards vaginal birth and the tendency to normal vaginal delivery and cesarean section. Also, according to the results of the study of 8 components of attitudes, counseling sessions and prenatal training sessions can be identified based on counseling needs and be guided counseling sessions more purposefully.


[1] Boz, İ., Teskereci, G., & Akman, G. (2016). How did you choose a mode of birth? Experiences of nulliparous women from Turkey. Women and Birth, 29(4), 359-367.
[2] Abbaspoor Z. (2014). The objective of the factors influencing the choice of delivery method: Development and Psychometric native instruments. PhD of Reproductive health. TMU. Tehran. 2014.
[3] Valizadehberoz, M., & Ghahremani, J. (2016). Evaluating The Role of Pregnant Womenparticipation in Prenatal Education Classes Inchoosing the Type of Delivery in Zanjan Hospitals. 2016. Retrieved from
[4] Fioretti, B. R. M., Betran, A., & Torloni, M. (2015). Googling caesarean section: a survey on the quality of the information available on the Internet. BJOG: An International Journal of Obstetrics & Gynaecology, 122(5), 731-9.
[5] Fuglenes, D. O. P., & Kristiansen, I. S. (2009). Obstetricians' choice of cesarean delivery in ambiguous cases: is it influenced by risk attitude or fear of complaints and litigation? American Journal of Obstetrics and Gynecology, 200(1), 48. e1-. e8.
[6] Hellerstein, S. F. S., & Duan, T. (2015). China's 50% caesarean delivery rate: is it too high? BJOG: An International Journal of Obstetrics & Gynaecology, 122(2), 160-164.
[7] Mazzoni, A. A. F., Liu, N. H., Bonotti, A. M., Gibbons, L., Sanchez, A. J., et al. (2011). Women’s preference for caesarean section: a systematic review and meta‐analysis of observational studies. BJOG: an international journal of obstetrics & gynaecology, 118(4), 391-399.
[8] Torloni, M. C. M., Merialdi, M., & Betran, A. (2014). What do popular S panish women's magazines say about caesarean section? A 21‐year survey. BJOG: An International Journal of Obstetrics & Gynaecology, 121(5), 548-55.
[9] Betrán, A. P., Torloni, M. R., Zhang, J. J., Gülmezoglu, A., Section, W. W. G. C., Aleem, H., et al. (2016). WHO statement on caesarean section rates. BJOG: An International Journal of Obstetrics & Gynaecology, 123(5), 667-70.
[10] Betran, A. P., Torloni, M. R., Zhang, J., Ye, J., Mikolajczyk, R., Deneux-Tharaux, C., et al. (2015). What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reproductive Health, 12(1), 57.
[11] Nosratabadi, M., Hekmat, K., Dencker, A., & Abbaspoor, Z. (2018). Individual and Group Psycho-Educational Counseling on Knowledge, Attitude and Preference for Birth Method in Nulliparous Women: A Randomized Controlled Trial. Journal of Family & Reproductive Health, 12(2), 103.
[12] Ghooshchian, S., Dehghani, M., Khorsandi, M., & Farzad, V. (2011). The role of fear of pain and related psychological variables in prediction of cesarean labor. Arak Uni Med Sci J., 14(56), 45-54.
[13] Najafi-Sharjabad, F., Keshavarz, P., & Moradian, Z. (2018). Survey on the prevalence and influencing factors for choosing Normal vaginal delivery among pregnant women in Bushehr City, 2015. Community Health Journal, 11(1), 20-9.
[14] Akbari, N. M. M., Rakhshani, F., & Montazeri, A. (2017). Knowledge and attitude of pregnant women towards mode of delivery in Tehran, Iran. Journal of the Iranian Institute for Health Sciences Research, 16(2), 211-218.
[15] Bagheri, A., Masoodi-Alavi, N., & Abbaszade, F. (2012). Effective factors for choosing the delivery method among the pregnant women in Kashan. KAUMS Journal (FEYZ), 16(2), 146-153. Retrieved from
[16] Mohammaditabar, S., Rahnama, P., & Mohammadi, K. (2014). Cesarean section on maternal request in Tehran 2010-2011: Incidence and predisposing factors. Journal of Mazandaran University of Medical Sciences, 24(114), 74-82.
[17] Fenwick, J., Gamble, J., Nathan, E., Bayes, S., & Hauck, Y. (2009). Pre‐and postpartum levels of childbirth fear and the relationship to birth outcomes in a cohort of Australian women. Journal of Clinical Nursing, 18(5), 667-677.
[18] Tavassoli, A., Kalari, F., & Dizji, A. Z. (2015). Social Factors affecting Cesarean Trend in pregnant women. Medical Ethics Journal, 8(29), 145-170.
[19] Hildingsson, I. (2014). Swedish couples’ attitudes towards birth, childbirth fear and birth preferences and relation to mode of birth–a longitudinal cohort study. Sexual & Reproductive Healthcare, 5(2), 75-80.
[20] Baghianimoghadam, M., Baghianimoghadam, M., Hatamzadah, N., Mehrabbik, A., Hashemifard, F., & Hashemifard, T. (2014). The relationship between HBM constructs and intended delivery method. Tolooebehdasht, 12(4), 105-16. Retrieved from