The Impact of Educational Intervention Based on the Theory of Planned Behavior in Choosing Delivery Mode in Primigravida Pregnant Women

Childbirth is a physiological process to end the pregnancy which during it, a child is born. Therefore, the delivery method is extremely important along with it (1). In the meantime, birth of the first child is considered as an important event in the pregnant women's life due to lack of previous experiences. So delivery type is one of the most significant and considerable experiences of the first delivery (2,3). Childbirth is a normal and physiological process which has to happen without any intervention. Despite advances in surgical procedures in recent decades, elective cesarean section (CS) has been increasingly common and raised as a critical issue for healthcare politicians, obstetricians and gynecologists, hospitals as well as mothers (4). The CS refers to the delivery of fetus through incision of abdominal wall and the wall of the uterine (5). The high rate of CS is a modern midwifery problem that raises nowadays, not only enhances obstetric complications, but also imposes an additional financial burden on families, government and insurance institutions (4). The CS rate rises in both developed and developing countries. In a study done by the World Health Organization (WHO) in 2007 and 2008 in 24 countries, the average amount of CS rate was 27%. According to this report, China has the highest rate (46.2%). It was also reported that in the United States almost 32% of deliveries has been through CS. In Iran, several studies have shown that the increasing of CS rate is higher than the recommended rate by the WHO (10%-15%). For example, in Tehran, the CS rate was 66.5% and it increases to 84% in the private centers. According to international estimates, the request of mothers has been 4% to 18% of all the CSs. In Iran, the rate is variable between 7% and 13.5% (6,7). Childbirth through CS is necessary in emergencies and dangerous cases, to save the lives of mother and the child and it worth to accept the dangers of it, but we should not forget that there is no surgery without risk (8). CS has a lot of complications for mother and the child, include bleeding, infection, thromboembolism, increased mortality, premature birth and child breathing problems. CS may increase the risk of problems such as maternal mortality, urinary tract injuries and hysterectomy. On the other hand, mother disabilities after the operation may cause lack of proper breastfeeding and full attention to the child. The results of recent studies show that CS affects the fertility decline and also the creation of postpartum depression (6,9). Overall, the CS, in each country, is one of the performance evaluation indicators for maternal health care programs, and increase in unnecessary CS, indicates inadequate performance of the health care system (10). However, the normal vaginal de-