Why do primigravidae request caesarean section in a normal pregnancy? A qualitative study in Iran.
OBJECTIVE
to gain a deeper understanding of why Iranian primigravidae request caesarean section without any medical indication.


METHODS
qualitative study. Data were gathered through semi-structured interviews, and thematic analysis was undertaken.


METHODS
four health care centres at Hamadan University of Medical Sciences, Hamadan, Iran.


METHODS
14 primigravidae who requested caesarean section without any medical indication.


RESULTS
reasons for requesting caesarean section were related to fear of childbirth (labour pain, injury to mother or infant), complications after vaginal delivery (vaginal prolapse, urinary incontinence, sexual dysfunction), trust in obstetricians, and lack of trust in maternity ward staff.


CONCLUSIONS
the main reasons given for requesting caesarean section show that there is urgent need for effective antenatal assessment to enable pregnant women to ask questions and express their concerns. In order to promote vaginal birth, there is a need to develop antenatal education and strategies to enhance women's knowledge, confidence and competence about vaginal birth. Health care providers should be re-educated about the observance of medical ethics and professional rules in their practices, and change their attitudes and behaviours to vaginal birth. Evaluation, improvement and change in maternity care policies are recommended to promote natural childbirth.
Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia.
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Faisal
Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia; Department of Nursing, Faculty of Science, Islamic Azad University of Hamadan, Iran. Electronic address: nmatinniach@gmail.com.
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Matinnia
Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia.
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Hejar
Department of Nursing, Faculty of Science, Islamic Azad University of Hamadan, Iran.
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Khodakarami
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000523:psychology*; D002755:Choice Behavior; D005069:Evaluation Studies as Topic; D005260:Female; D020073:Gravidity; D006801:Humans; D007407:Interviews as Topic; D007492:Iran; D008427:Maternal Health Services; D008880:Midwifery; D011247:Pregnancy; D055815:Young Adult
Childbirth; Elective caesarean section; Iranian primigravidae; Qualitative research