Psychological Predictors of Intention to Deliver Vaginally through the Extended Parallel Process Model: A Mixed-Method Approach in Pregnant Iranian Women.
OBJECTIVE
Despite the fact that cesarean delivery does not offer significant health benefits for either mother or newborn, there has been a noticeable upward trend in elective cesarean births in Iran, over the last two decades. This study aims to examine whether knowledge, perception of health threats, efficacy, and personal beliefs act as psychological predictors towards the intention of women to have a normal vaginal delivery.


METHODS
The mixed-method approach was used as quantitative and qualitative design. Simultaneously, 290 pregnant women who visited prenatal clinics participated in the study. Quantitative and qualitative data were collected using a structured questionnaire based on Witte's Extended Parallel Process Model, and four focus groups, respectively.


RESULTS
Women perceived lower personal risk but higher levels of efficacy. Perceived self-efficacy, severity, and response efficacy emerged as significant predictors of intention to experience vaginal birth. The participants' insufficient knowledge and misconceptions about birth methods were prevalent. Major themes were identified and divided into negative and positive beliefs about vaginal birth.


CONCLUSIONS
This educational model is useful for understanding women's intention to undergo a vaginal birth, especially when it is combined with a qualitative approach. Maternal care providers should acknowledge their clients' beliefs and intended childbirth methods prior to offering medical intervention.
Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sepideh
S
Hajian
Mohammad
M
Shariati
Khadijeh Mirzaii
KM
Najmabadi
Masud
M
Yunesian
Mohammad Esmaeel
ME
Ajami
Extended Parallel Process Model; Normal vaginal delivery; mixed methods