title: Women's knowledge and attitude towards mode of delivery and frequency of cesarean section on mother's request in six public and private hospitals in Tehran, Iran, 2012.
abstract: OBJECTIVE
  The rate of cesarean section (CS) has been reported to be as high as 40% among Iranian women in the year 2009. The aim of this study was to determine the rate of cesarean delivery on mother's request (CDMR) and to determine maternal attitude and knowledge about various modes of delivery in private and public (university) hospitals in Tehran.
  
  
  METHODS
  All primiparous mothers delivering in six selected hospitals between April 2010 and March 2011 were included. Trained investigators handed a predesigned questionnaire to mothers 1 day after delivery to be filled out in the presence of the investigator.
  
  
  RESULTS
  From 600 deliveries, 501 (83.5%) were CS and 99 (16.5%) were normal vaginal delivery. The CS rates in university hospitals versus private hospitals were 78.5% and 91.9%, respectively. In total, mothers' knowledge scores were poor, intermediate, and good in 55.6%, 37.9%, and 6.5% of cases, respectively, and no significant difference in knowledge was observed between mothers attending private or public hospitals. The overall rate of CDMR was 20.8%; and the most frequent reason was fear of pain. Women with CDMR were at higher marital age, education, insurance coverage, and socioeconomic status compared with the women with vaginal delivery.
  
  
  CONCLUSIONS
  Prompt action is needed to reduce the unacceptably high rate of unwarranted cesarean deliveries. Improving women's knowledge about the risks and benefits of different modes of delivery can lead to a positive maternal attitude towards vaginal delivery.
authors.affiliation: Department of Neonatal Intensive Care Unit, Taleghani Hospital, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Ghotbi
authors.forename: Azadeh
authors.initials: A
authors.lastname: Akbari Sene
authors.forename: Eznollah
authors.initials: E
authors.lastname: Azargashb
authors.forename: Farideh
authors.initials: F
authors.lastname: Shiva
authors.forename: Mina
authors.initials: M
authors.lastname: Mohtadi
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Zadehmodares
authors.forename: Farah
authors.initials: F
authors.lastname: Farzaneh
authors.forename: Fakhr-al-Molouk
authors.initials: FA
authors.lastname: Yasai
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D016304:Hospitals, Private; D006779:Hospitals, Public; D006801:Humans; D007492:Iran; D013997:Time Factors
keywords: attitude; cesarean section; elective surgical procedure; knowledge; normal vaginal delivery