title: Effect of role play education on primiparous women's fear of natural delivery and their decision on the mode of delivery.
abstract: BACKGROUND
  The number of women who select cesarean section due to fear of childbirth has increased. Role play education seems to be a helpful method to remove or reduce the fear of childbirth. Therefore, this study aimed to investigate the effect of role play education on primiparous women's fear of natural delivery and their decision on the mode of delivery.
  
  
  METHODS
  In this blind clinical trial, 67 primiparous women with natural pregnancy at 34-36 weeks of gestational age and with no indication of cesarean section were selected from the health care centers in Mashhad. They were randomly assigned to two groups who underwent pre-test and post-test with the help of delivery attitude questionnaire to investigate their fear of childbirth and a researcher-made pregnant women's decision investigation questionnaire. Education through role play was conducted in the form of three scenarios during seven stages. The findings were analyzed by Fisher's exact test and independent t-test through SPSS.
  
  
  RESULTS
  The two groups were significantly different concerning the fear of childbirth after the intervention (P = 0.007), and the fear score showed a higher reduction in the role play group compared to the lecture group. There was a significant difference between the two groups concerning the reduction of elective cesarean section and the decision on the mode of delivery at the time of admission in the labor room (P = 0.000). About 75% in the lecture group and 100% in the role play group selected natural delivery.
  
  
  CONCLUSIONS
  In the present study, the effect of role play was more in making a decision on natural delivery, reducing the fear of childbirth, and reducing the rate of elective cesarean section. It is suggested to use role play method to educate pregnant women to reduce the rate of cesarean sections.
authors.affiliation: Instructor of Midwifery, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Navaee
authors.affiliation: Department of Midwifery, Faculty of Nursing and Midwifery, Mums, Mashhad, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Abedian
keywords: Decision; fear of childbirth; lecture; mode of delivery; role play