title: Socio-Cultural Beliefs, Values and Traditions Regarding Women's Preferred Mode of Birth in the North of Iran.
abstract: BACKGROUND
  Pregnant women rely heavily on informal information while making a decision about the mode of delivery they would rather have, either as normal vaginal delivery (NVD) or cesarean section (CS). Through recognition of social attitudes towards different modes of delivery, societies can be directed towards a positive understanding of vaginal delivery, which can ultimately lead to maternal health promotion. Thus, this study aimed to explore the common beliefs, values and traditions surrounding women's preferred mode of birth in the North of Iran.
  
  
  METHODS
  Using a focused ethnographic approach, twelve pregnant women, 10 women with previous experience of childbirth, seven midwives, seven obstetricians, and nine non-pregnant women were included in this study through a purposeful sampling in health clinics of Tonekabon in the North of Iran. Semi-structured interviews and participant observations were used for data collection. Study rigor was confirmed through prolonged engagement, member check, expert debriefing, and thick description of the data. Data were analysed using Braun & Clarke thematic analysis (2006) and MAXqda software.
  
  
  RESULTS
  Through analysis, three major themes and 10 subthemes emerged.  They included: 1) sociocultural childbirth beliefs with five subthemes: a) CS as protector of genital tract integrity, b) blind imitation in choosing mode of birth, c) NVD as a low cost type of delivery,  d) CS as a prestigious mode of birth and, e) NVD as a symbol of woman's power and ability; 2) traditional health beliefs with two subthemes: a) NVD as a guarantee for woman's health, b) traditional childbirth facilitators; 3) religious beliefs and values with three subthemes: a) NVD as a symbol of God's power, b) call for help from the Mighty God, and c) NVD as a sacred phenomenon.
  
  
  CONCLUSIONS
  The results of this study indicated that cultural beliefs, values and traditions can significantly affect individuals' attitudes towards modes of delivery, their definitions of different modes, and the decisions they make in this regard. In order to develop a positive cultural and religious attitude towards vaginal delivery, women's awareness has to be raised through various ways and the existing misconceptions need to be corrected.
authors.affiliation: Evidence-Based Care Research Centre, Department of Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran;
authors.forename: Robab
authors.initials: R
authors.lastname: Latifnejad Roudsari
authors.affiliation: Department of Midwifery, School of Medicine, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran;
authors.forename: Maryam
authors.initials: M
authors.lastname: Zakerihamidi
authors.affiliation: Iranian National Center for Addiction Studies (INCAS), Institution of Risk Behavior Reduction, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Effat
authors.initials: E
authors.lastname: Merghati Khoei
keywords: Birth; Cultural beliefs; Iran; Qualitative study; Women