The Impact of an Educational Intervention Based on Theory Of Planned Behavior on Selecting Mode of Delivery in Primigravidae Women With Intention of Elective Cesarean Section

Background & aim: Reducing cesarean section (CS) rate in order to improve maternal and neonatal health indicators is considered as one of the goals of Iran's health system transformation plan. This study aimed to examine the effect of an educational intervention based on the theory of planned behavior on selecting mode of delivery in primigravidae women with intention of elective CS. Methods: This experimental study was conducted on 130 primigravidae women referred to health centers in Neyshabour, Iran, in 2018. Multistage sampling was performed and the subjects were randomly assigned into two groups. In the intervention group, the designed educational package was implemented in four- 90-minute sessions and the control group received routine care. The theory of planned behavior constructs were measured by a self-structured tool before and after the intervention. The data were analyzed by SPSS software (version 19) using t-test, Mann-Whitney, and Chi-square tests. Results: The results showed that there was no significant difference between the mean score of attitude, subjective norm, perceived behavioral control and intention of primigravide women in two groups. However, after the educational intervention a significant difference was found between the control and intervention groups in terms of attitude (p <0.001), subjective norm (p <0.001), perceived behavioral control (p <0.001) and intention (p <0.001) towards elective CS. Conclusion: Designing educational intervention based on the theory of planned behavior can be an effective strategy to change the positive perceptions of primigravidae women about CS and ultimately decrease the intention to elective CS.