Effects of Reviewing Childbirth Scenarios on Choice of Delivery Type: A Randomized Controlled Trial

Objective: Cesarean section (CS) was estimated about 48% from 2000 to 2012 in Iran. Study was conducted to assess the effects of reviewing written childbirth scenarios on the selection of delivery method.
Material and Methods: This randomized controlled trial was conducted in Shohada Women’s Hospital in Behshahr, Mazandaran, Iran from May to December 2015. A total of 223 women at 28 to 32 weeks of gestation as the participants were allocated randomly into three groups, namely, the standard care (control), theory of planned behavior-based education (TPB), and TBP education plus additional support via written childbirth scenarios (scenario) groups. Participants were assessed at the baseline (weeks 28–32) and intervention (week 37 of pregnancy) periods. Both the intervention groups (i.e., TPB and scenario groups) participated in three learning sessions that were based on TPB, whereas the control group received routine care service.
Results: The frequencies of normal vaginal delivery (NVD) in the scenario, TPB, and control groups were 73.2%, 58.5%, and 45.7%, respectively (p = 0.004). Results showed that the relative risks of CS decision in the scenario and TPB groups relative to the control group were both 0.87 and statistically significant (95% CI: 0.018 and 0.013, respectively). The relative risk of choosing CS after the removal of obligatory CS cases in the scenario group compared with the control and TPB groups decreased by 0.15 and 0.07, respectively.
Conclusion: Written childbirth scenarios that contain information on NVD and CS as additional support are effective educational tools for reducing CS rates.