Attitude of pregnant women, midwives, obstetricians and anesthesiologists toward mode of delivery: a qualitative study

To investigate the attitudes toward mode of delivery of pregnant women, midwives, obstetricians and anesthesiologists who participate in childbirth in Shahrood, Iran. This was a qualitative research with tri-angulations data collection strategy. The study sample was consisted of primiparous and multiparous women, midwives, obstetricians and anesthesiologists. A total of 18 women who seek prenatal care from Fatemiyeh obstetrics clinics during pregnancy, were asked to participate in 3 focus group discussions. 8 midwives in labour ward and clinic were interviewed individually. All of physicians were participate in study by Delphi method for data collection purpose. All interviews and discussions were tape recorded. The main themes were categorized into two main categories: "causes of intention to cesarean" and "causes of intention to vaginal delivery". The main reason for intention to use cesarean was fear of pain due to vaginal delivery and the main reason for intention to use vaginal birth was fear of post cesarean pain and its morbidity. Other reasons that raise the cesarean section rate in Shahrood included, fear of legal complaints after vaginal birth complications fear of sexual disorders after vaginal birth, existing conflicts between midwives duties and obstetricians and negative attitudes. The results clearly show that although most of women and health providers do not consider cesarean section as the first option for delivery, but some essential obstacles remain as major reasons for increasing cesarean rate.