Applying the Theory of Planned Behavior in Predicting Factors Influencing the Choice of the Type of Delivery of Pregnant Women Referring to Comprehensive Health Centers

The high prevalence of caesarean section is a global health concern, especially in Iran. Considering the possibility of complications caused by cesarean section and the importance of identifying the development process of this delivery method, the present research was conducted with the aim of determining the factors influencing the behavioral intention and the choice of the type of delivery by pregnant women of Bojnord city based on the theory of planned behavior.

The current cross-sectional study was conducted in 2021 on 369 pregnant women first abdomen who referred to comprehensive health centers in Bojnurd city. The sampling method was multi-stage. The data collection tool was a questionnaire based on the theory of planned behavior. The data were analyzed by SPSS 21 software by using t-test, Mann-Whitney, and Chi-square tests. 

72.6% of the participants wanted to give birth naturally and 27.4% had a cesarean birth. People who intended to have a natural birth significantly had better knowledge, a more positive attitude towards natural birth, and a better perceived behavioral control (P<0.001). The two constructs of attitude (β=-0.234) and perceived behavioral control (β=-0.215) had the most negative and significant predictors of the behavioral intention to perform cesarean delivery (P<0.001). The results of the subjective norms showed that the doctor's opinion and the mass media had the greatest and least influence on the choice of the type of delivery in pregnant women, respectively. The constructs of the theory of planned behavior together predicted 17.2 of the variance of natural childbirth intention in pregnant women.

The theory of planned behavior can be effective by identifying the factors of pregnant women's intention in choosing natural delivery. It is suitable with training and interventions to reduce the rate of cesarean section for pregnant women using this theory.