A review on strategies to important knowledge and attitude of Iranian pregnant women requesting for caesarean

Background and Purpose: Maternal request for cesarean section is a major influential factor in the rising trend of this childbirth mode.
Lack of knowledge and negative attitudes toward natural delivery are the main causes of this issue. This study aimed to review the
strategies to increase the knowledge and change the attitudes and request of Iranian pregnant women for caesarean section.
Methods: In this narrative review, all interventional studies conducted on Iranian pregnant women with the objective of enhancing
the knowledge and attitudes toward natural delivery were identified via searching in databases such as Google Scholar, ScienceDirect,
Scopus, SID, MedLib, Magiran, and PubMed for articles published during 2000-2015.
Results: In total, 22 articles were reviewed in this study. In these studies, systematic and planned educational interventions were
carried out, including group education and discussion, question and answer and role-playing (n=10). Other intervention methods were
based on various models and theories, such as the health belief model (n=3), behavioral intention model (n=4), theory of reasoned
action (n=1), theory of planned behavior (n=2), and cognitive-behavioral consultation (n=2). Reviewed findings were indicative of
the significant improvement of knowledge, attitudes and intentions toward natural delivery following the interventions (P<0.05).
Conclusion: According to the results of this review, various education and consultation programs are effective in enhancing the
knowledge and changing the attitudes and intentions of pregnant women toward natural childbirth. Nevertheless, high rate of cesarean
section suggests that these interventions are not implemented consistently. It is noteworthy that effects of other confounders must be
considered in this regard.