Evaluation of the knowledge and attitudes of the nulliparous pregnant women about delivery types during pregnancy period

INTRODUCTION AND AIM: In this study, the aim was to determine the effect of the knowledge and attitudes of the nulliparous women who applied to a hospital on the type of delivery they prefer, whether the type of delivery they prefer has changed with the progression of pregnancy and whether there is any difference between the preferred types of delivery and how they actually delivered. MATERIAL AND METHOD: This study, which was planned as a cross-sectional type descriptive study, included 232 nulliparous pregnant women over the age of 18 who were admitted to the outpatient clinic of the Sakarya University Education and Research Hospital's Obstetrics and Gynecology Campus for various complaints and agreed to participate in the study. Three interviews were conducted with the pregnant women and the data were collected through a questionnaire prepared by the researcher in these interviews. The first interview with the pregnant women was done within the first 24 weeks of pregnancy and the second interview was carried out at the 36th week of pregnancy or after. The last interview was performed after birth. RESULTS: The mean age of the pregnant women included in the study was 24.5 ± 4.05 (SD) (min = 18, max = 41). In the first interview, 83.6% of the pregnant women stated that if there is no medical reason, they want to give birth by normal vaginal delivery (NVD) and 5.6% by cesarean section but 10.8% was undecided. The fact that the normal delivery was healthier and the recovery time was shorter was reported as the primary reason for choosing NVD in the first interview. The fear of normal birth pain was the most common reason for choosing cesarean section. Logistic regression analysis was performed to see the effects of certain variables on the choice of delivery method in the first interview. The pregnant women who were high school graduates were 3,1 times more likely to prefer cesarean section or to be undecided than those who were not. In addition, undergoing treatment to become pregnant and being surrounded by people with negative NVD experiences made subjects more likely to prefer cesarean section or to be undecided 4,0 times in the former case and 2,9 times in the latter (p<0.05). In addition, it was found that those who thought they did not have enough knowledge about the types of delivery were also 4,7 times more likely either to prefer cesarean delivery or to be undecided (p <0.05). In the second interview, 90% of 201 pregnant women reported that they wanted to give birth with NVD and 8.5% expressed their intention to give birth by cesarean section and 1.5% were undecided. However, the actual cesarean section rate for this 201 pregnant woman was 44.3%. Although there was no statistically significant difference between the preferred types of delivery in the first and second interviews, a significant difference was found between the two interviews and the actual type of delivery. Also no significant difference was found between the preferred type of delivery in the second interview and the type of delivery recommended by the physicians who performed the follow-ups of the pregnant women. CONCLUSION: Although the caesarean preference rate was 5.6% in the first interview and 8.5% in the second interview and the recommendations of the doctors were close to these rates, the rate of the cesarean sections performed was as high as 44.3%. Despite the fact that the study can't be generalized to the population, we think that it is necessary to investigate the causes of this change in the percentage. Various hypotheses can be developed, but doing qualitative research together with the other relevant parties (health care managers, obstetricians and gynecologists, midwives, prospective parents) will make a significant contribution to this area.