Factors Contributing to Iranian Pregnant Women’s Tendency to Choice Cesarean Section

Background: Cesarean section (C-section) not only is associated with health risks for both mother and child, but also is costly. C-section rates are on the rise worldwide. In Iran, it is becoming a major challenge for current population policies. Objectives: The current study aimed to investigate the main factors of the tendency to C-section in Iran. Methods: In this cross-sectional study 320 pregnant women admitted to health centers in Lorestan province (west of Iran) in 2019 are included. Participants were selected using the multi-stage cluster sampling technique. Data were collected using a demographic form, the Fear of Pain Questionnaire, and the Knowledge and Attitude about Delivery Methods scale. Descriptive statistics and multivariate logistic regression model were employed to analyze the data using the Stata version 14. Results: 48.44% of participants preferred cesarean delivery. The mean scores of fear of pain in the C-section and vaginal delivery groups were 39.98 ± 8.21 and 36 ± 8.62, respectively, indicating a significant difference (P < 0.001). Level of education of the husband (OR = 2.79), income (OR = 5.9), fear of labor pain (OR = 1.04), history of C-section, and improved attitude toward C-section (P < 0.001) were directly associated with increased tendency to C-section (OR = 0.36); in contrast, female gender of the fetus (OR = 0.36), increased BMI (OR = 0.75), and improved attitude toward vaginal delivery were indirectly associated with women’s tendency to C-section. Conclusions: This study showed that while many pregnant women prefer vaginal delivery, the tendency to C-section in Lorestan province is high, which reveals the need to design and implement effective interventions and programs to reduce unnecessary C-section and promote vaginal delivery. Educating families, especially pregnant women, about the advantages and disadvantages of delivery modes, promoting and using new low pain techniques of vaginal delivery, and increasing women’s participation in childbirth preparation programs are effective measures that can reduce the rate of unnecessary C-section.