Assessment of Primiparous Pregnant Women's Knowledge about the Complications of Cesarean Section among Mothers Referred to Health Centers in Ardabil County

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

2 Department of Social Medicine & Biostatistics, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

3 Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

10.22038/psj.2026.92990.1513

Abstract

Introduction:
The increasing rate of cesarean section is a major public health concern. Despite its benefits in specific conditions, this method leads to increased complications such as infection, bleeding, thromboembolism, and neonatal problems. In Iran, the cesarean rate has been reported to be 3 to 4 times higher than the WHO standard. Lack of sufficient knowledge and incorrect attitudes of pregnant women towards cesarean complications are important reasons for the unnecessary choice of this method, which further reveals the necessity of investigating the knowledge level of this group. To determine the level of knowledge about cesarean section complications among primiparous pregnant women in Ardabil County.
Materials and Methods:
This descriptive-cross-sectional study was conducted on 398 primiparous pregnant women referred to Ardabil health centers. Multi-stage cluster sampling was performed. The research tool was an 18-item questionnaire to assess knowledge. A correct answer received one point, and an incorrect or "I don't know" answer received zero points. Data analysis was performed using SPSS software version 21, using Spearman's correlation, Mann-Whitney, Kruskal-Wallis, and logistic regression tests.
Results:
The mean knowledge score of women was 11.38 ± 2.67. A significant relationship was observed between knowledge and education, occupation, income, and prenatal education, but no significant relationship was found between knowledge and age or gestational age. According to logistic regression, prenatal education was a predictor of knowledge.
Conclusion:
The study concludes that knowledge levels are insufficient. Implementing targeted prenatal educational programs is crucial to increase awareness and reduce unnecessary cesarean sections.

Keywords

Main Subjects

References

  1. Liu NH, Mazzoni A, Zamberlin N, Colomar M, Chang OH, Arnaud L, et al. Preferences for mode of delivery in nulliparous Argentinean women: a qualitative study. Reprod Health. 2013;10(1):2. doi: 10.1186/1742-4755-10-2.
  2. Vasegh Rahimparvar SF, Hamzehkhani M, Geranmayeh M, Rahimi R. Effect of educational software on self-efficacy of pregnant women to cope with labor: a randomized controlled trial. Archives of gynecology and obstetrics. 2012;286(1):63-70. doi: 10.1007/s00404-012-2243-4.
  3. Azizi M, Salari P. C-section in request: an ethical approach. Iranian Journal of Medical Ethics and History of Medicine. 2009; 2(2):55-66. URL: http://ijme. tums.ac. ir/ article-1-281-en.html
  4. Attarian S, Feyzi Z, Jamali J, Firoozi M. The effect of motivation and ability to choice of delivery type on the labor self-efficacy in women with previous cesarean section. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2022;25(2):44-51. Doi: 10. 22038/ ijogi.2022.20321
  5. Rahmanian K, Rahmanian V, Ghasvari M. The Knowledge of Pregnant Women about Shortcomings of ‌Cesareanand Its Associated Factors in 2009. J Res Dev Nurs Midw 2013; 10 (1) :84-91 URL: http:/ /nmj. goums.ac.ir/article-1-324- en.html
  6. Macfarlane AJ, Blondel B, Mohangoo AD, Cuttini M, Nijhuis J, Novak Z, et al. Wide differences in mode of delivery within Europe: risk-stratified analyses of aggregated routine data from the Euro-Peristat study. BJOG: an international journal of obstetrics and gynaecology. 2016;123(4):559-68. DOI: 10.1111/1471-0528.13284
  7. Yamasmit W, Chaithongwongwatthana S. Attitude and preference of Thai pregnant women towards mode of delivery. Journal of the Medical Association of Thailand. 2012;95(5):619.
  8. Ashimi A, Amole T, Aliyu L. Knowledge and attitude of pregnant women to caesarean section in a semi-urban community in northwest Nigeria. Journal of the West African College of Surgeons. 2013;3(2):46.
  9. Begum T, Ellis C, Sarker M, Rostoker J-F, Rahman A, Anwar I, et al. A qualitative study to explore the attitudes of women and obstetricians towards caesarean delivery in rural Bangladesh. BMC pregnancy and childbirth. 2018;18(1):368. DOI: 10. 1186/ s12884-018-1993-9
  10. EREN SY, BÜYÜKBODUR AÇ. The Relationship Between the Self-Perceived Power and Fear of Childbirth Among Pregnant Women. JOURNAL OF WORLD WOMEN STUDIES. 2023;8(2):237-47.
  11. Joshi A, Thapa M, Panta OB. Maternal Attitude and Knowledge towards Modes of Delivery. J Nepal Health Res Counc. 2018 Jul 3;16(2):209-214. PMID: 29983439.
  12. Janati S, Montazeriyan M, Kassani A, Kianmanesh S. Women's knowledge and attitude towards mode of delivery in Ganjavian Hospital in Dezful. Navid No. 2022; 24(80):66-74.
  13. Rydahl E, Declercq E, Juhl M, Maimburg RD. Cesarean section on a rise-Does advanced maternal age explain the increase? A population register-based study. PLoS One. 2019;14(1): e0210655. DOI: 10.1371/ journal. pone.0210655
  14. Richards MK, Flanagan MR, Littman AJ, Burke AK, Callegari LS. Primary cesarean section and adverse delivery outcomes among women of very advanced maternal age. J Perinatol. 2016;36(4):272-7. DOI: 10.1038/jp.2015.204
  15. Hochler H, Lipschuetz M, Suissa-Cohen Y, Weiss A, Sela HY, Yagel S, et al. The Impact of Advanced Maternal Age on Pregnancy Outcomes: A Retrospective Multicenter Study. J Clin Med. 2023;12(17). DOI: 10.3390/jcm12175696
  16. Rademaker D, Hukkelhoven C, van Pampus MG. Adverse maternal and perinatal pregnancy outcomes related to very advanced maternal age in primigravida and multigravida in the Netherlands: A population-based cohort. Acta Obstet Gynecol Scand. 2021;100(5):941-8. DOI: 10.1111/aogs.14064
  17. Lee HY, Kim R, Oh J, Subramanian SV. Association between the type of provider and Cesarean section delivery in India: A socioeconomic analysis of the National Family Health Surveys 1999, 2006, 2016. PLoS One. 2021;16(3):e0248283. DOI: 10.1371/journal.pone.0248283
  18. Sun Y, Huang K, Hu Y, Yan S, Xu Y, Zhu P, et al. Pregnancy-specific anxiety and elective cesarean section in primiparas: A cohort study in China. PLoS One. 2019; 14(5): e0216870. DOI: 10.1371/journal. pone. 0216870
  19. Eide KT, Morken NH, Bærøe K. Maternal reasons for requesting planned cesarean section in Norway: a qualitative study. BMC Pregnancy Childbirth. 2019;19(1):102. DOI: 10.1186/s12884-019-2250-6
  20. Harrison MS, Goldenberg RL. Cesarean section in sub-Saharan Africa. Matern Health Neonatol Perinatol. 2016;2:6. DOI: 10.1186/ s40748-016-0033-x
  21. Singh P, Hashmi G, Swain PK. High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India. BMC Public Health. 2018;18(1):613. DOI: 10.1186/s12889-018-5533-3
  22. Jenabi E, Khazaei S, Bashirian S, Aghababaei S, Matinnia N. Reasons for elective cesarean section on maternal request: a systematic review. J Matern Fetal Neonatal Med. 2020;33(22):3867-72. DOI: 10.1080/14767058.2019.1587407
  23. Faisal-Cury A, Menezes PR, Quayle J, Santiago K, Matijasevich A. The relationship between indicators of socioeconomic status and cesarean section in public hospitals. Rev Saude Publica. 2017;51(0):14. DOI: 10.1590/S1518-8787.2017051006134
  24. Maher GM, Ward LJ, Hernandez L, Kublickas M, Duvekot JJ, McCarthy FP, et al. Association between socioeconomic status with pregnancy and neonatal outcomes: An international multicenter cohort. Acta Obstet Gynecol Scand. 2023;102(11):1459-86. DOI: 10.1111/aogs.14659
  25. Zhang J, Zhang Y, Ma Y, Ke Y, Huo S, He L, et al. The associated factors of cesarean section during COVID-19 pandemic: a cross-sectional study in nine cities of China. Environ Health Prev Med. 2020;25(1):60. DOI: 10.1186/s12199-020-00899-w
  26. Breintoft K, Pinnerup R, Henriksen TB, Rytter D, Uldbjerg N, Forman A, et al. Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis. J Clin Med. 2021;10(4). DOI: 10.3390/jcm10040667
  27. Jiang C, Wen H, Hu T, Liu Y, Dai X, Chen Y. Perinatal characteristics and pregnancy outcomes of advanced maternal age women with gestational diabetes mellitus: A retrospective cohort study. Health Sci Rep. 2024;7(2):e1903. DOI: 10.1002/hsr2.1903

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. Zaman A, Fadlalmola HA, Ibrahem SE, Ismail FH, Abedelwahed HH, Ali AM, et al. The role of antenatal education on maternal self-efficacy, fear of childbirth, and birth outcomes: A systematic review and meta-analysis. Eur J Midwifery. 2025;9. DOI: 10.18332/ejm/200747
  2. Ayalew M, Mengistie B, Dheressa M, Demis A. Magnitude of Cesarean Section Delivery and Its Associated Factors Among Mothers Who Gave Birth at Public Hospitals in Northern Ethiopia: Institution-Based Cross-Sectional Study. J Multidiscip Healthc. 2020; 13:1563-71. DOI: 10.2147/ JMDH. S277747
  3. Rutayisire E, Wu X, Huang K, Tao S, Chen Y, Tao F. Cesarean section may increase the risk of both overweight and obesity in preschool children. BMC Pregnancy Childbirth. 2016;16(1):338. DOI: 10.1186/ s12884-016-1131-5
  4. Kan A. Classical Cesarean Section. Surg J (NY). 2020;6(Suppl 2): S98-s103. DOI: 10.1055/s-0039-3402072
Journal of Patient Safety & Quality Improvement
Volume 14, Issue 2
April 2026
Pages 97-106

Files

Share

How to cite

Statistics