Predictors of mode of childbirth based on medicalized maternal care : a cross-sectional study

Abstract EN

Background: Although there are studies that suggest a vast expansion of medicalization of pregnancy and birth in Iran, data about the rate of intervention applications caused by the medicalization in low-risk pregnancies and birth is limited.

Moreover, there is limited information on the effectiveness of these interventions for different modes of childbirth.

Objectives: This study aimed to determine the rate of application of maternal medicalized care in low-risk pregnancies and births and to identify the factors that are associated with type of delivery.

Patients and Methods: This cross-sectional study was performed by stratified-cluster sampling on 320 postpartum women from four public and private hospitals in Mashhad, Iran.

The data collection instrumentwas a designed and standardized tool for assessment of medicalized pregnancy and childbirth.

Also, descriptive tests and logistic regression were used.

A value of P < 0.05 was considered statistically significant for all tests.

Results: In this study, the rates of natural vaginalandcaesarean birth were 34.7% and65.3%, respectively.

Preconceptionandprenatal care receivedfromanobstetrician were 72.8% and51.6%, respectively.

Themediannumberof prenatal visits, laboratory examinations andsonography procedureswas12, 3and4, respectively.

In 49.4% of the cases, thewomenwere hospitalized before the onset of labor.

Early admission (OR = 2.40; 95% CI = 1.93 - 2.97; P = 0.001) and performing electronic fetal heart monitoring during admission (OR = 2.47; 95% CI = 1.28 - 4.73; P = 0.006) were the interventions that the regression logistic analysis identified as associated with a higher rate of caesarean delivery.

Conclusions: It seems that obstetric interventions are widely applied in low-risk pregnancies and births.

Some of these interventions have the effect of increasing the rate of caesarean delivery.

According to the provided information, it seems that it is necessary to adjust health policy to provide appropriate care for low-risk pregnancies and births.