Effect of "motivational interviewing," and "information, motivation and behavioral skills" counseling interventions on choosing the mode of delivery in pregnant women: A randomized controlled trial

Abstract

Abstract Background: This randomized controlled trial aimed at comparing the effects of "motivational interviewing" and "information, motivation and behavioral skills" counseling interventions on choosing the mode of delivery in pregnant women in Tehran, Iran. Methods: In a four-armed, parallel-design randomized controlled trial, 120 women were randomly assigned to three interventions and one control groups. The intervention groups included the following: 1) motivational interviewing (MI group); 2) face-to-face information, motivation, and behavioural skills training (IMB group); and 3) information, motivation, and behavioural skills training provided using a mobile application (IMB-App. group). The control group received usual antenatal care. The inclusion criteria included being in gestational age from 24 to 32 weeks at the time of recruitment, being literate, being able to speak Persian, and having no complications in the current pregnancy, having no indications for Cesarean section, and having enough time to participate in the study. The primary outcome of the study was the mode of delivery. The secondary outcomes included women's intentions to undergo Cesarean section (CS) and self-efficacy for choosing the mode of delivery. Results: More than half of the women (56.7%) in the intervention groups preferred to undergo NVD. However, only 37.5% of them underwent NVD. The participants’ self-efficacy scores and intentions to choose the mode of delivery significantly increased (P < 0.05) in all three intervention groups. The participants in the IMB-App group reported significantly higher self-efficacy and intentions compared with the other two intervention groups and the control group. Conclusions: Brief educational and motivation enhancement interventions could positively help pregnant women to choose normal vaginal delivery instead of unnecessary CS. Moreover, women's self-efficacy and intention to choose mode of delivery were improved in all three interventions, especially when offered using a mobile application. The use of non-expensive brief psycho-educational interventions may significantly reduce unnecessary CS, especially when combined with other evidence-based strategies to change healthcare providers’ practices and institutional policies. Trial registration: This study has been registered in Iran's Randomized Clinical Trial Center (IRCT20151208025431N7), registered on (07/12/2018).