Unwillingness to have Vaginal Delivery among Iranian Women: A Qualitative Study

Abstract

Background: Cesarean section imposes a huge social and economic cost on the individual and health care system. Iran is one of the countries that have experienced a significant increase in cesarean section in recent decades. There are few studies on the causes of women's reluctance to give natural birth. This study was conducted to determine the women’s unwillingness to have vaginal delivery through qualitative methods. Methods: The present qualitative study was conducted between March to July 2023 at private and three public centers in Qom City. Purposeful sampling was used and based on inclusion criteria; 17 women were recruited in the study. MAXQDA software was used to analyze and manage the qualitative data. Results: Three main categories appeared from the data analysis, which included individual factors, professional factors, and social factors. The findings of this study showed that beliefs, fear, lack of knowledge, previous experiences, and psychological factors are the most important individual factors that cause unwillingness to give birth vaginally. Factors related to midwives and physicians, birth environment, social modeling, and legal protection affected women’s decision to choose cesarean delivery. Conclusion: The findings of this study showed that unwillingness to have vaginal delivery by women is an issue that has various reasons. These reasons remind us that education, awareness, and support in prenatal care should be considered more than ever. In addition, treatment systems play a role in increasing cesarean section, so it is the responsibility of midwifery and obstetric experts to make improvements in the treatment systems.