Knowledge and Attitudes of Pregnant Thai Women Regarding Modes of Birth: A Hospital-Based Study in Southern Thailand

Abstract

Objective: This study aimed to determine the knowledge and attitudes of pregnant Thai women regarding modes of birth. Methods: A cross-sectional study was conducted at Songklanagarind Hospital. A total of 605 women with a singleton pregnancy and gestational age >20 weeks who attended an antenatal clinic from September 2018 to June 2019 were recruited. Women having a history of cesarean section, or any condition associated with indications for cesarean section, having a fetus with an obvious anomaly, could not read or write in the Thai language, or could not complete the questionnaire were excluded. Their knowledge and attitudes regarding modes of birth were evaluated through self-administered questionnaires. Results: Most women (69.4%) had poor knowledge scores (<5), with a median score of 3 (range, 0-9). Only 14.5% of women knew about serious complications of cesarean section in future pregnancies(placental adherence). Multivariate logistic regression analysis showed that factors associated with adequate knowledge scores (>5) were high educational levels (OR 2.06; 95% CI 1.23-3.47), high incomes (OR 1.96; 95%CI 1.32-2.90), and multiparity(OR 1.73; 95%CI 1.18-2.52). Most women had positive attitudes towards vaginal birth. Only 10.2% of women had a preference for cesarean birth. Factors associated with the preference for cesarean birth were advanced maternal age (OR 3.10; 95%CI 1.72-5.60), having an underlying disease (OR 3.61; 95% CI 1.79-7.25), and poor knowledge scores (OR 2.43; 95% CI 1.21-4.91). Conclusion: Most pregnant Thai women had poor knowledge of the modes of birth. However, the majority of women had positive attitudes towards vaginal birth.