Comparative study of teaching natural delivery benefits and optimism training on mothers' attitude and intention to select a type of delivery: an educational experiment.

Background: Despite advantages of normal vaginal delivery (NVD) and disadvantages of caesarean section (C-section) and the increasing C-section rate Iran, appropriate training is essential in reducing this trend. Optimism is one of the important psychological determinants which is a combination of positive desire and attitude in people.

Objective: The purpose of this study was to determine the effects of optimism training as well as training the benefits of natural childbirth on attitude and intentions to choose the type of delivery.

Methods: In this experimental study, 96 primiparous women referring to health centers in Mashhad (Iran) in 2014 with pregnancy duration of 30 to 34 weeks and without indication of C-section, were selected and randomly divided into two training groups and one control group. Optimism training was provided during six 60-minute sessions, whereas training the benefits of NVD was conducted in four 60-minute sessions. Pre-test and post-test were performed using valid and reliable questionnaires, researcher-made questionnaire, attitude-measuring questions on NVD and C-section, and optimism-measuring standard questionnaires (LOT-R). Data were analyzed by IBM-SPSS version 22, using Kruskal-Wallis, Chi square, paired-samples t-test, Independent-samples t-test, Man-Whitney U, and Wilcoxon signed-rank test.

Result: There was a significant difference between the mean scores of attitudes towards natural delivery in the group that received both optimism and natural delivery advantages trainings compared with the group receiving only the latter (p>0.001). Frequency of intentions to choose the type of delivery after optimism and natural delivery advantages trainings compared with training the benefits of natural childbirth only, did not show a significant difference (p=0.135).

Conclusion: Optimism training combined with training the benefits of natural childbirth is more effective in creating positive attitude towards natural delivery in comparison with only the NVD advantages education, but it has no effect on selecting the type of delivery. Probably one of the most important reasons of failure of achieving a proper result is the low sample size.

Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2015063022995N1.

Funding: This trial is funded by Mashhad University of Medical Sciences in collaboration with the Evidence-Based Research Center (Ref: research/930321/1/172).