Evaluation of childbirth self-efficacy and associated factors among pregnant women

BACKGROUND: Increasing the rate of Normal Vaginal Delivery (NVD) and reducing elective cesarean section is one of the important concerns, especially in Iran. Childbirth self-efficacy can play an important role in managing the fear of childbirth and increasing the rate of NVD. The aim of this study was to determine demographic, fertility, and social factors related to childbirth self-efficacy. MATERIALS AND METHODS: The present study was a single-group, single-stage, multivariate, cross-sectional study that assessed childbirth self-efficacy and associated factors in 358 eligible pregnant women with gestational age of 37 weeks and over in Guilan (North Iranian province) from November 2018 to July 2019. Data collection was performed based on consecutive sampling method from the pregnant women referring to the prenatal clinic. Data collection tools included a demographic and reproductive characteristics questionnaire; Lowe's childbirth self-efficacy Inventory and Zimet's perceived social support multidimensional questionnaire. RESULTS: There was a significant relationship between the educational level of pregnant women and Outcome Expectancy (OE) and Self-efficacy Expectancy (EE) and also between the spousal level of education and OE (P < 0.05). Parity, previous experience of birth, participation in pregnancy preparation classes, access to information sources about childbirth, and birth preference were significantly related to OE and EE (P < 0.05). There was a significant relationship between the two domains of perceived social support, spouse and friends, and the OE and EE (P < 0.05). The multivariate logistic regression model revealed that birth preference was a predictor for OE and EE, while a pregnant woman's education level and perceived social support in the domain of significant others were predictors for OE. Spousal age, mean family income, and participation in the prenatal preparation classes were predictors for EE. CONCLUSIONS: Regarding the importance of self-efficacy in childbirth in encouraging pregnant women to perform NVD, pregnancy and childbirth preparation classes with an emphasis on concepts including self-efficacy of childbirth should be focused by midwives and other health-care workers in order to improve pregnant women's knowledge regarding the benefits of NVD and to strengthen their belief in the benefits of pain-compatible actions.