Author/Authors :
Esmaily Habibollah نويسنده Health Sciences Research Center, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, I. R , Ghazi Tabatabaie Mahmoud نويسنده Department of Demography and Population Studies, Faculty of Social Science, University of Tehran, Tehran, IR Iran , Sedigh Mobarakabadi Sedigheh نويسنده Department of Midwifery, Mashhad University of Medical
Sciences, Mashhad, IR Iran , Mirzaie Najmabadi Khadijeh نويسنده Department of Midwifery, Mashhad University of Medical
Sciences, Mashhad, IR Iran
Abstract :
Background Although there are studies that suggest a vast
expansion of medicalization of pregnancy and birth in Iran, data about
the rate of intervention applications caused by the medicalization in
low-risk pregnancies and birth is limited. Moreover, there is limited
information on the effectiveness of these interventions for different
modes of childbirth. Objectives This study aimed to determine the rate
of application of maternal medicalized care in low-risk pregnancies and
births and to identify the factors that are associated with type of
delivery. Patients and Methods This cross-sectional study was performed
by stratified-cluster sampling on 320 postpartum women from four public
and private hospitals in Mashhad, Iran. The data collection instrument
was a designed and standardized tool for assessment of medicalized
pregnancy and childbirth. Also, descriptive tests and logistic
regression were used. A value of P < 0.05 was considered
statistically significant for all tests. Results In this study, the
rates of natural vaginal and caesarean birth were 34.7% and 65.3%,
respectively. Preconception and prenatal care received from an
obstetrician were 72.8% and 51.6%, respectively. The median number of
prenatal visits, laboratory examinations and sonography procedures was
12, 3 and 4, respectively. In 49.4% of the cases, the women were
hospitalized before the onset of labor. Early admission (OR = 2.40; 95%
CI = 1.93 - 2.97; P = 0.001) and performing electronic fetal heart
monitoring during admission (OR = 2.47; 95% CI = 1.28 - 4.73; P = 0.006)
were the interventions that the regression logistic analysis identified
as associated with a higher rate of caesarean delivery. Conclusions It
seems that obstetric interventions are widely applied in low-risk
pregnancies and births. Some of these interventions have the effect of
increasing the rate of caesarean delivery. According to the provided
information, it seems that it is necessary to adjust health policy to
provide appropriate care for low-risk pregnancies and births.
