Prenatal Care and the Decision Making about Mode of Delivery: a case control study

Background: In recent years, greater emphasis is being placed on women’s choice in decision making during pregnancy and childbirth.Objectives: In this paper we aimed to investigate the relationship between prenatal care and the decision about mode of delivery .Patients and Methods: A case-control study was conducted in Shahroud, Iran, ۲۰۰۱۸. The target population was ۴۰۰ women who were delivered in the Fatemieh hospital. The study population consisted of two groups. The case group (n = ۲۰۰) was women who had been cesarean section. The control group (n =۲۰۰) was including age-matched women who had vaginal delivery. The adequacy of prenatal care was leveled according to Adequacy of prenatal care utilization (APNCU).Results: Analyses revealed that the case group received more adequate (OR =۱.۵۹, ۹۵% CI ۱.۰۶ -۲.۴۹) and the case group received more prenatal care in Non-government services (OR =۳.۵۳, ۹۵% CI ۱.۵۶ -۶.۷۰). According to Adequacy of prenatal care utilization (APNCU, ۲۲% of antenatal care in the case group were in the other levels, with no differences between groups. There is a relationship between prenatal care and cesarean section. Also there is a relationship between prenatal care in Non-governmental services and cesarean section. Conclusion: Adequacy of prenatal care is related to the decision about the mode of delivery . Despite the association found in the study, we cannot conclude that cesarean section would be prevented only by an inadequate prenatal care, as cesarean section is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery. That should be more investigated in further studies.