Sepideh Hajian - PhD, Assistant professor, Department of Midwifery & Reproductive health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Background and objectives: In spite of this fact that surgical childbirth may not always reduces the risk of unwanted perinatal outcomes, there are noticeable upward trend in surgical cesarean childbirths in various parts of Iran including Shahroud. The aim of this study was to determine the effect of using an educational program based on the fear appeal model, Extended Parallel Process Model, in childbirth education for decreasing the mother s request for cesarean childbirth in Shahroud.Methods: The study had an experimental design and was conducted on the 284 first time pregnant women in two randomly allocated groups (experiment and control). Firstly, a formative evaluation was done with a structured questionnaire using the Risk Behavior Diagnosis Scale. Then, childbirth education The 1ts National conference On Safe Pregnancy. program was developed based on Extended Parallel Process Model for experiment group in 6 sessions from 20th to 38th weeks of gestational age. Finally, outcome evaluation compared between two groups.Results: Intention to have cesarean childbirth in experiment group decreased significantly using within group (p < 0.001, 95% CI = 1/3 –4/9) and between group versus the control (p<0.001, 95% CI = -3/7 – -2/8). In addition, the rate of caesarean birth was significantly reduced in the experimental group compared with control (66.2% and 48.2%, respectively) and the odds of giving birth by cesarean was 2.1 times greater in the control group (p < 0.001). No significant differences was observed for neonatal outcomes between two groups. Conclusions: Using childbirth education based on the fear appeal models can efficiently reduce the rate of intention to mother s request for and actual rate of cesarean childbirth.

childbirth education, cesarean birth, Iran