Effect of Self-Efficacy Regarding a Smooth Labor on Cesarean Deliveries Among Primiparas in Taiwan

Purpose: The objective of this study was to examine the association between self-efficacy regarding a smooth labor during pregnancy and cesarean deliveries among primiparas in Taiwan.

Methods: This prospective study included 770 women, who were interviewed during the second and third trimester of pregnancy for their self-efficacy regarding a smooth labor, and at one month postpartum for their actual mode of delivery. Self-efficacy regarding a smooth labor was defined as the level of confidence in going through a smooth normal spontaneous labor process and successfully giving birth to a baby. The scale included 20 items, with a higher score indicating a higher level of self efficacy.

Results: The rate of cesarean section was 36.5%. Women undergoing cesarean deliveries have lower mean self-efficacy regarding a smooth labor during second and third trimesters of pregnancy. The logistic regression results showed that spousal age >40 years, being unmarred, and had received assisted reproductive technology were associated with an increased risk for cesarean delivery. After adjusting for those variables, self-efficacy during second trimester (OR = 0.99, 95% CI: 0.98-0.99) and increases in self-efficacy from the second to third trimesters (OR=0.98, 95% CI: 0.97-0.99) were associated with lower risks for cesarean delivery.  

Conclusion: Health professionals could screen pregnant women with low self-efficacy about labor, identify their concerns and obstacles about normal spontaneous delivery, and intervene to increase their self-efficacy, which could help decrease rate of cesarean section.