Effects of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan
The accepted rate rate of caesarean section is 15%. It is expected that an increase in the density of midwives in the family physician program lead to a decrease in this indicator. This study aimed to compare the rates of caesarean section and women's awareness and preference for mode of delive...
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| description | The accepted rate rate of caesarean section is 15%. It is expected that an increase in the density of midwives in the family physician program lead to a decrease in this indicator. This study aimed to compare the rates of caesarean section and women's awareness and preference for mode of delivery before and after the implementation of the family physician program in health centres with and without an increase in midwives density.
In this cross-sectional study, using multistage cluster sampling method a total of 668 mothers with two-month-old children were selected from among all mothers with two-month-old children who were living in rural areas of Kurdistan province. Using the difference-in-differences model and Matchit statistical model, the factors associated with caesarean section rates and women's awareness and preference for mode of delivery were compared in centres with and without an increase in midwives density after the implementation of the family physician program. To compare the changes before and after the program, we used the data collected from the same number of women in 2005 as the baseline.
After adjusting for baseline data collected in 2005, the resutls showed no significant change in caesarean section rates and women's awareness and preference for mode of delivery in the centres with and without an increase in midwives density after the implementation of the family physician program. The Matchit model showed a significant mean increase 14%(0.03-0.25) in women's awareness of the benefits of natural childbirth between 2005 and 2013 in health centres where the density of midwives increased compared with health centres where it did not. The difference-in-differences model showed that the odds ratio of women's preference for caesarean section decreased by 41% among participants who were aware of the benefits of natural childbirth, (OR = 0.59, 95% CI: (0.22-0.85); P>0.001).
The results of this study showed that an increase in the density of midwives in the family physician program led to an increase in women's awareness of the benefits of natural childbirth. An increase in women's awareness of the benefits of natural childbirth was associated with a decreased preference for caesarean section, however this reduction did not have a significant impact on caesarean section rates; possibly, this finding might be attributed to the complexity of this problem that needs a mixed strategy involving various stockholders. |
| doi_str_mv | 10.1371/journal.pone.0151268 |
| format | Article |
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In this cross-sectional study, using multistage cluster sampling method a total of 668 mothers with two-month-old children were selected from among all mothers with two-month-old children who were living in rural areas of Kurdistan province. Using the difference-in-differences model and Matchit statistical model, the factors associated with caesarean section rates and women's awareness and preference for mode of delivery were compared in centres with and without an increase in midwives density after the implementation of the family physician program. To compare the changes before and after the program, we used the data collected from the same number of women in 2005 as the baseline.
After adjusting for baseline data collected in 2005, the resutls showed no significant change in caesarean section rates and women's awareness and preference for mode of delivery in the centres with and without an increase in midwives density after the implementation of the family physician program. The Matchit model showed a significant mean increase 14%(0.03-0.25) in women's awareness of the benefits of natural childbirth between 2005 and 2013 in health centres where the density of midwives increased compared with health centres where it did not. The difference-in-differences model showed that the odds ratio of women's preference for caesarean section decreased by 41% among participants who were aware of the benefits of natural childbirth, (OR = 0.59, 95% CI: (0.22-0.85); P>0.001).
The results of this study showed that an increase in the density of midwives in the family physician program led to an increase in women's awareness of the benefits of natural childbirth. An increase in women's awareness of the benefits of natural childbirth was associated with a decreased preference for caesarean section, however this reduction did not have a significant impact on caesarean section rates; possibly, this finding might be attributed to the complexity of this problem that needs a mixed strategy involving various stockholders.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0151268</identifier><identifier>PMID: 27058952</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Awareness ; Biology and Life Sciences ; Cesarean Section ; Childbirth & labor ; Children ; Cross-Sectional Studies ; Decision making ; Demography ; Density ; Earth Sciences ; Endocrinology ; Female ; Health aspects ; Health care facilities ; Health centres ; Health education ; Health services ; Humans ; Infant, Newborn ; Iran ; Male ; Management ; Mathematical models ; Medicine and Health Sciences ; Midwifery ; Midwives ; Mortality ; Mothers ; National Health Programs ; People and Places ; Physicians ; Physicians, Family ; Population ; Practice ; Preferences ; Pregnancy ; Primary care ; Reproductive health ; Rural areas ; Rural Population ; Sampling methods ; Social Sciences ; Statistical models ; Studies ; Wellness programs ; Women's health ; Womens health ; Workforce planning</subject><ispartof>PloS one, 2016-04, Vol.11 (4), p.e0151268</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Hajizadeh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Hajizadeh et al 2016 Hajizadeh et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-e114ab9be823b14536a5b0ecf087a5419929674617ca5ae1caddfc08cf0668aa3</citedby><cites>FETCH-LOGICAL-c692t-e114ab9be823b14536a5b0ecf087a5419929674617ca5ae1caddfc08cf0668aa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825997/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825997/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27058952$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Hills, Robert K</contributor><creatorcontrib>Hajizadeh, Shayesteh</creatorcontrib><creatorcontrib>Tehrani, Fahimeh Ramezani</creatorcontrib><creatorcontrib>Simbar, Masoumeh</creatorcontrib><creatorcontrib>Farzadfar, Farshad</creatorcontrib><title>Effects of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The accepted rate rate of caesarean section is 15%. It is expected that an increase in the density of midwives in the family physician program lead to a decrease in this indicator. This study aimed to compare the rates of caesarean section and women's awareness and preference for mode of delivery before and after the implementation of the family physician program in health centres with and without an increase in midwives density.
In this cross-sectional study, using multistage cluster sampling method a total of 668 mothers with two-month-old children were selected from among all mothers with two-month-old children who were living in rural areas of Kurdistan province. Using the difference-in-differences model and Matchit statistical model, the factors associated with caesarean section rates and women's awareness and preference for mode of delivery were compared in centres with and without an increase in midwives density after the implementation of the family physician program. To compare the changes before and after the program, we used the data collected from the same number of women in 2005 as the baseline.
After adjusting for baseline data collected in 2005, the resutls showed no significant change in caesarean section rates and women's awareness and preference for mode of delivery in the centres with and without an increase in midwives density after the implementation of the family physician program. The Matchit model showed a significant mean increase 14%(0.03-0.25) in women's awareness of the benefits of natural childbirth between 2005 and 2013 in health centres where the density of midwives increased compared with health centres where it did not. The difference-in-differences model showed that the odds ratio of women's preference for caesarean section decreased by 41% among participants who were aware of the benefits of natural childbirth, (OR = 0.59, 95% CI: (0.22-0.85); P>0.001).
The results of this study showed that an increase in the density of midwives in the family physician program led to an increase in women's awareness of the benefits of natural childbirth. An increase in women's awareness of the benefits of natural childbirth was associated with a decreased preference for caesarean section, however this reduction did not have a significant impact on caesarean section rates; possibly, this finding might be attributed to the complexity of this problem that needs a mixed strategy involving various stockholders.</description><subject>Analysis</subject><subject>Awareness</subject><subject>Biology and Life Sciences</subject><subject>Cesarean Section</subject><subject>Childbirth & labor</subject><subject>Children</subject><subject>Cross-Sectional Studies</subject><subject>Decision making</subject><subject>Demography</subject><subject>Density</subject><subject>Earth Sciences</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health care facilities</subject><subject>Health centres</subject><subject>Health education</subject><subject>Health services</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Iran</subject><subject>Male</subject><subject>Management</subject><subject>Mathematical models</subject><subject>Medicine and Health Sciences</subject><subject>Midwifery</subject><subject>Midwives</subject><subject>Mortality</subject><subject>Mothers</subject><subject>National Health Programs</subject><subject>People and Places</subject><subject>Physicians</subject><subject>Physicians, Family</subject><subject>Population</subject><subject>Practice</subject><subject>Preferences</subject><subject>Pregnancy</subject><subject>Primary care</subject><subject>Reproductive health</subject><subject>Rural areas</subject><subject>Rural Population</subject><subject>Sampling methods</subject><subject>Social Sciences</subject><subject>Statistical models</subject><subject>Studies</subject><subject>Wellness programs</subject><subject>Women's health</subject><subject>Womens health</subject><subject>Workforce 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of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan</title><author>Hajizadeh, Shayesteh ; Tehrani, Fahimeh Ramezani ; Simbar, Masoumeh ; Farzadfar, Farshad</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-e114ab9be823b14536a5b0ecf087a5419929674617ca5ae1caddfc08cf0668aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Analysis</topic><topic>Awareness</topic><topic>Biology and Life Sciences</topic><topic>Cesarean Section</topic><topic>Childbirth & labor</topic><topic>Children</topic><topic>Cross-Sectional Studies</topic><topic>Decision making</topic><topic>Demography</topic><topic>Density</topic><topic>Earth Sciences</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health care facilities</topic><topic>Health 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hajizadeh, Shayesteh</au><au>Tehrani, Fahimeh Ramezani</au><au>Simbar, Masoumeh</au><au>Farzadfar, Farshad</au><au>Hills, Robert K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-04-08</date><risdate>2016</risdate><volume>11</volume><issue>4</issue><spage>e0151268</spage><pages>e0151268-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The accepted rate rate of caesarean section is 15%. It is expected that an increase in the density of midwives in the family physician program lead to a decrease in this indicator. This study aimed to compare the rates of caesarean section and women's awareness and preference for mode of delivery before and after the implementation of the family physician program in health centres with and without an increase in midwives density.
In this cross-sectional study, using multistage cluster sampling method a total of 668 mothers with two-month-old children were selected from among all mothers with two-month-old children who were living in rural areas of Kurdistan province. Using the difference-in-differences model and Matchit statistical model, the factors associated with caesarean section rates and women's awareness and preference for mode of delivery were compared in centres with and without an increase in midwives density after the implementation of the family physician program. To compare the changes before and after the program, we used the data collected from the same number of women in 2005 as the baseline.
After adjusting for baseline data collected in 2005, the resutls showed no significant change in caesarean section rates and women's awareness and preference for mode of delivery in the centres with and without an increase in midwives density after the implementation of the family physician program. The Matchit model showed a significant mean increase 14%(0.03-0.25) in women's awareness of the benefits of natural childbirth between 2005 and 2013 in health centres where the density of midwives increased compared with health centres where it did not. The difference-in-differences model showed that the odds ratio of women's preference for caesarean section decreased by 41% among participants who were aware of the benefits of natural childbirth, (OR = 0.59, 95% CI: (0.22-0.85); P>0.001).
The results of this study showed that an increase in the density of midwives in the family physician program led to an increase in women's awareness of the benefits of natural childbirth. An increase in women's awareness of the benefits of natural childbirth was associated with a decreased preference for caesarean section, however this reduction did not have a significant impact on caesarean section rates; possibly, this finding might be attributed to the complexity of this problem that needs a mixed strategy involving various stockholders.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27058952</pmid><doi>10.1371/journal.pone.0151268</doi><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1780977533 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Awareness Biology and Life Sciences Cesarean Section Childbirth & labor Children Cross-Sectional Studies Decision making Demography Density Earth Sciences Endocrinology Female Health aspects Health care facilities Health centres Health education Health services Humans Infant, Newborn Iran Male Management Mathematical models Medicine and Health Sciences Midwifery Midwives Mortality Mothers National Health Programs People and Places Physicians Physicians, Family Population Practice Preferences Pregnancy Primary care Reproductive health Rural areas Rural Population Sampling methods Social Sciences Statistical models Studies Wellness programs Women's health Womens health Workforce planning |
| title | Effects of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T09%3A09%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effects%20of%20Recruiting%20Midwives%20into%20a%20Family%20Physician%20Program%20on%20Women's%20Awareness%20and%20Preference%20for%20Mode%20of%20Delivery%20and%20Caesarean%20Section%20Rates%20in%20Rural%20Areas%20of%20Kurdistan&rft.jtitle=PloS%20one&rft.au=Hajizadeh,%20Shayesteh&rft.date=2016-04-08&rft.volume=11&rft.issue=4&rft.spage=e0151268&rft.pages=e0151268-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0151268&rft_dat=%3Cgale_plos_%3EA453448518%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1780977533&rft_id=info:pmid/27058952&rft_galeid=A453448518&rft_doaj_id=oai_doaj_org_article_a0a0f79d554d4d298b77192030ccb2f6&rfr_iscdi=true |