Use of the Extended Parallel Process Model (EPPM) to Predict Iranian Women’s Intention for Vaginal Delivery

Abstract

Purpose: To explicate whether knowledge, perception of health threat, efficacy, and personal beliefs act as predictors for women’s intention to have a normal vaginal birth. Design: The study uses a mixed approach. Simultaneously, 290 pregnant women who visited prenatal clinics completed the study. Quantitative and qualitative data were collected using a structured questionnaire based on Witte’s extended parallel process model and four focus groups, respectively. Results: Women perceived lower risk but higher levels of efficacy. Perceived self-efficacy, severity, and response efficacy were identified as significant predictors of intention to experience vaginal birth. Participants’ insufficient knowledge and misconceptions about birth methods were dominant. Two major themes were identified and divided into negative and positive beliefs about vaginal birth. Discussion: The extended parallel process model provides a useful framework to assess women’s intention to have a vaginal birth, especially when it is combined with a qualitative approach. Within Iranian women, self-confident mothers are more likely to intend to deliver vaginally. Implication for Further Practice: Prenatal care provides an opportunity for nurses and midwives to explore mothers’ beliefs and intended childbirth method prior to offering medical intervention.