Health Education to Reduce Unnecessary Cesarean Section Among Primigravida Women

Percentage of Participants Undergoing Cesarean Delivery, Assessed Using the Actual Mode of Delivery Data Collection Form

1. The actual mode of delivery will be assessed using the researcher-developed Actual Mode of Delivery Data Collection Form during postpartum follow-up. The participant's mode of delivery will be classified as vaginal delivery or cesarean delivery. 2. The number of participants who undergo cesarean delivery will be divided by the total number of participants in each study arm who complete delivery follow-up and multiplied by 100. The outcome will be reported as the percentage of participants who undergo cesarean delivery in each study arm. The unit of measure is percentage of participants 3. For participants who undergo cesarean delivery, the reason for the cesarean procedure will also be recorded.

Mean Change in Attitude Score Measured by the Attitudes Toward Modes of Delivery Questionnaire.

1. Participants' attitudes toward normal vaginal delivery and cesarean delivery will be assessed using the researcher-administered Attitudes Toward Modes of Delivery Questionnaire. The questionnaire consists of 15 statements rated on a 3-point Likert scale. 2. For positively worded statements, "agree" is scored 2 points, "uncertain" is scored 1 point, and "disagree" is scored 0 points. Negatively worded statements will be reverse scored, as appropriate. Item scores are summed to produce a total attitude score ranging from 0 to 30 points, with higher scores indicating a more positive attitude toward evidence-based selection of the mode of delivery. 3. A total score of 18 to 30 points is categorized as a positive attitude, while a score of 0 to 17 points is categorized as a negative attitude. The outcome will be reported as the mean change in the total attitude score from baseline to 4 weeks after the educational intervention. The unit of measure is points.

Percentage of Participants Preferring Vaginal Delivery Measured by the Women's Choice of Mode of Delivery Questionnaire.

1. Participants' preferred mode of delivery will be assessed using the Women's Choice of Mode of Delivery Questionnaire. The questionnaire asks each participant to select her preferred mode of delivery as either normal vaginal delivery or cesarean delivery. 2. The questionnaire also assesses the reported reasons for the participant's preference, including labor pain, cost, physician preference, health beliefs, familiarity with the mode of delivery, previous knowledge, and information received through the educational program. 3. The outcome will be reported as the percentage of participants who select normal vaginal delivery as their preferred mode of delivery at baseline and at 4 weeks after the educational intervention. The unit of measure is percentage of participants.

Mean Change in Knowledge Score Measured by the Knowledge Regarding Modes of Delivery Questionnaire.

1. Participants' knowledge regarding normal vaginal delivery and cesarean delivery will be assessed using the researcher-administered Knowledge Regarding Modes of Delivery Questionnaire. The questionnaire consists of 30 items covering the definition of cesarean delivery, maternal and fetal indications for cesarean delivery, and maternal, fetal, and neonatal complications associated with the modes of delivery. 2. Each correct answer is scored 2 points, an "I do not know" answer is scored 1 point, and an incorrect answer is scored 0 points. Item scores are summed to produce a total knowledge score ranging from 0 to 60 points, with higher scores indicating greater knowledge. Knowledge levels are categorized as poor knowledge (less than 30 points), fair knowledge (30 to 44 points), or good knowledge (45 to 60 points). 3. The outcome will be reported as the mean change in the total knowledge score from baseline to 4 weeks after the educational intervention. The unit of measure is points.