Impact of Motivational Interviewing on Women's Knowledge, Attitude and Intention to Choose Vaginal Birth after Caesarean Section: A Randomized Clinical Trial

Abstract

Background & aim: Promoting vaginal birth after cesarean section (VBAC) is a suitable approach to reduce repeat cesarean section. It seems that counseling can help women to choose VBAC appropriately. The present study, therefore, aimed to investigate the impact of motivational interviewing on knowledge, attitude, and intention of women to choose VBAC. Methods: In this randomized clinical trial 60 pregnant women who referred to the health centers of Mashhad, Iran in 2018, were randomly assigned to two groups of motivational interviewing and control. Intervention group received three 60-90 minutes sessions of group counseling, which scheduled every other week based on motivational interviewing. The control group only received routine care. Subjects' knowledge, attitude, and intention were assessed before and two weeks after intervention. Self-structured tools were used to measure knowledge, attitude and intention of participants towards VBAC. The data were analyzed using SPSS version 25 with independent and paired t-test, U Mann-Whitney, Chi-Square and Kruskal-Wallis tests. Results: The mean score of knowledge and attitude during weeks 34-36 of pregnancy was 14.57±0.54 and 65.6±1.3 in the intervention group and 11.7±0.56 and 58.2±1.42 in the control group, respectively; which was significantly different between two groups (P 0.05); although a difference was seen in intention of intervention group after compared with before intervention (22.7 vs 43.4%, P < 0.05). Conclusion: motivational interviewing enhances knowledge and attitude toward vaginal birth after cesarean. Therefore, this method can be applied for prenatal counseling about vaginal birth after cesarean.