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\begin{document}


\def\RunningAuthor{Deenajothy R. et al.}
\firstPage{910}
\articleType{Editorial Note}
\receivedDate{17 May 2020}
\acceptedDate{17 Aug 2020}
\revisedDate{15 Aug 2020}
\journalVolume{2020, 11 (SPL4)}
\journalDoi{ijrps.v11iSPL4.4223}
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\title{\textbf{A Study To Assess The Attitude Towards Vaginal Delivery VS Caesarean Delivery Among Mothers}\textbf{ At Primary Health Centre At Guduvancherry, Kancheepuram District, Tamil Nadu, India} \textbf{\space }}
\author{Deenajothy~R.\textsuperscript{*},  
            Jayabharathi~B.,  
            Abirami~P.,  
            Sangeetha~Jagdish~G., 
            Bhuvaneswari~A.~\\[5pt]{Obstetrics and Gynaecological Nursing, SRM College of Nursing, Kattankulathur, Tamil Nadu-603203, India}}

\begin{abstract}
The objective of the study was to assess the number and percentage distribution of demographic variables among mothers\textbf{\space }and to assess the number and percentage distribution of attitude towards normal vaginal delivery among mothers and also to assess the number and percentage distribution of attitude towards caesarean delivery among mothers. Non experimental design was used. One hundred six mothers were selected for this study. It was conducted at the primary health centre at Guduvancherry, Kanchipuram district, Tamilnadu, India. Three Parts were used. Part.A, Demographic variables, Part .B, Contains attitude towards Vaginal delivery of 15 questions, Part.C, contains attitude towards caesarean delivery among mothers. Contains 15 questions of Study variable among attitude on caesarean delivery and normal delivery and the demographic variable was the age of the mother, type of family, number of children in the family, dietary pattern, monthly income, education, place of living, religion, occupation, type of work, preferences of the mother for the mode of delivery. Scoring key 5 points on the Likert scale was used for this study. The final result of this study shows that\textbf{\space }most of the mothers 82(77.4\%) had a favourable attitude, 24(22.6\%) of them had moderately unfavourable attitude, and none of them had an unfavourable attitude towards normal delivery. Most of the mothers 68(64.2\%) had Moderately favourable attitude, 38(35.8\%) of them had an unfavourable attitude, and none of them had a favourable attitude towards caesarean delivery. \textbf{\space }
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Assess,\newline Attitude,\newline Caesarean Delivery,\newline Mothers,\newline Vaginal Delivery
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Deenajothy~R.~\\ Phone:\ +91-9789070449~\\  Email:\ deenajothy@gmail.com
        \par}\vspace*{-11pt}\hrulefill\par{\fontsize{12}{14}\selectfont ISSN: 0975-7538}\par% 
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\section{Introduction}
There was are two modes of birth. One is vaginal birth, and another is caesarean birth. If both mother and foetus health condition were good doctors can plan vaginal delivery. In some situation both the mother and foetus had any medical abnormalities such as diabetes mellitus, increased blood pressure, malpresentation, significant baby weight more than, 3.5-kilogram small pelvis, intrauterine growth retardation, etc. In that condition doctor to decide for caesarean delivery.

Doctor, Allison Bryant suggested that most of the mothers mentioned that vaginal delivery was the natural one. \unskip~\citep{855864:20050139} In India having too many cesarean section.

The caesarean delivery rate in India was increased in both the Government hospital and Private hospital in the year 2008 to 2009. But now compared to Government hospital, the private hospital for cesarean delivery rate was increased by 33.80 percentage, in the year of 2018 to 2019. \unskip~\citep{855864:20050142}

In many medical procedures, there are many benefits, and many risks may occur. \unskip~\cite{855864:20050143} stated that both vaginal delivery and caesarean delivery was based on the understanding of women's culture, beliefs, perceptions and values. In the north of Iran, it was believed that vaginal delivery was a safe method and more benefits of both baby and mother, but caesarean delivery had more complications. In the same study, some mothers had a more positive belief in caesarean delivery. They perceived that it was a safe and painless delivery. It also maintains the beauty and also protects the reproductive organs. \unskip~\citep{855864:20050143}

Author Dr Sangeeta Agrawa stated that all regular deliveries were not safe. If the mother had painful contractions, they need epidural analgesia and pain killers. In some conditions, if the mother had pelvic floor disorders, including urinary and faecal incontinence and excessive bleeding means they need medical interventions. 

In the case of caesarean birth, the mother had anaesthesia related complications and surgery-related infections. So any mode of a delivery mother should have a proper birth plan. They should have professionally trained women who provide support, before, during and after delivery. Mother should have adequate knowledge of childbirth procedures. Mother should take healthy diet, proper exercise and also avoid a labour induction before 37 weeks. So these are the safe mode of delivery, either vaginal and caesarean delivery. \unskip~\citep{855864:20050144}

The author describes that the mother's cultural beliefs, traditions, values were significantly affected by the modes of delivery. They believe that normal vaginal delivery was a symbol of God's power and inexpensive. But in caesarian delivery was to protect of genital tract integrity and also it's a prestigious mode of birth \unskip~\citep{855864:20050145}. Shantha Sharma, Indra dhakal did a study of caesarian vs vaginal delivery an institutional experience. 

In this study, they reported that caesarian delivery was performed for the safety of mother's obstetrical indication. Sometimes mother's solicitation. In this study, most of the mother underwent normal vaginal delivery, and the remaining cases were caesarean delivery. This study reports that maternal complications were prolonged labour postpartum haemorrhage and wound infections.

Conclusion of this study stated that vaginal delivery has fewer complications when compared to caesarean delivery. \unskip~\citep{855864:20050146}
    
\section{Materials and Methods}
\textbf{The objective of the Study}


  
  \begin{enumerate}
  \item \relax To assess the number and percentage distribution of demographic variables among mothers
  \item \relax To assess the number and percentage distribution of attitude towards normal vaginal delivery among mothers
  \item \relax To assess the number and percentage distribution of attitude towards caesarean delivery among mothers
  \end{enumerate}
  Non experimental design was used. One hundred six mothers were selected for this study. It was conducted at the primary health centre at Guduvancherry, Kanchipuram district, Tamilnadu, India. 

Three Parts were used, Part. A, Demographic variables, Part. B, Contains attitude towards Vaginal delivery of 15 questions, Part. C, contains attitude towards caesarean delivery among mothers. It contains 15 questions study variable was the attitude on caesarean delivery. 

Standard delivery and the demographic variables were the age of the mother, type of family, number of children in the family, dietary pattern, monthly income, education, place of living, religion, occupation, type of work, preferences of the mother for the mode of delivery. Scoring key\textbf{\space }5 points on the Likert scale was used for this study.

After establishing good rapport, a brief introduction to the study was explained. Verbal consent was obtained. The researcher observed the attitude, and it was assessed by Structured Questionnaire on attitude towards normal delivery vs caesarean delivery.

The investigator collected information regarding section-A [demographic data], Section-B [to assess the attitude towards normal delivery] and section C [to assess the attitude towards Caesarean delivery. 

Each sample spent 15 minutes for data collection. Researcher thanked all the samples for their full cooperation.

Table~\ref{tw-c3d6f11fd650} shows that scoring interpretation.one to thirty-three per cent indicates Unfavorable attitude, forty to sixty-seven per cent indicates Moderately favourable attitude and seventy-three to hundred per cent indicates Favorable attitude.


\begin{table*}[!htbp]
\caption{\boldmath {Scoring interpretation} }
\label{tw-c3d6f11fd650}
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\tbltoprule \rowcolor{kwdboxcolor}\cAlignHack Level of Attitude & \cAlignHack Questions & \cAlignHack \%\\
\tblmidrule 
Unfavourable Attitude  &
  \cAlignHack 1 to 5 &
  \cAlignHack 1 to 33\\
Moderate Favourable Attitude  &
  \cAlignHack 6 to 10 &
  \cAlignHack 40 to 67\\
Favourable Attitude  &
  \cAlignHack 11-15 &
  \cAlignHack 73 to 100\\
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\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Attitude towards normal delivery vs caesarean delivery among mothers. N=106} }
\label{tw-708b791bbb9f}
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\tbltoprule \rowcolor{kwdboxcolor}\cAlignHack S. No & \cAlignHack Demographic Variables & \cAlignHack Class & \cAlignHack No. of Mothers (n) & \cAlignHack Distribution (\%)\\
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 &
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 &
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 &
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  \cAlignHack 11.3\\
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  \cAlignHack 55.7\\
\cAlignHack  &
  \cAlignHack  &
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  \cAlignHack 44.3\\
\cAlignHack  &
  \cAlignHack  &
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  \cAlignHack 46.2\\
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  \cAlignHack 46.2\\
\cAlignHack  &
  \cAlignHack  &
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  \cAlignHack 7.5\\
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  \cAlignHack 22.6\\
\cAlignHack  &
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  \cAlignHack 82 &
  \cAlignHack 77.4\\
\cAlignHack  &
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  \cAlignHack 0.9\\
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  \cAlignHack 6.6\\
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  \cAlignHack  &
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  \cAlignHack 28 &
  \cAlignHack 26.4\\
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  \cAlignHack 66.0\\
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  \cAlignHack 8.5\\
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 &
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  \cAlignHack 63.2\\
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  \cAlignHack 56.6\\
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  \cAlignHack 39.6\\
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\cAlignHack  &
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  \cAlignHack 66.0\\
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  \cAlignHack 76 &
  \cAlignHack 71.7\\
\cAlignHack  &
  \cAlignHack  &
  \cAlignHack Moderate &
  \cAlignHack 30 &
  \cAlignHack 28.3\\
\cAlignHack 11 &
  \cAlignHack Preferences of mother for mode of delivery &
  \cAlignHack Normal Vaginal Delivery &
  \cAlignHack 82 &
  \cAlignHack 77.4\\
 &
  \cAlignHack  &
  \cAlignHack Caesarean Section &
  \cAlignHack 24 &
  \cAlignHack 22.6\\
 &
  \cAlignHack  &
  \cAlignHack  &
  \cAlignHack  &
  \cAlignHack \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Frequency and percentage distribution of attitude towards normal delivery among mothers N=106} }
\label{tw-9d21c80e1c60}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.2061\linewidth-2\tabcolsep}p{\dimexpr.3092\linewidth-2\tabcolsep}p{\dimexpr.2347\linewidth-2\tabcolsep}p{\dimexpr.25\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}\cAlignHack S. No. \mbox{}\protect\newline  & \cAlignHack Level of Attitude & \cAlignHack No. of\textbf{\space }Mothers \mbox{}\protect\newline (n) & \cAlignHack Percentage distribution (\%)\\
\tblmidrule 
\cAlignHack 1 &
  \cAlignHack Unfavourable Attitude &
  \cAlignHack 0 &
  \cAlignHack 0.0\%\\
\cAlignHack 2 &
  \cAlignHack Moderate Favourable Attitude &
  \cAlignHack 24 &
  \cAlignHack 22.6\\
\cAlignHack 3 &
  \cAlignHack Favourable Attitude &
  \cAlignHack 82 &
  \cAlignHack 77.4\\
\cAlignHack  &
  \cAlignHack  &
  \cAlignHack  &
  \cAlignHack \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Frequency and percentage distribution of Attitude towards caesarean delivery among mothers N=106} }
\label{tw-40beeae5e5fb}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.14119999999999997\linewidth-2\tabcolsep}p{\dimexpr.3588\linewidth-2\tabcolsep}p{\dimexpr.25\linewidth-2\tabcolsep}p{\dimexpr.25\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}\cAlignHack S. No. & \cAlignHack Level of Attitude & \cAlignHack No. of Mothers \mbox{}\protect\newline (n) & \cAlignHack Percentage distribution (\%)\\
\tblmidrule 
\cAlignHack 1 &
  \cAlignHack Unfavourable Attitude &
  \cAlignHack 38 &
  \cAlignHack 35.8\%\\
\cAlignHack 2 &
  \cAlignHack Moderate Favourable Attitude &
  \cAlignHack 68 &
  \cAlignHack 64.2\%\\
\cAlignHack 3 &
  \cAlignHack Favourable Attitude &
  \cAlignHack 0 &
  \cAlignHack 0\\
\cAlignHack  &
  \cAlignHack  &
  \cAlignHack  &
  \cAlignHack \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}
Table~\ref{tw-708b791bbb9f} depicts the attitude towards normal delivery versus caesarean delivery among mothers. It shows the Numbers and percentage.

Table~\ref{tw-9d21c80e1c60} reveals that majority 82(77.4\%) of mothers had favourable attitude, only 24 (22.6\%) of them had Moderate Favourable Attitude, and none of them had Unfavourable Attitude towards normal delivery.

Table~\ref{tw-40beeae5e5fb} reveals that most of mothers 68(64.2\%) had Moderatefavourable Attitude, 38(35.8\%) of them had an unfavourable attitude, and none of them had a favourable attitude towards caesarean delivery.
    
\section{Discussion}
Stefan 2016 conducted a postpartum quality of life regarding vaginal birth and cesarean delivery of the mothers. The author selected 178 mothers of vaginal delivery in a public hospital and 46 mothers of caesarean delivery in a private hospital. He compared and concluded that the vaginal delivery of the mothers had a higher quality of life. \unskip~\citep{855864:20050141}

Fatemen Ghobi (2012)selected a six public and private hospital for to conduct a study on women's knowledge and attitude towards the mode of delivery.28.8 percentage of mothers underwent for cesarean delivery due to the fear. The author concluded that if women's knowledge increased means, it would lead to normal vaginal delivery. \unskip~\citep{855864:20050140}

According to the objectives of the study the results were, most of mothers 68(64.2\%) had Moderate favourable Attitude, 38(35.8\%) of them had unfavourable attitude, and none of them had favourable attitude towards caesarean delivery.
    
\section{Conclusion}
The myths of Indian women was the birth of the baby was not in our hands. God only decided. The researcher concluded that doctors only have to decide the mode of delivery. It consists of the health condition of both mother and baby.
\section*{Acknowledgement}I thank all the participants those who are involved in this study. 

\textbf{Conflict of Interest}

Mrs.Deenajothy Dr.Jayabharathi, Mrs Dr.Abirami.P, SangeethaJagdeesh, and Ms Bhuvaneswari informed that there was no conflict of interest about the study. 

\textbf{Source of Funding}

There were no funding agencies involved. It is fully self-financed
    

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