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Jan 2020, Vol 8, Issue 1
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Review
Dramatic Rise in Cesarean Birth in Iran: A Coalition of the Private Medical Practices and Women’s Choices
Zohreh Behjati Ardakani1, Mehrdad Navabakhsh2, Fahimeh Ranjbar3, Soraya Tremayne4, Mohammad Mehdi Akhondi5, Alireza Mohseni Tabrizi6
1Department of Sociology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
2Faculty of Humanistic and Social Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
3Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
4Fertility and Reproductive Studies Group (FRSG), Institute of Social and Cultural Anthropology, Oxford, UK
5Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
6Department of Sociology, University of Tehran, Tehran, Iran


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Keywords : Cesarean Section,Natural Childbirth, Delivery, Medicalization, Iran
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Abstract

Objectives: Cesarean delivery without medical indication has increased regularly among Iranian women in the last three decades and Iran has one of the highest rate of cesarean in the world. The present study aims at reviewing the studies regarding the increase of cesarean in Iran and discussing the root causes for such an increase.

Materials and Methods: This article is a literature review of the existing quantitative and qualitative studies conducted from 1990 to Jan 2019 about the reasons for the increase in cesarean section in Iran. The combination of key words including cesarean section, C-section, cesarean delivery, and Iran was conducted in MEDLINE/PubMed, Embase, ISI Web of Science and Scopus, and national databases (SID, MagIran, Iran Medex, IranDoc).

Results: Dramatic rise in cesarean birth stems from a number of factors including the role of health care professionals, insurance companies, socio-cultural factors, and the health policies, which all of them have their roots in the medicalization of birth.

Conclusion: Reducing the cesarean on maternal request requires de-medicalization of birth, cultural awareness through the mass media, informing women of the long-term complications of cesarean, physical and mental preparation of mother,inter-professional teamwork and collaboration between midwives and obstetrician-gynecologists, transforming the current curriculum of the midwifery and residency education, applying the midwifery-led care models and decreasing the fear of litigation in midwifery and obstetrics-gynecology. Otherwise, maternal and fetal mortality will rise in the near future, due to increased complications in subsequent pregnancies.

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