Determinants of attitudes and awareness regarding delivery methods among pregnant women attending comprehensive health centers

Background. The method of childbirth is a critical decision for expectant mothers. While vaginal delivery is generally the preferred physiological process, cesarean section rates are rising globally. Understanding the factors that influence pregnant women's attitudes and awareness is essential for promoting informed decision-making and supporting natural childbirth. This study aimed to identify the determinants of attitudes and awareness regarding delivery methods among pregnant women in Birjand, Iran. Methods. This descriptive, cross-sectional study was conducted in eight comprehensive health centers in Birjand, Iran, from 2023 to 2024. A total of 370 pregnant women were selected using a multi-stage sampling method involving quotas for each center and convenience sampling within centers. Data were collected using a structured questionnaire assessing demographic characteristics, knowledge (awareness), and attitudes toward delivery methods. Data were analyzed using SPSS version 21 with chi-square, Mann-Whitney U, and Kruskal-Wallis tests. A p-value less than 0.05 was considered statistically significant. Results. The mean maternal age was 29.13 ± 6.01 years. Awareness of delivery methods was rated as good in 48.4% of participants, moderate in 38.9%, and poor in 12.7%. In contrast, attitudes were moderate in 79.2%, poor in 18.9%, and good in only 1.9%. A majority (58.9%) preferred vaginal delivery, while 23% preferred cesarean section. Awareness was significantly correlated with maternal age (p = 0.037), maternal education (p = 0.008), spouse's education (p = 0.011), spouse's occupation (p = 0.002), and family income. Attitude was significantly associated with the method of a previous delivery (p < 0.001) and the type of health insurance (p = 0.043). Conclusion. A significant gap exists between pregnant women's knowledge of and attitudes toward delivery methods. While awareness is relatively high, attitudes remain predominantly neutral or unfavorable toward natural childbirth. These findings highlight a critical need for targeted educational programs to improve not only knowledge but also to foster positive attitudes, thereby empowering women to make informed choices that support natural childbirth.