Investigating the relationship among theory-based beliefs, resilience, and socio-economic factors of first-time pregnant women with the intention for elective caesarean section

Psychological, socio-economic, and belief-related factors significantly influence women’s decision-making processes regarding their preferred childbirth method. This study aimed to explore the relationship among beliefs based on the Theory of Reasoned Action (TRA), resilience, and socio-economic factors with intention for elective cesarean section in first-time pregnant women. This cross-sectional study was conducted with a sample of 200 first-time pregnant women in Urmia, Iran, in 2024. Participants were selected using a stratified-cluster sampling method. Data were collected using the Shortened Socio-Economic Status Questionnaire (SES-SQ), the Resilience Questionnaire, and the Theory-Based Intention for Cesarean Section (IR-TBICS) scale. Statistical analysis was performed using t-tests, one-way analysis of variance, and linear regression via SPSS software (version 21). Beliefs about the behavior’s outcomes ( p < 0.001, β = 0.3), evaluations of expected outcomes ( p < 0.001, β = 0.26), motivation to comply ( p < 0.001, β = 0.28), resilience ( p = 0.007, β = -0.11), socio-economic status ( p < 0.001, β = -0.15), prenatal care provider ( p < 0.001, β = 0.14), and attendance at childbirth preparation classes ( p = 0.04, β = 0.08) explained 68% of the variation for cesarean section intention. This cross-sectional study revealed that TRA constructs, resilience, and socioeconomic factors explain a substantial proportion of variance in CS intention among first-time pregnant women. However, prospective cohort studies are needed to establish temporal and causal relationships between these predictors and CS intention.