Journal of Midwifery and Reproductive Health

Journal of Midwifery and Reproductive Health

The Role of Counseling based on the Fogg Behavior Model as a Trigger for the Choice of Vaginal Birth after Cesarean Section: A Randomized Clinical Trial

Document Type : Original Research Article

Authors
Somayeh Attarian 1
Zhaleh Feyzi 2
Jamshid Jamali 3
Mahboobeh Firoozi 4
1 a) MSc of Consulting in Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran b) Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
2 PhD in Health Psychology, Psychiatric and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3 Associate Professor, Department of Statistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
4 a) Associate Professor, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran b) Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
10.22038/jmrh.2025.77916.2317
Abstract
Background & aim: The high rate of repeated cesarean section and its complications necessitates the need to change the behavior of choosing the mode of birth by mothers with previous cesarean section.. The present study investigates the role of counseling as a trigger in Fogg’s model on the choice of vaginal birth after cesarean section (VBAC).
Methods: : Parallel cluster randomized clinical trial conducted on 62 previous cesarean section mothers at 28-30 weeks of gestation by multistage sampling in Mashhad’s health centers between June and December 2020. Participants were randomly allocated to counseling and control groups. Both groups received the routine cares and intervention group participated in two sessions (45-60 minutes) of individual counseling and one online session through the Telegram channel. Participants in the control group only. Both groups completed the demographic characteristics form and questionnaire of triggers for birth options and choice of birth at the beginning and two weeks after the counseling. Data analyzed by using SPSS 25 and Fisher's exact, Chi-squared and the Mann-Whitney U tests in significant level 0.05.
Results: Findings showed that the frequency of intention to choose VBAC in the intervention group before and two weeks after counseling was significant (P<0.001). There was a statistically significant difference between the frequency of intention to choose after the counseling in the two groups (P<0.001).
Conclusion: Counseling as a trigger by increasing the motivation and ability in choosing birth mode, increased the intention to choose VBAC and can be considered during prenatal care.
Keywords
Counseling
Choice
Cesarean Section
Vaginal Birth after Cesarean
Subjects
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Journal of Midwifery and Reproductive Health
Volume 14, Issue 4
Autumn 2026
Pages 5641-5651