Evidence map›Paper›PMID 33388072›Full record

SynthesisReproductive health2021

Prevalence of and reasons for women's, family members', and health professionals' preferences for cesarean section in Iran: a mixed-methods systematic review.

Mahboubeh Shirzad, Elham Shakibazadeh, Khadijeh Hajimiri, Ana Pilar Betran, Shayesteh Jahanfar, Meghan A Bohren, Newton Opiyo, Qian Long, Carol Kingdon, Mercedes Colomar and 1 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Reproductive health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 2 pooled it
16.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 2 syntheses or guidelines pooled it, 151 citations in OpenAlex.

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  11. Reducing Unnecessary Medical Interventions in Childbirth: The Need for Community-Based Solutions in Iran.International journal of community based nursing and midwifery · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 9 institutions in 7 countries.

Mahboubeh ShirzadDepartment of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Second floor, Building Two, Poursina Avenue, Tehran, Iran.
Elham ShakibazadehDepartment of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Second floor, Building Two, Poursina Avenue, Tehran, Iran. shakibazadeh@tums.ac.ir.ORCID http://orcid.org/0000-0002-1320-2133
Khadijeh HajimiriDepartment of Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
Ana Pilar BetranDepartment of Reproductive Health and Research, UNDP/UNFPA, UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
Shayesteh JahanfarSchool of Public Health, Central Michigan University, Michigan, USA.
Meghan A BohrenGender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.
Newton OpiyoDepartment of Reproductive Health and Research, UNDP/UNFPA, UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
Qian LongGlobal Health Research Center, Duke Kunshan University, Kunshan,, Jiangsu, China.
Carol KingdonSchool of Community Health and Midwifery, University of Central Lancashire, Preston, UK.
Mercedes ColomarMontevideo Clinical Research Unit (UNICEM), Montevideo, Uruguay.
Mehrandokht AbediniMaternal Health Department, Ministry of Health, Tehran, Iran.
Tehran University of Medical Sciences · IRWorld Health Organization · CHDuke Kunshan University · CNMinistry of Health and Medical Education · IRThe University of Melbourne · AUTufts University · USUniversidad de Montevideo · UYUniversity of Lancashire · GBZanjan University of Medical Sciences · IR

Funding

Iran National Science Foundation 6532Tehran University of Medical Sciences 240.773World Health Organization 001
6 · The paper itself

Abstract

backgroundCesarean section (CS) rates have been increasing globally. Iran has one of the highest CS rates in the world (47.9%). This review was conducted to assess the prevalence of and reasons for women's, family members', and health professionals' preferences for CS in Iran. METHODS AND

findingsIn this mixed-methods systematic review, we searched MEDLINE/PubMed, Embase, CINAHL, POPLINE, PsycINFO, Global Health Library, Google scholar; as well as Iranian scientific databases including SID, and Magiran from 1 January 1990 to 8th October 2019. Primary quantitative, qualitative, and mixed-methods studies that had been conducted in Iran with Persian or English languages were included. Meta-analysis of quantitative studies was conducted by extracting data from 65 cross-sectional, longitudinal, and baseline measurements of interventional studies. For meta-synthesis, we used 26 qualitative studies with designs such as ethnography, phenomenology, case studies, and grounded theory. The Review Manager Version 5.3 and the Comprehensive Meta-Analysis (CMA) software were used for meta-analysis and meta-regression analysis. Results showed that 5.46% of nulliparous women (95% CI 5.38-5.50%; χ

conclusionDespite low preference for CS among women, CS rates are still so high. This implies the role of factors beyond the individual will. We identified a multiple individual, health facility, and health system factors which affected the preference for CS in Iran. Numerous attempts were made in recent years to design, test and implement interventions to decrease unnecessary CS in Iran, such as mother-friendly hospitals, standard protocols for labor and birth, preparation classes for women, midwives, and gynaecologists, and workshops for specialists and midwives through the "health sector evolution policy". Although these programs were effective, high rates of CS persist and more efforts are needed to optimize the use of CS.

Indexed as

Choice BehaviorConsumer BehaviorPatient PreferenceCesarean SectionFamilyFemaleHealth PersonnelHumansIranMalePregnancyPrevalenceCesarean sectionIranMixed methodQualitative synthesisQuantitative analysisVaginal birth

Identifiers

PMID33388072
PMCPMC7778821
OpenAlexW2896431357

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.