Breastfeeding Outcomes, Decisional Conflict
Conditions
Keywords
Shared decision-making, Primiparous women, Prenatal counseling, Breastfeeding performance
Brief summary
This quasi-experimental embedded mixed-methods study evaluated the effect of a prenatal shared decision-making (SDM) counseling session on decisional conflict and breastfeeding performance among primiparous women in Zahedan, Iran. A total of 112 pregnant women at 35-37 weeks' gestation were allocated to either an intervention group receiving one 90-minute SDM counseling session or a control group receiving routine prenatal care. Decisional conflict was assessed at baseline, one week post-intervention, and three days postpartum. Breastfeeding performance was evaluated on days 3 and 60 postpartum.
Detailed description
This interventional quasi-experimental study with an embedded qualitative component was conducted among primiparous pregnant women in Zahedan, Iran. The quantitative phase included 112 participants recruited at 35-37 weeks of gestation and assigned to either a shared decision-making (SDM) counseling group or a routine care control group. The intervention consisted of a single 90-minute individualized prenatal SDM counseling session conducted according to the three-step SDM model (choice talk, option talk, and decision talk). The session addressed infant feeding options, benefits and risks of exclusive breastfeeding, clarification of maternal values and preferences, and available support systems. The primary outcome was decisional conflict measured using the 16-item Decisional Conflict Scale (score range 0-100). Secondary outcomes included breastfeeding performance measured using the 7-item Breastfeeding Performance Index at 3 and 60 days postpartum. An embedded qualitative grounded theory component explored sociocultural and personal processes influencing infant feeding decisions among participants.
Interventions
BEHAVIORALShared Decision-Making Counseling
Pregnant women received shared decision-making counseling sessions regarding breastfeeding during prenatal care.
Sponsors
Zahedan University of Medical Sciences
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Participants were assigned to two parallel groups. The intervention group received shared decision-making counseling regarding breastfeeding during pregnancy, while the control group received routine prenatal care. Outcomes were compared between the two groups.
Eligibility
Sex/Gender
FEMALE
Age
15 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
-Irani * Primiparous pregnant women * Gestational age between 35 and 37 weeks at enrollment * Singleton pregnancy * First breastfeeding experience * Planned delivery in Zahedan hospitals * Maternal age between 15 and 40 years * Receiving care at comprehensive health centers in Zahedan, Iran * Willingness to participate and provide informed consent
Exclusion criteria
* Contraindications to breastfeeding (e.g., chemotherapy, ergotamines, breast lesions, HIV infection, prenatal depression) * Preterm birth (\<37 weeks) * Neonatal intensive care unit (NICU) admission * Absence from counseling sessions * Congenital anomalies in the infant (e.g., cleft lip or palate) * Maternal intensive care unit (ICU) admission * High-risk pregnancy (e.g., pre-eclampsia/eclampsia, insulin-dependent diabetes, cardiac disease)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Breastfeeding Performance Index (BPI) score | 3 days postpartum and 60 days postpartum | Breastfeeding performance will be assessed using the Breastfeeding Performance Index (BPI). The total score ranges from 0 to 7, with higher scores indicating better breastfeeding performance and greater adherence to exclusive breastfeeding practices. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Decisional Conflict Scale (DCS) score | Baseline (35-37 weeks' gestation), immediately after the counselling session (same day), and 3 days postpartum | Decisional conflict will be measured using the Decisional Conflict Scale (DCS). The total score ranges from 0 to 100, with higher scores indicating greater decisional conflict. |
Countries
Iran
Outcome results
None listed