Effect of Pecha Kucha-Based Normal Birth Education on Birth Beliefs and Birth Preferences Among Pregnant Women Considering Elective Cesarean Section

June 13, 2026 updated by: ENDAM ÇETİNKAYA AK, Burdur Mehmet Akif Ersoy University

Effect of Pecha Kucha-Based Normal Birth Education on Birth Beliefs and Mode of Birth Preferences Among Pregnant Women Considering Elective Cesarean Section: A Randomized Controlled Trial

This randomized controlled trial was conducted to evaluate the effect of Pecha Kucha-based normal birth education on birth beliefs and mode of birth preferences among primiparous pregnant women considering elective cesarean section without a medical indication. A total of 76 pregnant women between 28 and 32 weeks of gestation were randomly assigned to either an experimental group or a control group. The experimental group received normal birth education using the Pecha Kucha presentation technique, whereas the control group received the same educational content through a traditional face-to-face oral presentation. Birth beliefs and birth mode preferences were assessed before the intervention, immediately after the intervention, and one month after the intervention. The study aimed to determine whether a brief, structured, and visually supported educational intervention could improve beliefs regarding normal birth and increase preference for vaginal delivery among women considering elective cesarean section.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Background Cesarean section rates have increased substantially worldwide and represent an important public health concern. In addition to medical indications, maternal preference has emerged as a contributing factor to elective cesarean section. Women's beliefs about childbirth are known to influence their delivery preferences. Belief in birth as a natural process is associated with viewing childbirth as a normal and safe physiological event, whereas belief in birth as a medical process is associated with perceiving childbirth as potentially dangerous and requiring medical intervention. Prenatal education provided by healthcare professionals may influence these beliefs and subsequently affect women's birth preferences.

Pecha Kucha is a structured presentation technique consisting of 20 slides displayed for 20 seconds each, resulting in a total presentation time of 6 minutes and 40 seconds. The method emphasizes concise communication through visual materials and has been reported to facilitate attention, comprehension, and retention of information. Although the Pecha Kucha technique has been used in various health education settings, evidence regarding its effectiveness in antenatal education is limited.

Objective The objective of this study was to determine the effect of Pecha Kucha-based normal birth education on birth beliefs and mode of birth preferences among pregnant women considering elective cesarean section.

Study Design This study was conducted as a single-blind, randomized controlled trial between March 2025 and June 2025 in Family Health Centers affiliated with a district Health Directorate in southern Türkiye. Participants were randomly assigned to either an experimental group or a control group using a simple randomization method. Women who met the eligibility criteria were allocated by drawing numbered papers from a box.

Participants The study included primiparous pregnant women who were at least 20 years of age, between 28 and 32 weeks of gestation, considering elective cesarean section without a medical indication, able to read and speak Turkish, and willing to participate. Women with maternal or fetal conditions requiring cesarean delivery and those who did not meet the inclusion criteria were excluded. A total of 76 participants completed the study, including 38 women in the experimental group and 38 women in the control group.

Interventions Both groups received education based on the Ministry of Health's Motherhood Journey Guide. Educational content included preparation for childbirth, birth planning, physiology and stages of labor, maternal and fetal changes during childbirth, coping with labor pain, breathing and relaxation techniques, movement and positioning during labor, benefits of vaginal birth, indications and risks of cesarean section, management of childbirth-related fears and anxieties, partner and family support, skin-to-skin contact, breastfeeding initiation, postpartum care, and common misconceptions regarding childbirth.

Participants in the experimental group received the educational content through the Pecha Kucha presentation technique. The presentation consisted of 20 visually supported slides presented for 20 seconds each. Participants in the control group received the same content through a conventional face-to-face oral presentation. Following the educational sessions, participants were given the opportunity to ask questions and receive feedback.

Outcome Assessment Data were collected at three time points: before the intervention (baseline), immediately after the intervention, and one month after the intervention. Outcome measures included the Birth Beliefs Scale and the Pregnant Women's Birth Mode Preferences Scale. The Birth Beliefs Scale evaluated beliefs regarding childbirth as a natural process and as a medical process. The Pregnant Women's Birth Mode Preferences Scale assessed preferences regarding vaginal birth and cesarean delivery.

Study Hypothesis The investigators hypothesized that normal birth education delivered through the Pecha Kucha technique would increase belief in childbirth as a natural process, decrease belief in childbirth as a medical process, and strengthen preferences for vaginal birth among pregnant women considering elective cesarean section.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
76

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

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Study Locations

Participation Criteria

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Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Female pregnant women aged 20 years or older. Primiparous. Between 28 and 32 weeks of gestation. Considering elective cesarean section. No maternal or fetal medical indication requiring cesarean delivery. Able to read, write, and speak Turkish. Willing to participate in the study and provide informed consent. Available to complete all study assessments throughout the study period.

Exclusion Criteria:

Younger than 20 years of age. Multiparous women. Presence of a maternal or fetal medical indication requiring cesarean delivery. Hearing or visual impairment that could interfere with participation in the educational intervention.

Inability to read, write, or speak Turkish. Refusal to participate or withdrawal of consent during the study. Failure to complete study procedures or follow-up assessments.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Pecha Kucha-Based Normal Birth Education
Pregnant women received normal birth education delivered using the Pecha Kucha presentation technique. The education consisted of 20 visually supported slides presented for 20 seconds each and included information on preparation for childbirth, birth planning, physiology and stages of labor, coping with labor pain, breathing and relaxation techniques, benefits of vaginal birth, indications and risks of cesarean section, partner support, breastfeeding initiation, postpartum care, and common misconceptions about childbirth. Participants completed outcome assessments at baseline, immediately after the intervention, and one month after the intervention.
Behavioral: Pecha Kucha-Based Normal Birth Education
A structured face-to-face educational intervention delivered using the Pecha Kucha presentation format consisting of 20 slides displayed for 20 seconds each. The intervention was designed to provide evidence-based information about normal birth and cesarean section through concise, visually supported content.
Active Comparator: Traditional Normal Birth Education
Pregnant women received the same normal birth educational content through a conventional face-to-face oral presentation. Educational topics were identical to those provided in the experimental group. Outcome assessments were completed at baseline, immediately after the intervention, and one month after the intervention.
Behavioral: Traditional Normal Birth Education
Face-to-face education delivered using a conventional oral presentation method. The educational content was identical to that provided in the experimental group but was delivered without the Pecha Kucha presentation format.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Birth Beliefs Scale - Natural Process Belief Subscale Score
Time Frame: Baseline, immediately after the intervention, and 1 month after the intervention.
The Natural Process Belief subscale of the Birth Beliefs Scale assesses the extent to which pregnant women perceive childbirth as a natural, normal, and safe physiological process. Higher scores indicate stronger belief in childbirth as a natural process.
Baseline, immediately after the intervention, and 1 month after the intervention.
Change in Birth Beliefs Scale - Medical Process Belief Subscale Score
Time Frame: Baseline, immediately after the intervention, and 1 month after the intervention.
The Medical Process Belief subscale of the Birth Beliefs Scale assesses the extent to which pregnant women perceive childbirth as a medical event requiring professional control and medical intervention. Higher scores indicate stronger belief in childbirth as a medical process.
Baseline, immediately after the intervention, and 1 month after the intervention.
Change in Pregnant Women's Birth Mode Preferences Scale Score
Time Frame: Baseline, immediately after the intervention, and 1 month after the intervention.
The Pregnant Women's Birth Mode Preferences Scale evaluates pregnant women's preferences regarding vaginal birth and cesarean delivery. Total scores range from 18 to 90, with higher scores indicating a stronger preference for vaginal birth.
Baseline, immediately after the intervention, and 1 month after the intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Burdur Mehmet Akif Ersoy University

Publications and helpful links

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General Publications

Study record dates

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Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 15, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 15, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 15, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 13, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 13, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 18, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 18, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 13, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • GO 2024/840

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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