الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Based on the information presented in this thesis, we make the following summary: Childbirth is a natural physiological event as well as a life-changing emotional experience for women. Vaginal delivery is the most accepted mode of birth being the natural mode and safer for the mother and the fetus, in absence of contraindications, but it needs active participation from the pregnant woman. The increasing rate of CS worldwide is an alarming concern for public health and obstetricians due to the increase in financial burden and risk to the health of the mother in comparison to vaginal delivery As the incidence of delivery by CS is markedly increasing in Egypt, defining women’s preferences and its determinants could help in planning health education programs to modulate the mode of delivery in Egypt were the objectives of our study. The present study was carried out in Said medical Center and Shobar Primary Healthcare unit, Al Gharbia governorate, Egypt. On 304 mothers attending vaccination sessions for the scheduled vaccine included in the Expanded Program of Immunization (EPI) in the second and ninth months of child age. The study was done during a period of two years (from 1st November 2020 through December 2022). The results of the present study shows that, urban women were older, their age of marriage was higher, highly educated, more of them were working, their husbands were highly educated, most of their husbands were professionals with a higher percentage of enough and saving income. Regarding parity, urban women were more multiparous, about 40% had previous abortion, most of them delivered at private hospitals. CS was preferred by approximately 40.2% and 15.1% of females in urban and rural communities, respectively. Regarding concomitant medical diseases, hypertension reported in 13.8% among those delivered by CS. The logistic regression determines that urban residence, age 25- and living in separate home, primiparity, no abortion, and previous CS delivery were the most significant determinants of delivery mode. For the effect of the delivery mode on early feeding practices, the current study shows that, those who delivered by CS had delayed initiation of breastfeeding more than 6 hours after delivery, more of them were partial breastfeeding. Regarding maternal complications, women who had CS delivery at the last pregnancy had more respiratory difficulties, vaginal bleeding and need blood transfusion. While more of females who had VD had more high fever or bad-smelling vaginal discharge. Regarding admission to NICU, more infants who were born vaginally were admitted. On the other hand, more infants who were born via CS had more bluish discoloration the of lips. Regarding motor milestones, the current study showed that infants who were born via CS had delayed holding their heads steadily, sitting without support and teeth eruption compared to those who were born vaginally. On the other hand, more infants who were born vaginally had delayed timing for crawling. Finally, we recommend that antenatal care should be maintained and strengthened to allow early detection of complications. All pregnant women should be informed of the dangers of elective CS for breastfeeding practices. Physicians should take part in health education program. Written informed consent should be taken from mother to inform her about benefits and complications of mode of delivery. Infants should be check for motor milestones regularly to allow early management of delayed.