Abstract: Objective To study the change in delivery intention and patterns among mothers of infants before and after the implementation of a health promotion on spontaneous labor in Hunan province and to provide evidences for developing spontaneous labor interventions.Methods With self-controlled design and two stage stratified cluster random sampling,two waves of questionnaire survey were conducted among 603 and 588 women giving births to their children at 6 hospitals in Hunan province before and after the implementation of a health promotion on spontaneous labor from September to August in 2012 and 2015.Results Compared to the results of baseline survey,a significant increase in the proprotion of the women with the intention of spontaneous labor (74.30%426/588vs.65.67%396/603),χ²=10.383;P=0.001)and a decrease of those with the intention of caesarean section (25.70%147/588vs.34.33%207/603) were observed at the end survey.Among the women having labors at hospitals of grade-three and county-level,the proprotion of with the intention of spontaneous labor significantly increased (χ²=13.325,P<0.001).Before the health promotion on spontaneous labor,the main reason for the mothers choosing cesarean section was with abnormal condition based on prenatal examination (39.30%);while after the intervention,the main reason was with the history of cesarean section (44.10%).The proportion of women selecting spontaneous labor increased significantly at the end survey (χ²=6.098,P=0.014).Conclusion Health promotion on spontaneous labor could obviousely influence the selection of delivey pattern,rusulting in increased intension of choosing spontaneous labor and decreased of cesarean section among pregnant women in Hunan province.