Cesarean section in relation to self‐esteem and parenting among new mothers in southwestern Nigeria

Loto, Olabisi Morebise; Adewuya, Abiodun O.; Ajenifuja, Olusegun Kayode; Orji, Ernest O.; Ayandiran, Emmanuel Olufemi; Owolabi, AT; Ade-Ojo, Idowu Pius

doi:10.3109/00016340903280966

Cited by 20 publications

(23 citation statements)

References 12 publications

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“…Our data also showed that some women stayed away from some formal facilities and opted for alternative home births in fear of "unnecessary" caesarian section whenever their labor did not progress well due to perceived inadequate care or health-care provider engagement at these facilities. Just like our study, other scholars have reported perceptions on caesarian sections in some communities as socially or culturally unacceptable and a limiting factor to how many children one was destined to have (26)(27)(28)(29).…”

Section: Discussionsupporting

confidence: 59%

When women deliver at home with no one present: Are health care systems in Uganda driving women away?

Atukunda

Mugyenyi

Obua

et al. 2019

Preprint

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Background Uganda’s maternal mortality remains unacceptably high, with thousands of women and newborns still dying of preventable deaths from pregnancy and childbirth-related complications. Despite the fact that over 95% of women in Uganda attend at least one antenatal care (ANC) visit, over 30% of women still deliver at home with no skilled birth attendant, many choosing to come to hospital after experiencing a complication. We explored barriers to women’s decisions to deliver in a health care facility among postpartum women in rural southwestern Uganda, to ultimately inform interventions aimed at improving skilled facility births.Methods Between December 2018 and March 2019, we conducted in-depth qualitative face-to-face interviews with 30 post-partum women delivering at home or health facility in rural southwestern Uganda. The purposeful sample was intended to represent women with differing experiences of pregnancy, delivery and ANC. Women were recruited from 10 villages within 20km of a referral hospital. Interviews were conducted and digitally recorded in a private setting by a trained native speaker. Translated transcripts were generated and coded. Coded data was iteratively reviewed and sorted to derive descriptive categories using grounded theory methodology.Results Regardless of where they decided to give birth, women wished to deliver in a supportive, respectful, responsive and loving environment. The data revealed six key barriers to women’s decisions to deliver from a health care facility: 1) Fear of unresponsive care, fueling a fear of being neglected or abandoned while at the facility, 2) fear of embarrassment and mistreatment by health care providers, 3)low perception of risk associated with pregnancy and childbirth, 4) preferences for particular birthing positions and their outcome expectations, 5) perceived lack of privacy in public facilities, and 6) perceived poor clinical and interpersonal skills of health providers to adequately explain birthing procedures or support expectant or laboring women and their newborn.Conclusion Anticipation of unsupportive, unresponsive, disrespectful treatment, and a perceived lack of tolerance for simple, non-harmful traditions prevent women from delivering at health facilities. Building better interpersonal relationships between patients and providers within health systems could reinforce trust, confidence, improve patient-provider interaction, and facilitate useful information transfer during ANC and delivery visits.

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Section: Discussionsupporting

confidence: 59%

When women deliver at home with no one present: Are health care systems in Uganda driving women away?

Atukunda

Mugyenyi

Obua

et al. 2019

Preprint

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“…A total of 30 study participants with differing experiences of pregnancy and antenatal care; 15 women who delivered from their homes and 15 who delivered from a health facility were purposively selected from the 10 villages within 20 km from of a referral hospital with the help of existing village health teams and interviewed ( [20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Twelve women (40%) had completed education beyond primary school.…”

Section: Resultsmentioning

confidence: 99%

<p>When Women Deliver at Home Without a Skilled Birth Attendant: A Qualitative Study on the Role of Health Care Systems in the Increasing Home Births Among Rural Women in Southwestern Uganda</p>

Atukunda¹,

Mugyenyi²,

Obua³

et al. 2020

IJWH

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Background: Uganda's maternal mortality remains unacceptably high, with thousands of women and newborns still dying of preventable deaths from pregnancy and childbirth-related complications. Globally, Antenatal care (ANC) attendance has been associated with improved rates of skilled births. However, despite the fact that over 95% of women in Uganda attend at least one ANC, over 30% of women still deliver at home alone, or in the presence of an unskilled birth attendant, with many choosing to come to hospital after experiencing a complication. We explored barriers to women's decisions to deliver in a health care facility among postpartum women in rural southwestern Uganda, to ultimately inform interventions aimed at improving skilled facility births. Methods: Between December 2018 and March 2019, we conducted in-depth qualitative face-to-face interviews with 30 post-partum women in rural southwestern Uganda. The purposeful sample was intended to represent women with differing experiences of pregnancy, delivery, and antenatal care. We included 15 adult women who had delivered from their homes and 15 who had delivered from a health facility in the previous 3 months. Women were recruited from 10 villages within 20 km of a regional referral hospital. Interviews were conducted and digitally recorded in a private setting by a trained native speaker to elicit experiences of pregnancy and birth. Translated transcripts were generated and coded. Coded data were iteratively reviewed and sorted to derive descriptive categories using an inductive content analytic approach. Results: Regardless of where they decided to give birth, women wished to deliver in a supportive, respectful, responsive and loving environment. The data revealed six key barriers to women's decisions to deliver from a health care facility: 1) Fear of unresponsive care, fueling a fear of being neglected or abandoned while at the facility; 2) fear of embarrassment and mistreatment by health care providers; 3) low perception of risk associated with pregnancy and childbirth; 4) preferences for particular birthing positions and their outcome expectations; 5) perceived lack of privacy in public facilities; and 6) perceived poor clinical and interpersonal skills of health providers to adequately explain birthing procedures or support expectant or laboring women and their newborn. Conclusion: Anticipation of unsupportive, unresponsive, disrespectful treatment, and a perceived lack of tolerance for simple, non-harmful traditions prevent women from delivering at health facilities. Building better interpersonal relationships between patients and providers within health systems could reinforce trust, improve patient-provider interaction, and facilitate useful information transfer during ANC and delivery visits. These expectations are important considerations in developing supportive health care systems that provide acceptable patient-friendly care. These findings are indicative of the vital need for midwives and other health care providers to have additional training i...

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“…In vaginal birth, the amount of oxytocin increases in the maternal brain, which helps reduce stress and elevate feelings of happiness, and thus decreases the possibility of postpartum mental disorders . In addition, women who undergo cesarean may have less self‐confidence in parenting because they could not give birth naturally by themselves . Women who lack self‐confidence may feel nervous in parenting, which in turn is associated with distress, adjustment, and mood‐related mental disorders after childbirth.…”

Section: Discussionmentioning

confidence: 99%

“…Taken together, the association between cesarean birth and postpartum mental disorders has been inconclusive and controversial . Nonetheless, the mechanisms that link cesarean birth and postpartum mental disorders proposed by researchers seem plausible, possibly because of decreased levels of oxytocin, maternal and neonatal physical problems, and low parental confidence …”

Section: Introductionmentioning

confidence: 99%

Understanding the relationship between cesarean birth and stress, anxiety, and depression after childbirth: A nationwide cohort study

Chen¹,

Lai

Hwang

et al. 2017

Birth

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Cesarean section in relation to self‐esteem and parenting among new mothers in southwestern Nigeria

Abstract: CS in Nigerian women is associated with lowered self-esteem and predicts poor parenting self-efficacy in the postnatal period. Psychological support and techniques to improve self-esteem and parenting should be incorporated into the management of women having CS.

Cited by 20 publications

References 12 publications

When women deliver at home with no one present: Are health care systems in Uganda driving women away?

When women deliver at home with no one present: Are health care systems in Uganda driving women away?

<p>When Women Deliver at Home Without a Skilled Birth Attendant: A Qualitative Study on the Role of Health Care Systems in the Increasing Home Births Among Rural Women in Southwestern Uganda</p>

Understanding the relationship between cesarean birth and stress, anxiety, and depression after childbirth: A nationwide cohort study

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