Maternal perceptions about caesarean section deliveries and their role in reducing perinatal and neonatal mortality in the Upper West Region of Ghana; a cross-sectional study

Abstract

Background Maternal perceptions about caesarean section contribute to delayed presentation of women for emergency obstetric care. This increases the risks of perinatal and neonatal mortality and slows down the reductions needed to achieve the sustainable development goal (SDG) target of reducing neonatal mortality and ending new-born deaths. The aim of the study is to determine maternal perceptions about caesarean section deliveries and their role in reducing neonatal mortality at a regional and a district hospital in the Upper West Region of Ghana. Methods This descriptive study was carried out at two hospitals in the Upper West Region, the most rural region in Ghana, between 15th January and 29th June, 2018. Maternal perceptions were examined among antenatal care attendants at the Upper West Regional Hospital (UWRH) and St Joseph’s Hospital Jirapa (SJH), a district hospital, using questionnaires administered by trained nurses. Results Altogether, 416 completed questionnaires were obtained, comprising 206 from expectant women attending the UWRH and 210 from SJH. Although the majority of women in this study preferred spontaneous vaginal delivery (87.4%, n = 348) to caesarean section, most of the respondents (n = 281, 73%) indicated their willingness to have a caesarean section if necessary. The main reason for not wanting a CS was the long recovery time (51.8%, n = 148). Almost half of women interviewed, representing 45.1% (180) did not know or feel that CS can promote child survival and about a fifth, 21.6% (85) believed that CS can have adverse effects on child survival. Factors associated with poor perception of CS included, no formal education, age less than 19 years and no employment. Conclusion Majority of women in this study had a positive attitude towards the uptake of CS if it becomes necessary. Lack of formal education, age less than 19 years and unemployment are associated with poor maternal perception of CS. Education to improve the perception of CS as a promoter of child survival is necessary and to discourage perceptions that it causes adverse perinatal or neonatal outcome particularly in at risk populations.

Communication Between Healthcare Providers and their Clients: How Accurately do Mothers Remember the Indications for the Caesarean Section that they had?

“…[1] A further reason may be the aversion towards CS [6] and the generally poor knowledge of reproductive health issues. [7] This seems corroborated by Prah and colleagues who found that only 45% of their respondents who were pregnant women attending antenatal clinic could correctly identify one indication for CS. [8] The findings of these studies are limited by the fact that they involved mixed populations of women many of whom had never experienced a Caesarean delivery.…”

“…counselling, poor maternal recall due to many competing demands immediately after delivery, the general lack of information on reproductive health matters and the lack of importance attached to the issue. [1,10,12] Though it has been shown in some reports from LMICs that women generally have poor knowledge of reproductive health issues, [7,8] their recall of information made available to them also depends on the importance they attach to that information. Certain basic information such as mode of delivery had almost 100% recall in previous studies.…”

Local Perception about Caesarian Section among Post Caesarian Section Women in Pakistan

“…The research found that uneducated women associate natural birth with true motherhood and C-section with incapability of a mother or luxury. A study in Ghana concluded that women who are deprived of formal education and are unemployed show a poor perception of the Caesarian section and women see the Caesarian section as a reproductive failure whereas, vaginal delivery is a symbol of womanhood (Gandau, et al, 2019). Whereas, qualified/educated women tend to focus more on their health and are sensitive to baby's birth defects which may result in normal delivery therefore, educated women consider C-section as a safer option.…”

“…‗The greatest increase was seen in women with a higher educational level and those in the richest wealth quintile' (Mumtaz, Bahk, & Khang, 2017). A study in Ghana also revealed that economically poorer women perceived C-section as a long term disease as the recovery time is longer after C-section and it keeps women from doing their domestic chores and economic affairs therefore they avoid C-section and widespread of such perceptions runs in the community (Gandau, et al, 2019).…”

<p>Perspectives on Research Internships for Medical Students and Young Doctors in Ghana: An Opportunity to Replenish the Stock of Physician Investigators?</p>

“…Altogether, 5 scientific papers involving 1 resident, 4 house officers and 1 medical officer have been published. [15][16][17][18][19] There are 2 other manuscripts, one by a resident and another with a house officer waiting for posting, near publication, among others at different stages of development. Five papers have also been presented at meetings, national and international conferences including two by the residents and one by a house officer.…”