Obstetricians' opinions and attitudes toward maternal refusal of recommended cesarean delivery in Nigeria

Chigbu, Chibuike O.; Ezenyeaku, Cyril C.; Ezenkwele, Eziamaka Pauline

doi:10.1016/j.ijgo.2009.01.012

Cited by 6 publications

(7 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, in some countries, including Nigeria, due to economic problems, one fourth of women do not accept performing CS even in emergency situations (23). A study showed that only 2.5% of deliveries in the USA in 2003 were performed using CS based on women's request (24).…”

Section: Introductionmentioning

confidence: 99%

İran Bonab'da yaşayan kadınların sezaryen konusundaki görüş ve eğilimleri

Ranjbar¹,

Rahmani²,

Mirgafourvand³

et al. 2016

Ege Tıp Dergisi

View full text Add to dashboard Cite

Aim: Studies conducted in large cities of Iran showed a tendency to prefer Cesarean section (CS) among women. On the other hand, there is a lack of studies investigating the thoughts of women about CS in small cities. The aim of this study was to investigate the knowledge and attitudes of women living in a small city in the Northwest of Iran regarding CS. Materials and Methods:This descriptive study was carried out in four health centers in Bonab, a city in the Northwest of Iran. There were 189 women participating in this study. A questionnaire on their background, knowledge, attitudes and the reason for the selection of CS was used for data collection. Data analysis was performed using SPSS version 17 software (version 17). Results:The results of this study showed that fear of pain, prevention of genital tears and fear of vaginal exams are the most important reasons for selecting CS. This study also showed that participants had a limited knowledge and positive attitude regarding CS. Conclusion:Positive attitude of women in combination with their limited knowledge about CS, show the need for educating women on the complications of CS. Keywords

show abstract

Section: Introductionmentioning

confidence: 99%

İran Bonab'da yaşayan kadınların sezaryen konusundaki görüş ve eğilimleri

Ranjbar¹,

Rahmani²,

Mirgafourvand³

et al. 2016

Ege Tıp Dergisi

View full text Add to dashboard Cite

show abstract

“…These debates about the status of the fetus are relevant here insofar as they reflect how clinicians' views on the fetus may influence women's care. Most empirical research about pregnant women who decline recommended care has been devoted to refusal of caesarean section (CS; see Adams et al, 2003;Chigbu et al, 2009;Chigbu & Iloabachie, 2007;Cuttini et al, 2006;Danerek et al, 2011;Samuels et al, 2007) and, to a lesser extent, blood products (see Iris et al, 2009;van Wolfswinkel et al, 2009). Studies examining other maternal refusals are rare.…”

Section: Delimiting the Scopementioning

confidence: 99%

“…A similar study (Chigbu et al, 2009) explored the attitudes of obstetricians in Nigeria to several hypothetical scenarios, all involving maternal refusal of recommended CS. Obstetricians expressed the opinion that ongoing counselling was their preferred way of "managing" maternal refusals, but resource constraints were likely to lead them to "insist on planned caesarean delivery" (Chigbu et al, 2009, p250).…”

Section: Obstetricians' Attitudesmentioning

confidence: 99%

“…Most of the published literature concerning women who decline recommended care focusses on the experiences of clinicians (Chigbu et al, 2009;Cuttini et al, 2006;Danerek et al, 2011) and their attitudes to court intervention (Samuels et al, 2007); the experiences of women are less commonly described. Three papers (Chervenak & McCullough, 1990;Deshpande & Oxford, 2012;Pinkerton & Finnerty, 1996)…”

Section: Introductionmentioning

confidence: 99%

“…What remains unclear, however, is what happens when women decline recommended care. The literature focusses on the experiences and attitudes of obstetricians to court intervention (Chigbu et al, 2009;Cuttini et al, 2006;Samuels et al, 2007). Although these studies have generally reported low levels of willingness to seek court orders to compel pregnant women to accept recommended care, they have not investigated strategies that might address ethical and medico-legal concerns of doctors.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Getting the ‘Comfortable’ to listen: a mixed methods study of refusal of recommended maternity care

Jenkinson¹

View full text Add to dashboard Cite

Background: The right to refuse medical treatment, held by all competent adults and unaltered by pregnancy status, is a central tenet of respectful maternity care. This right is well established in case law, midwifery and obstetric ethical guidance and health policy. However, when pregnant women decline recommended care, concerns about maternal and fetal safety can lead to conflict. Clinicians may feel their own autonomy is challenged and also grapple with ethical and medico-legal concerns. Processes to guide clinicians when women decline recommended care are rare and unstudied. Aim: This thesis set out to support women's rights in maternity care by investigating the research question: Could a documentation and communication process support pregnant women's rights to decline recommended maternity care? Methods: A sequential, explanatory mixed-methods study was undertaken in a Brisbane (Australia) tertiary maternity hospital where a structured process, the Maternity Care Plan (MCP), had been established to guide communication and documentation when women declined recommended care. The first stage of the study was quantitative and mapped the scope and use of the MCP process via a retrospective cohort study of women with MCPs. Results of the quantitative stage then informed selection of participants for the qualitative phase of the study which involved thematic analysis of in-depth semi-structured interviews with women, midwives, and obstetricians. Within the qualitative phase, two layers of thematic analysis were undertaken. The first layer of thematic analysis was descriptive, and focused on participant's experiences of the MCP process, while the second layer applied a more critical and feminist lens, foregrounding the underlying values and attitudes that drove care when pregnant women declined to follow professional advice. Findings: The retrospective cohort study included 52 women with MCPs and concluded that the MCP process enabled clinicians to provide care outside of hospital policies but was used rarely, for a narrow range of situations and with significant variation in its application. These results were then followed up in interviews with nine women, twelve midwives, and nine obstetricians. The descriptive thematic analysis of interviews found that obstetricians felt protected and reassured by the structured documentation and communication, while other clinicians felt reassured by the perception of obstetric authorisation. This, in turn, protected women's access to maternity care. However, inconsistencies in the implementation of the MCP process, and fragmented care, diminished both the utility of the process and women's access to it. While the MCP process 3 provided a symbol of respect for maternal autonomy, the larger forces of patriarchy and medical hegemony remained largely unchallenged. The feminist thematic analysis then identified both supportive and punitive interactions between women and clinicians, depending on whether the woman's birth intentions were perceived by individual clinicians to transg...

show abstract

The experiences of women, midwives and obstetricians when women decline recommended maternity care: A feminist thematic analysis

2017

View full text Add to dashboard Cite

declining recommended care situated women at the intersection of two powerful normative discourses: medical dominance and the patriarchal institution of motherhood. Significant pressures on women's autonomy resulted from an apparent gap between clinicians' espoused and reported practices. Implications for policy and practice include a need for specific guidance for clinicians providing care in situations of maternal refusal, the potential value of an independent third-party for advice and advocacy, and the development of models that support reflexive practice amongst clinicians.

show abstract

Obstetricians' opinions and attitudes toward maternal refusal of recommended cesarean delivery in Nigeria

Cited by 6 publications

References 11 publications

İran Bonab'da yaşayan kadınların sezaryen konusundaki görüş ve eğilimleri

İran Bonab'da yaşayan kadınların sezaryen konusundaki görüş ve eğilimleri

Getting the ‘Comfortable’ to listen: a mixed methods study of refusal of recommended maternity care

The experiences of women, midwives and obstetricians when women decline recommended maternity care: A feminist thematic analysis

Contact Info

Product

Resources

About