Perception of pregnant women towards caesarean section in Nigeria: a case study of a missionary hospital in EDO, Nigeria

Abstract

INTRODUCTIONCaesarean section is a surgical procedure in which one or more incisions are made through a mother's abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies, or to remove a dead fetus.1 It is one of the most important operations performed in obstetrics and gynaecology. Its life saving value to both mother and fetus has increased over the decades although specific indications for its use have changed. Its purpose of preserving the life of a mother with obstructed labour and delivering a viable infant from a dying mother have gradually expanded to include the rescue of the fetus from subtle dangers.2 If there are no complications, a vaginal birth is safer than a CS. Advantages of having a CS especially when it has been planned over the vaginal births includes: no contraction, minimized risk of prolapse, no vaginal injury and reduced bleeding while its disadvantages includes: increased cost, uterine rupture and increased probability of complications.Various factors such as: prolonged labour, foetal distress, cord prolapse, uterine rupture, placental problems like placenta praevia, placenta accreta, abnormal presentation ABSTRACT Background: The perception of pregnant women towards caesarean section (CS) even in the face of danger has been a major concern. The major objective of the study was to investigate the perception of pregnant women attending a missionary hospital in Edo state, Nigeria. A simple random sampling technique was used to select one hundred pregnant women from the antenatal clinic the hospital. Methods: Data were collected using a structured questionnaire and analyzed using descriptive statistics in form of frequency, percentages and tables, t-test and one way analysis of variance (ANOVA) at the significance level of 5%. Results: Findings revealed that perception of pregnant women towards caesarean sections is negative/low, 79% objected delivery via CS for fear of death while 82% objected due to family preference of vaginal delivery. 60% also objected because of the cost of undergoing CS. Findings further revealed that the group of respondents who have experienced caesarean section have a more positive perception towards caesarean section than the group who haven't. Conclusions: This study clearly indicate that there is a negative perception of pregnant women in this setting and majority of them were clearly adverse to CS. Educational level also significantly influences the perception of pregnant women towards caesarean section. It is therefore recommended that proper education of the masses be done so as to correct the wrong notions about caesarean section.

Factors influencing decision-making to accept elective caesarean section: A descriptive cross-sectional study

“…The decision-making process for the woman involves a multiplicity of factors which include knowledge of the CS process, finances and family support [ 10 , 14 ]. Osamor and Grady [ 15 ] in an integrative literature review of studies in Africa, South and Central Asia observed that women's decision-making regarding their healthcare seems not to be fully autonomous.…”

Factors influencing decision-making to accept elective caesarean section in a hospital in Ghana: A descriptive cross-sectional study

“…Findings from studies in Nigeria and Ghana indicate that some traditional women are unwilling to have caesarean section because of the general belief that abdominal delivery is reproductive failure on their part, and others for fear of mockery [18][19][20]. Chigbu and Iloabachie [19] found a high prevalence of caesarean section refusal among their study participants and noted very poor maternal and perinatal outcomes as a result of this refusal.…”

Public Health aspects of Cesarean section including overuse and underuse of the procedure

“…Informed refusals especially when the fetus's life is at risk is challenging. Factors that might influence these decisions include fear of postoperative pain, increased facility costs, cultural and religious beliefs, family/partner objection, lack of knowledge of the consequences and fear of death for both mother and child [37,38]. One Nigerian study (n=413) reported of mothers (12%) unwilling to accept the procedure under any circumstance [36].…”

“…One Nigerian study (n=413) reported of mothers (12%) unwilling to accept the procedure under any circumstance [36]. Reports of refusals are mostly from low income countries [34,35,38], but a small proportion are also reported from high income countries [37].…”