THE PERCEPTION AND ATTITUDE OF PREGNANT WOMEN TOWARDS CESAREAN SECTION

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THE PERCEPTION AND ATTITUDE OF PREGNANT WOMEN TOWARDS CESAREAN SECTION

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

For a healthy women population, the choice of delivery option is an important decision. Expectant parents make many choices which usually include site for delivery (hospital, birth centre, or home), and the choice between spontaneous vaginal delivery and caesarean section.1 Over time caesarean section rates has been on the increase in the whole world.2 Both developed and developing nations of the world have their own share of this increase.3

Epidemiological studies in Brazil and Chile have shown that there is higher caesarean section rate among women who have a higher level of education.4 In some African, increase in the rate of caesarean section have been documented; Ghana5 and Nigeria.6 However there is a broadly held belief that West African women have an aversion for caesarean section delivery.7 Maternal knowledge and occupation has also been seen to influence the attitude of women towards mode of delivery. Many studies have proven women preference for vaginal deliveries over surgical delivery.8-15 Although majority of caesarean sections are emergency caesarean

sections especially in developing nations there is also a noticeable increase in the rate of elective surgery of late probably due to increase level of knowledge of women, improvement in medical practice and women higher level of education. It is important to note that elective emergency caesarean section is known to be associated with more maternal and newborn morbidity than planned vaginal birth.16-19 In a study carried out by Nira and colleagues to assess the attitude of women toward caesarean section in Nepal they found out that vaginal delivery was the preferred mode of delivery by 93% of the respondents while 7% preferred caesarean section as mode of delivery.3 Their reasons for these ranges from it been a natural process, been good for mother’s health, safety to been an easy process.

Most of the women thought that caesarean delivery can cause long term ill effect on mother’s health. All the women who preferred elective caesarean delivery initially said that they would rather opt for painless labour and vaginal delivery if offered over caesarean section. Similarly Aziken, Omo-Aghoja, & Okonofua submitted that inaccurate cultural perception about caesarean section delivery account for poor attitude of women towards caesarean section.20 Aali & Motamedi reported that only one third of women demonstrate positive attitude towards caesarean delivery as against 95.5% for vaginal delivery in the same group of respondents. The study concluded no significant differences in attitude and knowledge scores according to women’s levels of education.

1.2 Statement of the problem

It is not strange to hear many pregnant women ventilating wrong attitude towards caesarean section as an alternative method of birth. Especially in the developing countries like Nigeria, a number of women believe caesarean section is a last resort used to deliver a pregnant women of her baby, many will even say, been told that they are going to deliver their babies through caesarean section is like giving a death warrant. This attitude towards caesarean section influence women acceptance of the procedure and resulted in psychological depression that women and their family usually experience when been told that their baby will be delivered through caesarean section, this will have adverse effect on the outcome of the procedure.

1.3 Objectives of the study

1. Assess the level of knowledge of women about caesarean section.

2. Determine the attitude of women towards caesarean section.

3. Assess the level of acceptance of caesarean section as a method of birth among women.

1.4 Research questions

1. What is the level of knowledge of women about caesarean section?

2. What is the attitude of women towards caesarean section?

3. What is the level of acceptance of caesarean section as a method of birth among women?

1.5 Research hypothesis

H0: Pregnant women have a negative attitude towards cesarean section

H1: Pregnant women does have a negative attitude towards cesarean section

Operational definition of terms:

Cesarean section:

Caesarean section, also known as C-section or caesarean delivery, is the use of surgery to deliver one or more babies. A caesarean section is often performed when a vaginal delivery would put the baby or mother at risk. This may include obstructed labour, twin pregnancy, high blood pressure in the mother, breech birth, problems with the placenta or umbilical cord

Morbidity: Morbidity is a measure of disease, illness or injury within a population. Like infant mortality, conditions resulting from prematurity and low birth weight are strongly associated with infant morbidity.

Multiple birth: A multiple birth is the culmination of one multiple pregnancy, wherein the mother delivers two or more offspring.

Eclampsia: Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia. Pre-eclampsia is a disorder of pregnancy in which there is high blood pressure and either large amounts of protein in the urine or other organ dysfunction

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