ACCESSING THE KNOWLEDGE, ATTITUDE AND PERCEPTION OF PREGNANT WOMEN TOWARD CAESAREAN SECTION

Abstract

Background: Caesarean section remains the most common major operation performed on women worldwide and rate is increasing. Mortality and morbidity from pregnancy and labour related causes have been observed to be high in developing nations, especially those of sub-Sahara Africa. Significant aspect of these causes can be averted by timely Caesarean section. There is therefore the need to appraise the procedure frequently especially with a view to evaluating factors militating against the acceptance of this life saving procedure. The study was conducted to assess the knowledge, acceptance and perception of Caesarean section among pregnant women attending antenatal clinic in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto. Methods: This was a cross-sectional study involving 200 pregnant women seen at the Usmanu Danfodiyo University Teaching hospital Sokoto between 1stOctober to 31st December 2015. Using an interviewer administered questionnaire, participants were scored for knowledge and perception; acceptance of Caesarean section was also assessed. Results: Majority (85.5%) had good knowledge of Caesarean section, and 77.5% viewed the procedure as an acceptable mode of delivery and will accept it if indicated. In the study, 193(96.5%) had good perception of C/S. Perception of denial of womanhood, pain, high cost and fear of death were the main reasons why some would not accept Caesarean section. Conclusion: This study showed a good knowledge, acceptance and perception of Caesarean section. This is against the wide assertion of aversion to C/s in developing countries

CHAPTER ONE

INTRODUCTION

1.1BACKGROUND OF STUDY

Maternal mortality represents the leading cause of death among the pregnant women in most developing countries including Cameroon (Mekonnen and Mekonnen, 2003; WHO, 2007). Furthermore, it is estimated that one third of all maternal deaths globally occur in just two countries, namely India and Cameroon (Mboho et al 2013). According to UNFPA (2012), in 2010, India was accountable for about 20% of global maternal deaths (56,000) and Cameroon, 14% (40,000). Meanwhile, disease, deformity and death are terms usually employed to describe the experiences of a vast majority of sub-Saharan African women during pregnancy and birthing (Harrison, 2001; Brookman-Amissah and Moyo, 2004; WHO, 2004a). Similarly, the majority of African women are often viewed as being at high risk of infections, injury and death during pregnancy and the periods surrounding it (Izugbara and Ukwayi, 2007). In recent time women in Cameroon have expressed worries about choices of childbirth especially the issues surrounding vaginal birth. The joy of every woman is to deliver her baby normally. Some decades ago the most available or preferred option for most women was vaginal birth. Some of the women had their babies at home with traditional birth attendants but quite often with difficult labour resulting from obstruction and the women died before any meaningful interventions. Today, however, many babies have been delivered successfully through caesarean section. This success story in not without criticism. Among women in the developing countries, caesarean section is still being perceived as a ‘curse’ of an unfaithful woman (Adeoye and Kalu 2011). The authors further assert that cesarean section is seen among weak women. In addition, cesarean section is surrounded with suspicion, aversion, misconception, fear, guilt, misery and anger among the women of South Western Cameroon (Adeoye and Kalu 2011). Furthermore, in most sub-Saharan African countries including Cameroon, cesarean section is being accepted reluctantly even in the face of obvious clinical indication (Adeoye and Kalu 2011). Despite the causes of maternal mortality often obstetric in origin, underlying cultural factors and beliefs also affect access to and use of health facilities and thus contribute to avoidable maternal deaths (Mboho et al 2013). Several studies have indicated how local beliefs and practices impact general health and childbearing. Some of these beliefs have been identified as contributing to the delays in accessing appropriate skilled help when complications arise in labour (Okafor 2000) It is necessary to note that the issue of vaginal birth is not only peculiar to developing countries but also in some developed countries. Women still choose vaginal birth after having cesarean section even in the case of post dates slated for elective cesarean section (Clift-Mathews 2010). The author further highlighted the fact that women desperately wished to go into labour before their appointment dates because not giving birth vaginally was a sign of ‘failure’. In addition; vaginal birth is something a number of women look upon as a rite of passage (Clift-Mathews 2010) Obstetrics in modern America is a contentious subject in general (Ecker 2013). Usually childbirth and action surrounding it whether medical or otherwise normally evoke strong emotions where discussion is often framed ideologically as a matter of nature versus technology. Hence the issue of caesarean section in particular is much contested issue (Ecker 2013). Even so, caesarean section rates are on the increase as evident in a number of western countries such as the United States of America and United Kingdom (McAra-Couper, Jones and Smythe 2010). In 1985, following the increasing disparity rate among nations in the number of caesarean births, the World Health Organisation (WHO) set out to determine an optimal rate of 15 percent as ideal. The postulated 15 percent by WHO would optimally prevent childbirth injuries and deaths. In addition, many women and babies would avoid unnecessary and potentially harmful surgery (Harvard magazine 2013). However, WHO has since modified this particular recommendation in 2009, stating that ‘the optimum rate is unknown but asserts that both very low and very high rates of caesarean sections can be dangerous’. In other words, the procedure should be done only when it is absolutely necessary. The editorial team of Academic Research International of Harvard Magazine concluded that there is need for a balance to be reached, that is, women should be allowed to have normal vaginal deliveries with as little intervention as possible. However, at the same time, the families, obstetricians will be ready to address any unexpected emergencies.

1.2 STATEMENT OF PROBLEM

Traditionally, Cameroonn women are unwilling to have CS because of the general belief that abdominal delivery is reproductive failure on their part regardless of the feasibility of vaginal birth after CS and the decreasing mortality from Caesarean sections. Imperative to the average pregnant woman irrespective of her level of education and parity therefore is CS. Available reports on knowledge of CS amongst women are mainly from tertiary health facilities situated in cities and in the southern parts of the country while little is known about the perception and acceptance of pregnant women towards Caesarean section in University Teaching Hospital in Yaounde.

1.3 RESEARCH OBJECTIVES

1. To explore the perception and acceptance of pregnant women in University Teaching Hospital, Yaounde toward caesarean section.

2. To ascertain what is known about caesarean section and the reasons for dislike by our women.

1.4 RESEARCH QUESTION

1. What is the perception and acceptance of pregnant women in University Teaching Hospital, Yaounde toward cesarean section?

What is known about cesarean section and the reasons for dislike by our women?

1.5 SIGNIFICANCE OF THE STUDY

The findings from this study would be used in planning strategies towards improving the knowledge, perception and acceptance towards CS in the community in order to possibly reduce the delay in presentation to the health facility when CS is needed, improve utilization of this mode of delivery and limit the avoidable maternal and foetal complications.

1.6 SCOPE OF STUDY

This study focused on the perception and acceptance of pregnant women towards Cesarean section. It was carried out in University Teaching Hospital (IUTH), Okada in Yaounde.

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Item Type: Project Material  |  Size: 53 pages  |  Chapters: 1-5

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