Caesarean section: the perspectives of women in Port Harcourt, Nigeria

Abstract

Background: The caesarean section rate in several health facilities in Nigeria is rising, even with the strong aversion to the procedure by women in Nigeria.  This study is to explore the experiences and views of women on caesarean section, as to identify areas of conflicts with the medical perception.

Methods: The study was carried out in Port Harcourt using a descriptive, cross-sectional study design, with a self - administered questionnaire and in-depth interviews as the study tools. The questionnaire was administered to pregnant women attending the antenatal clinics of the two public tertiary health institutions in Port Harcourt. The in-depth interviews were held with ten women that had antenatal care in a health facility, but had their delivery in private maternity homes, to further explore reasons why certain women could go to great length to avoid a caesarean section.

Results: A total of 347 questionnaires were retrieved and analyzed.  The  average  age  of  the

respondents was 29.5 years and they were mainly Pentecostal Christians (55.3%) and of tertiary education (53.3%). The aversion of the respondents for caesarean section stem from its stigma factor (52.7%)  its ability to limit the number of children a woman could have (68.0%), its cost (63.7%), and the likelihood of morbidity and mortality (51.0%). Some (25.1%) of the respondents felt doctors sometimes recommend the procedure for their own financial gratification, an opinion actively peddled by some private midwives.

Conclusions: There are some differences between the medical indications for caesarean section and the expressed need for the procedure by women. This should be taken into consideration in reaching the decision for the procedure.

Keywords: Caesarean section, Health system, Aversion, Customer demand