Perceptions and attitudes of pregnant women towards caesarean section in urban Nigeria

Objectives. To determine the perceptions and attitudes towards caesarean section [ CS] among women attending maternity care at the University of Benin Teaching Hospital in Nigeria. Methods. Some 413 consecutive women, attending antenatal care in the hospital, were interviewed with a structured questionnaire that solicited information on their socio-demographic characteristics, their previous pregnancy and delivery history, and their knowledge and attitudes towards CS. Additional focus group discussions and in-depth interviews were held with women who recently underwent CS in the hospital, to gain further insights into attitudes and perception about CS in the women. Results. The women had good knowledge of CS; however, only 6.1% were willing to accept CS as a method of delivery, while 81% would accept CS if needed to save their lives and that of their babies. Up to 12.1% of women would not accept CS under any circumstances. Logistic regression showed that women's low level of education, and past successful vaginal and instrumental deliveries, were most likely to be associated with women's non-acceptance of indicated caesarean section. Further analysis showed that this was mainly due to inaccurate cultural perceptions of labour and caesarean section in the cohort of women. Conclusion. There is a need for programs to increase women's and community understanding and perceptions of CS as a method of delivery in Nigeria.