Factors Associated with Preference for Caesarean Section among Women in the Ante-Natal Clinic of a Tertiary Hospital in the Niger Delta, Nigeria. A Pilot Study

Abstract

Aims: Preference for caesarean section for childbirth that could otherwise have been natural has led to a significant increase in the rate of caesarean sections in the world. This pilot study therefore, sought to determine the factors associated with preference for caesarean section among women receiving antenatal care in the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Study Design: A descriptive cross-sectional study. Place and Duration of Study: Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, between January and February 2014. Methodology: The pilot study was conducted among 256 pregnant women in the University of Port Harcourt Teaching Hospital. A pretested well-structured self-administered questionnaire was administered to all pregnant women in their third trimester that attended the antenatal clinic on the different days of the week and consented to be part of the study. Data was entered into an excel sheet and analysed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results: Respondents were aged between 18 and 44years. Two hundred and forty one (94.1%) of them were married, with 87(34%) and 75 (29.3%) of them being Business women (traders) and civil servants respectively. Of the respondents, 180 (70.3%) preferred vaginal delivery, 44(17.2%) did not mind if they had vaginal delivery or caesarean section while 32 (12.5%) would prefer a caesarean section. The major factors that influenced preference for caesarean section in this study were doctors’ advice 13(40.6%), previous caesarean section 8(25%), safety for both mother and child 3(9.4%), fear of labour pains 3(9.4%) and previous bad birth experience 3(9.4%). In addition, those who had had a previous vaginal delivery wanted a repeat vaginal delivery (77.5%) and those who had had a previous CS wanted it again (54.2%) (P <0.05). Conclusion: Our pilot study has shown that women's preferences are unlikely to be the most significant factor driving the high caesarean section rates in the Niger Delta region, Nigeria.