Evaluation of parturient perception and aversion before and after primary cesarean delivery in a low-resource country

ObjectiveTo determine the perception of and aversion to cesarean delivery (CD) and their determinants before and after primary CD.MethodsA prospective cross-sectional survey of pregnant women undergoing primary CD (elective or emergency) was conducted in six health facilities in Ilorin, Nigeria. All participants completed an interviewer-administered questionnaire before the operation and 3–4 days thereafter. The statistical analysis included the calculation of odds ratios (ORs) with 95% confidence intervals (CIs) and a logistic regression.ResultsOf the 254 participants, 182 (71.7%) and 53 (20.9%) had an aversion to CD before and after the procedure, respectively. A woman’s personal decision was the overriding factor influencing acceptance of the operation. Preoperative predictors of aversion were prenatal admission (OR 2.86 [95% CI,1.07–7.66]; P = 0.030) and a history of previous surgery (OR 0.42 [95% CI, 0.24–0.75]; P = 0.003), whereas postoperatively a low number of prenatal clinic visits (less than four; OR 3.05 [95% CI,1.63–5.69]; P = 0.001) and a history of previous surgery (OR 0.51 [95% CI, 0.27–0.96]; P = 0.034) were significant. Postprocedure, 164 (64.6%) women said they would accept a repeat CD.ConclusionPatient education, prenatal care, and previous surgical experiences were important in determining women’s perception of and aversion to CD.