Assessment Of The Level Of Acceptance Of Caesarean Section Among Pregnant Women Attending Maternity Unit

Project and Seminar Material for Nursing (Science)

Assessment Of The Level Of Acceptance Of Caesarean Section Among Pregnant Women Attending Maternity Unit (Charles)


Abstract


This study was carried out to assess the level of acceptance of Caesarean section among pregnant women attending Maternity Unit using Kwuba General Hospital as a case study. The study specifically was aimed to determine the level of awareness of caesarean section among pregnant women attending Maternity Unit, assess the perception of pregnant women towards caesarean section, assess the level of pregnant women acceptability of caesarean section, and identify the factors which influences pregnant women acceptance of caesarean section. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprised of pregnant women attending Maternity unit in Kwuba General Hospital. In determining the sample size, the researcher purposefully selected 147 respondents and 141 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables, and mean scores. While the hypotheses was tested Chi-square statistical tool. The result of the findings reveals that the level of pregnant women acceptability of Caesarean section is low. Furthermore, the study revealed that the factors which influences pregnant women acceptance of caesarean section includes: religious/cultural restrictions, the supports of husband or significant others, previous major surgery/caesarean section, trust in the competence of the health workers, cost of caesarean section procedure, fear of discrimination, concerns about babies safety, and desire to keep genital tract intact. Therefore, it is recommended that nurses, Midwives and other stakeholders in obstetric care should give health education and proper counselling during antenatal care to women on Caesarean section as well as birth preparedness and complication readiness. To mention but few.


Table of Content


  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Objective of the Study
  • 1.4 Research Questions
  • 1.5 Research Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Scope of the Study
  • 1.8 Limitation of the Study
  • 1.9 Definition of Terms
  • 1.10 Organisations of the Study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the Study
  • 3.3 Sample Size Determination
  • 3.4 Sample Size Selection Technique and Procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis
  • 3.8 Validity of the Study
  • 3.9 Reliability of the Study
  • 3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Analysis of Data
  • 4.3 Answering Research Questions
  • 4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • REFERENCES
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background of the Study

Maternal mortality is unacceptably high, especially in low-resource countries. Every day, approximately 800 women around the world die from causes associated with pregnancy or childbirth (UNFPA, 2016). In 2013, the World Health Organization (WHO) estimated maternal mortality ratio in low-resource countries to be 230 per 100000 live births, compared to 16 per 100000 live births in high-resource countries. Nigeria and India accounted for one-third of these global deaths (WHO and UNICEF, 2014). For each maternal death, between 20–30 women experience complications with severe or long-lasting consequences. However, the majority of these deaths and injuries are completely avoidable (UNFPA, 2016).

In many developing countries, complications of pregnancy and childbirth are the leading causes of death among women of reproductive age (WHO, 2016). A woman dies from complications arising from childbirth approximately every 2 minutes (UNFPA, 2016). These statistics become disturbing, considering that some of these deaths are preventable through caesarean section. A caesarean section is a surgical procedure in which incisions (one or more) are made through a mother’s abdomen and uterus to deliver one or more babies (Becher and Stokke, 2013).

A caesarean section is often performed when a vaginal birth would put the baby’s or mother’s life or health at risk (Becher and Stokke, 2013), based on medical need, maternal or fetal complications (WHO, 2015). Generally, most caesarean sections take place as a result of obstetric complications or medical illness (Liu et al, 2007).

In low-resource countries, caesarean section is still perceived by women as an abnormal means of birth (Orji et al, 2003; Sunday-Adeoye and Kalu, 2011). Okonofua (2001) also noted the negative view and perception of caesarean section by women in low-resource countries, which has led to gross underuse of the procedure, compared with the large burden of obstetric morbidity requiring resolution by caesarean section.

Although caesarean section provides hope to women who would have otherwise lost their lives through birth difficulties or other complications, many women in Nigeria are hostile to accepting it, for various reasons. Some women perceive caesarean section as a ‘curse’ on a woman who is not faithful to her husband; while others see caesarean section as suitable for weak women and a sign of failure (Sunday-Adeoye and Kalu, 2011; Mboho, 2013). There is a paucity of data on the perception and acceptance of caesarean section among highrisk pregnant mothers who receive this procedure.


1.2 Statement of the Problem

Caesarian section (C/S) is still being perceived as an abnormal means of delivery by many antenatal women in Nigeria. Notwithstanding the undeniable role of caesarian section in successful childbirth and the safety of the procedure in modern times, Nigerian women have developed aversion to caesarian section for various cultural reasons(Yakasai et al. 2014). The studies that reported the lowest CS preference rate came from Nigeria. The reasons given from these were the complications that followed the procedure and the discriminatory attitudes of others towards them. This finding has confirmed the suspicion that some inappropriate motherhood choices that Nigerian mothers make emanate from superstition and misconceived cultural and religious beliefs(Abazie et al. 2019).

Caesarean section preference is strongly associated with fear of birth, previous CS and previous negative birth experience compared to women with preference for vaginal delivery. Between 6-10% of women are said to suffer from tocophobia which is the fear of childbirth and is a major psychological cause for Caesarean Section due to Maternal Request (CSMR)(Wiklund 2008). Based on the aforementioned, this study seek to assess the level of acceptance of caesarean section among pregnant women attending Maternity Unit.


1.3 Objectives of the Study

The broad objective of this study is to assess the level of acceptance of caesarean section among pregnant women attending Maternity Unit.

Specifically, this research set out to:

  1. Determine the level of awareness of caesarean section among pregnant women attending Maternity Unit.
  2. Assess the perception of pregnant women towards caesarean section.
  3. Assess the level of pregnant women acceptability of caesarean section.
  4. Identify the factors which influences pregnant women acceptance of caesarean section.

1.4 Research Questions

The study will be guided by the following questions;

  1. What is the level of awareness of caesarean section among pregnant women attending Maternity Unit?
  2. What is the perception of pregnant women towards caesarean section?
  3. What is the level of pregnant women acceptability of caesarean section?
  4. What are the factors which influences pregnant women acceptance of caesarean section?

1.5 Research Hypothesis

  • Ho: Pregnant women does not accept caesarean section in Nigeria.
  • Ha: Pregnant women does accepts caesarean section in Nigeria.

1.6 Significance of Study

The findings from this study would be used in planning strategies towards improving the knowledge, perception and attitude 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.


1.7 Scope of the Study

The scope of this study boarders on the assessment of the level of acceptance of Caesarean section among pregnant women attending Maternity Unit. The study will be conducted in Kwuba General Hospital.


1.8 Limitation of the Study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint was the scanty literature on the subject owing that it is a new discourse thus the researcher incurred more financial expenses and much time was required in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size covering only Jos South Local Government.


1.9 Definition of Terms

Caesarean Section:

Caesarean section, also known as C-section, or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother’s abdomen, often performed because vaginal delivery would put the baby or mother at risk.

Perception:

The way in which something is regarded, understood, or interpreted, in this case caesarean section.

Acceptance:

The action of consenting to receive or undertake something offered, in this case caesarean section.


1.10 Organization of the Study

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, abnd selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.


Chapter Five


Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the level of acceptance of Caesarean section among pregnant women attending Maternity Unit using Kwuba General Hospital as a case study. The chapter consists of summary of the study, conclusions, and recommendations.


5.2 Summary of the Study

In this study, our focus was to assess the level of acceptance of Caesarean section among pregnant women attending Maternity Unit using Kwuba General Hospital as a case study. The study specifically was aimed to determine the level of awareness of caesarean section among pregnant women attending Maternity Unit, assess the perception of pregnant women towards caesarean section, assess the level of pregnant women acceptability of caesarean section, and identify the factors which influences pregnant women acceptance of caesarean section.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 141 responses were validated from the enrolled participants where all respondents are pregnant women attending Maternity unit in Kwuba General Hospital.


5.3 Conclusions

Based on the findings of this study, the researcher made the following conclusion.

  1. The level of awareness of Caesarean section among pregnant women attending Maternity Unit is high.
  2. The perception of pregnant women towards Caesarean section is negative.
  3. The level of pregnant women acceptability of caesarean section is low.
  4. The factors which influences pregnant women acceptance of caesarean section includes: religious/cultural restrictions, the supports of husband or significant others, previous major surgery/caesarean section, trust in the competence of the health workers, cost of caesarean section procedure, fear of discrimination, concerns about babies safety, and desire to keep genital tract intact.

5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered.

  1. Women should be encouraged to take appropriate decisions as it concerns their health during the birth process
  2. Nurses, Midwives and other stakeholders in obstetric care should give health education and proper counselling during antenatal care to women on Caesarean section as well as birth preparedness and complication readiness.
  3. Non-governmental organizations can also help in doing mass campaigns and awareness on birthing process as it concerns CS.
  4. Husbands, partners and significant persons should be encouraged to accompany pregnant women, especially those with high risk, to antenatal clinics so that they will be informed about risk factors and how to ensure safe birth
  5. Religious and traditional organizations and leaders need to assist in improving the dearth of knowledge as it concerns CS in the community by partnering with health workers.
  6. Government should make maternal and child health care accessible and affordable by building more maternity centres and subsidising the payments.

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