Perception And Acceptance Of Caesarean Section Among Pregnant Women (A Case Study in Iuth Okada, Edo State)


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Dedication


I humbly dedicate this work to God Almighty who has given me the gift of life, good health, protection, knowledge and above all wisdom to make this work a reality.

To my parents ……………… for giving me both moral and financial support throughout my ND time. And also to my sisters, …………………………… and to my brothers …………………


Acknowledgement


I am very thankful to God Almighty for his grace upon me. To my academic mentors in the persons of ……………, my project supervisor for educating me on the act of project writing and method of its researchers and also to other lecturers who have taught me in the course of writing this project.

I equally appreciate the effort of my family members and all those other in making sure that I am a useful member of the society.

May God bless and sustain them all in their pursuit or strive to attain their life goal.


Table Of Contents


  • Approval page
  • Dedication
  • Acknowledgement
  • Abstract

Chapter One:Introduction

  • 1.1 Background of study
  • 1.2 Statement of problem
  • 1.3 Research objectives
  • 1.4 Research question
  • 1.5 Significance of study
  • 1.6 Scope of study
  • 1.7 Definition of terms

Chapter Two:Literature Review

  • 2.1 Contributing Factors
  • 2.2 Practice Factors
  • 2.3 Repeat Cesarean Section versus Vaginal Birth After Cesarean Section
  • 2.4 Management of breech presentation
  • 2.5 Management of labour /induction
  • 2.6 Maternal choice
  • 2.7 Population Factors
  • 2.8 Maternal confidence in the ability to give birth
  • 2.9 System Factors

Chapter Three:Materials And Method

  • 3.1 Setting
  • 3.2 Subjects
  • 3.3 Study design
  • 3.4 Research Instrument
  • 3.5 Ethical Consideration
  • 3.6 Data Analysis

Chapter Four:Results And Discussion

  • 4.1 Results
  • 4.2 Discussions of findings

Chapter Five:Conclusion And Recommendation

  • 5.1 Conclusion
  • 5.2 Recommendation
  • Reference
  • Appendix
  • Questionnaire

Abstract


This study was carried out on perception and acceptance of caesarean section among pregnant women in Igbinedion University Teaching Hospital (IUTH), Okada, Edo state. Maternal mortality is unacceptably high in low resource countries. This is disturbing, considering that some of these deaths are preventable through caesarean section.

To determine the perception and factors associated with the acceptance of caesarean section among high-risk pregnant women. A structured interviewer-administered questionnaire was used to assess pregnant women’s knowledge and acceptance to CS.

The study proposal was approved by the Ethics and Research committee of the institution and informed consent was obtained from the participants prior to recruitment into the study. The data obtained was analysed using SPSS version 17.0 statistical software.

Qualitative variables were summarized using frequencies and percentages, while mean and standard deviation were used to summarize quantitative variables. Although this study revealed that 93.8% of the respondents were aware of CS, 40.9% had adequate knowledge of it while 2.7% knew that the woman undergoing CS was required to give consent for the surgery. The study recommended that doctors should actively get involved in the education of pregnant women.


Chapter One


Introduction

1.1 Background of study

Maternal mortality represents the leading cause of death among the pregnant women in most developing countries including Nigeria (Mekonnen and Mekonnen, 2003; WHO, 2007). Furthermore, it is estimated that one third of all maternal deaths globally occur in just two countries, namely India and Nigeria (Mboho et al 2013). According to UNFPA (2012), in 2010, India was accountable for about 20% of global maternal deaths (56,000) and Nigeria, 14% (40,000). Meanwhile, disease, deformity and death are terms usually employed to describe the experiences of a vast majority of sub-Saharan African women during pregnancy and birthing (Harrison, 2001; Brookman-Amissah and Moyo, 2004; WHO, 2004a).

Similarly, the majority of African women are often viewed as being at high risk of infections, injury and death during pregnancy and the periods surrounding it (Izugbara and Ukwayi, 2007). In recent time women in Nigeria have expressed worries about choices of childbirth especially the issues surrounding vaginal birth. The joy of every woman is to deliver her baby normally. Some decades ago the most available or preferred option for most women was vaginal birth.

Some of the women had their babies at home with traditional birth attendants but quite often with difficult labour resulting from obstruction and the women died before any meaningful interventions. Today, however, many babies have been delivered successfully through caesarean section.

This success story in not without criticism. Among women in the developing countries, caesarean section is still being perceived as a ‘curse’ of an unfaithful woman (Adeoye and Kalu 2011). The authors further assert that caesarean section is seen among weak women. In addition, caesarean section is surrounded with suspicion, aversion, misconception, fear, guilt, misery and anger among the women of South Western Nigeria (Adeoye and Kalu 2011). Furthermore, in most sub-Saharan African countries including Nigeria, caesarean section is being accepted reluctantly even in the face of obvious clinical indication (Adeoye and Kalu 2011).

Despite the causes of maternal mortality often obstetric in origin, underlying cultural factors and beliefs also affect access to and use of health facilities and thus contribute to avoidable maternal deaths (Mboho et al 2013). Several studies have indicated how local beliefs and practices impact general health and childbearing. Some of these beliefs have been identified as contributing to the delays in accessing appropriate skilled help when complications arise in labour (Okafor 2000) It is necessary to note that the issue of vaginal birth is not only peculiar to developing countries but also in some developed countries.

Women still choose vaginal birth after having caesarean section even in the case of post dates slated for elective caesarean section (Clift-Mathews 2010). The author further highlighted the fact that women desperately wished to go into labour before their appointment dates because not giving birth vaginally was a sign of ‘failure’. In addition; vaginal birth is something a number of women look upon as a rite of passage (Clift-Mathews 2010) Obstetrics in modern America is a contentious subject in general (Ecker 2013). Usually childbirth and action surrounding it whether medical or otherwise normally evoke strong emotions where discussion is often framed ideologically as a matter of nature versus technology.

Hence the issue of caesarean section in particular is much contested issue (Ecker 2013). Even so, caesarean section rates are on the increase as evident in a number of western countries such as the United States of America and United Kingdom (McAra-Couper, Jones and Smythe 2010). In 1985, following the increasing disparity rate among nations in the number of caesarean births, the World Health Organisation (WHO) set out to determine an optimal rate of 15 percent as ideal. The postulated 15 percent by WHO would optimally prevent childbirth injuries and deaths. In addition, many women and babies would avoid unnecessary and potentially harmful surgery (Harvard magazine 2013).

However, WHO has since modified this particular recommendation in 2009, stating that ‘the optimum rate is unknown but asserts that both very low and very high rates of caesarean sections can be dangerous’. In other words, the procedure should be done only when it is absolutely necessary. The editorial team of Academic Research International of Harvard Magazine concluded that there is need for a balance to be reached, that is, women should be allowed to have normal vaginal deliveries with as little intervention as possible. However, at the same time, the families, obstetricians will be ready to address any unexpected emergencies.


1.2 Statement Of Problem

Traditionally, Nigerian women are unwilling to have CS because of the general belief that abdominal delivery is reproductive failure on their part regardless of the feasibility of vaginal birth after CS and the decreasing mortality from Caesarean sections. Imperative to the average pregnant woman irrespective of her level of education and parity therefore is CS. Available reports on knowledge of CS amongst women are mainly from tertiary health facilities situated in cities and in the southern parts of the country while little is known about the perception and acceptance of pregnant women towards Caesarean section in Igbinedion University Teaching Hospital in Edo State.


1.3 Research Objectives

  1. To explore the perception and acceptance of pregnant women in Igbinedion University Teaching Hospital, Edo State toward caesarean section
  2. To ascertain what is known about caesarean section and the reasons for dislike by our women
  3. To explore the perception and acceptance of pregnant women in Igbinedion University Teaching Hospital, Edo State state towards caesarean section

1.4 Research Question

  1. What is the perception and acceptance of pregnant women in Igbinedion University Teaching Hospital, Edo State toward caesarean section?
  2. What is known about caesarean section and the reasons for dislike by our women?
  3. What is the perception and acceptance of pregnant women in Igbinedion University Teaching Hospital, Edo State towards caesarean section?

1.5 Significance Of Study

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


1.6 Scope Of Study

This study focused on the perception and acceptance of pregnant women towards Ceasarean section. It was carried out in Igbinedion University Teaching Hospital (IUTH), Okada in Edo State.


1.7 Definition Of Terms

Perception:

Is the process of recognizing and interpreting sensory stimuli. Learn the definition of perception, how it is related to the five senses, how it differs from reality, and more.

Acceptance:

In human psychology is a person’s assent to the reality of a situation, recognizing a process or condition (often a negative or uncomfortable situation) without attempting to change it or protest it.

Caesarean Section:

Also known as C-section or caesarean delivery is the use of surgery to deliver one or more babies. A caesarean section is often necessary when a vaginal delivery would put the baby or mother at risk.


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How to nail it on the head during your project defence


You are through with writing that project. Now what?

You have found yourself at that point where you have to defend what you have written. Of course you have to stand in front of your supervisor and other literary personalities to prove that you know what you wrote in your project paper. Unfortunately, the more you think about it, the more it looks like you are about to face a legion. It is not a war. But the emotion of dread welling up inside of you makes it look like one. So now you are asking yourself questions.

  • How am I going to start?
  • I hope I will do well enough to get an A.

You really want to nail it, but you need to come to terms with exactly how to get everything in perfect control. Especially your emotions of fear that seem to make a wreck of you every time you think about public speaking.
So here is the deal. I want to help you avoid that feeling that would ruin your precious moment if you dare to let it. And we are going to do it together.

I am going to highlight some very important tips to help you get in control for you to be comfortable enough to move from that feeling of DREAD to CONFIDENT; and making an awesome Impression for that great rating your supervisors should be giving to you so freely.

Consider these tips as you prepare for your defence. We will be taking them one after the other so here we go.


Watch Your Body Language And Keep It Confident:

Can you tell that a person is falling apart if they look confident? … If I can second guess you rightly, am sure you answered no to that question. Remind yourself that you need to come out that way. Now this might seem like a huge big deal when you are dealing with the foreboding. Maintaining a poise of confidence is very important. So find your most comfortable position, sitting or standing and draw up your body. You must exude confidence. It is something you need to do for yourself. People can only see what you allow your body language to show. So you must endeavour to put that out. Remember the story of David and Goliath? … At the end of your defence day, you want to be David.


Dress In Your Most Comfortable And Impressive:

Am sure this one is a no brainer. However I must highlight that you choose comfortable pieces. You don’t want to look so good and yet look like you were forced to wear something that does not belong to you. It’s great to ensure that as impressive as your clothes are on you, that they are also very comfortable.


Speak With Authority:

Going hand to hand with that aura of confidence is your most powerful asset:your words. If you look that confident, your words must not come out like whimpers. To be able to pull this off, you definitely need to speak as deliberately as possible in expressing yourself. Let them also hear what they see.


Use, Your Gestures:

I have often found this to come to my rescue in dealing with shyness and conveying my confidence. Usually it gives you an edge to also drive home your point. You must, however, ensure that you do not over use it. It doesn’t mean that your hands should be flying all over the place. That would be absolutely unnecessary. If you do this well, after a while you will realize that you are not as self-conscious as you used to be at the very start. For most situations, it would have completely disappeared altogether; leaving a really confident you talking.


Have A Good Opening And Closing Line:

Make sure you have perfected a good opening line. You should also be armed with a good closing line too. Try and rehearse it to a friend. If for the first time you presented it, your friend does not say “wow, that’s beautiful” or something like that; just know you need to keep refining it until you get the perfect line. Both opening and closing lines will go a long way in how impressed your panel gets to rate you high.


Make Sure You Know Your Work:

Certainly you should understand how important it is to know your own work from start to finish. Not having in-depth knowledge of your own work is tantamount to a suicide mission. Why should you kill yourself?
When all is said and done, this is what you came to defend in the first place. You should know your work from A to Z.


Prepare For The Questions:

Now this part is truly essential. You must be sure you do not floor all the good work you did on your presentation by not answering correctly. You must pay attention to the questions you are asked to be sure you will give the right answer. Many people get it wrong at this stage and spoil their good presentation. When you do not understand any question do endeavour to ask the person to expatiate what they mean before you answer.


These tips are by no means exhaustive, but applying these tips will give you some necessary advantage you need for a great outcome. Of course that outcome would mean that you eventually earn all your points on this project.


The structure of a good project work


Undergraduate projects in Nigeria is a prerequisite for graduation amongst Nigerian tertiary students who will which to obtain bachelors degree in their respective courses of study such as accounting, banking and finance, business administration and a host of others. Writing an undergraduate project in Nigeria for final year students entails a lot both financially and otherwise. Being able to develop any final year project depends on getting a researchable topic whether it is Accounting Undergraduate project topics, Banking and Finance research topics or banking and finance project topics and materials and it all requires diligent hard work of students who are willing to develop best undergraduate projects in Nigeria and graduate in flying colors.

A typical Undergraduate project in Nigerian tertiary institutions can be said to be divided into five or six chapters depending on the format of the school and course of study which are


1. Introduction

The introduction of an undergraduate project states the main research problem and research argument. What precisely the study is all about and why it is important. It looks at the originality of the research work and how it will fill the gap in other studies. Justification for a research undergraduate topic should not be lengthy before it has been explicitly stated.

Below are the contents in chapter one of an undergraduate research project which includes;

  • Background of the study,
  • Statement of the problem,
  • Objectives or aims of the study,
  • The research questions,
  • Research hypothesis,
  • Significance of the study,
  • Scope of the study,
  • Limitations of the study and
  • Operational definition of terms.

2. Literature review

Literature review of any undergraduate research work, be it business administration project topics or Economics project topics just to mention a few is very critical to securing a high grade in one’s project work. The literature review of a research process uncovers what other writers have written about the student’s topic. A student’s undergraduate research work should include a discussion or review of what is known about the subject and how that knowledge was acquired. The review could conclude with a brief summary of the literature and its implications. The contents of the literature review are the theoretical review, conceptual framework, empirical review and summary of literature review.

3. Research Methodology

This section includes a description of the research methods used in the undergraduate research work such as the sample size, data collection methods, measurement instruments, research data analysis procedures and the population from which the sample was selected.  This section also describes the method used in selecting the sample or samples, validation and reliability of the instruments used in the research work. There are different research statistical techniques used in undergraduate research work such as SPSS, e-views etc.


4. Results & Discussion

This section presents and discusses the data analysis results used in an undergraduate research work, the results of each analysis is being summarized, tabulated, and then discussed for each research question.  Then for each research hypothesis, the statistical test of significance selected and applied to the data is briefly described, followed by a statement indicating whether the hypothesis was supported or not supported.  In presenting the result analyses/summary in an undergraduate project tables and figures and or graph are used to add clarity to the presentation.


5. Summary, Conclusions And Recommendations

This section summarizes the findings of the study in an easy to understand manner.  It also explains the practical implications of those findings, and points to recommended directions for future research in that area.


References:

This is where every source cited in the undergraduate research work is being included. Every undergraduate research work must be properly referenced for its authenticity.


Choosing A Good Project / Research Topic


Students in Nigerian universities these days wish to choose a very simple project topic/material. There is no issue choosing a simple project topic; the only problem is your ability to choose a good project or research topic that your supervisor will easily approve for you.

Most project supervisors really want to see how good his or her project student understands his or her surrounding through the kind of topic he or she chooses for their project work.

There are some project topic that are not reject-able; for instance in Nigeria of today; what do you think is the major issue on ground now?

If a project student can choose or craft a topic on the effect of dollar increment on the economy of Nigeria. Such project topic will be very interesting to write on.

Now what are the qualities of a good project topic?

  1. The materials for the project topic must be easily assessable.
  2. The project topic itself must be meaningful.
  3. The variables must be able to give a clear aim of the project topic.

What do I mean by variable?

Well I am deriving my point from the area of project writing; the variables here are those main words in the project topic.

Like the above project topic; the effect of dollar increment on the economy of Nigeria. You can see the main variables that really define this project topic are:dollar, increment and economy.

Before you present your topic to your project supervisor, first of all understand your project topic, and then secondly try to do some research for your topic to see if at least you can get up to 60% of what you need to write the complete project.

I said that above because you might have a very nice topic that the materials are not available online and there are no books as regard the topic; in this case the project topic becomes difficult for you even though the topic is catchy.

What do I mean by your topic being assessable?

Well what I mean is very simple and easy to understand. Simply pick your project topic, type it on google and see if you will have at least a good background for the topic you are writing on.

If you can have a good background for your project topic and you can understand the problem associated with the project topic, then I believe the aim of the project is not far-fetched.

SAMPHINA ACADEMY

SAMPHINA ACADEMY

Samuel Obiora Blessed is the CEO and founder of Samphina Academy (samphina.com.ng) a.k.a Nigeria Students Media, the youngest engineering graduate of Federal Polytechnic Nekede in 2017 and the engine brain behind this great platform. He is the man behind the scene, filled with many potentials, a musician as well as a pro developer with the interest of Nigerian students at heart.

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