Demographic and obstetric background of respondents
Two-fifths of the study respondents were in the age range of 21 to 25 years (40.5%), with a few above 40 years (3.1%). Most of them were married (77.3%), had at least Junior High School education (82.2%) and were in a gainful employment (74.2%). For the majority, that was their first or second delivery and four of them had a parity between five and seven (Table 1). Out of the total respondents, 55 (33.7%) had a previous caesarean section (CS) and for the rest 108 (66.3%), that was their first caesarean section. Of the 55 who had a previous CS, 45 (81.8%) of them have had it once, and the rest 10 (18.2%) have had it twice.
Table 1. Demographic and Obstetric background of respondents
Variables
|
Category
|
N (%)
|
Age (years)
|
18-20
|
3 (1.8)
|
21-25
|
66 (40.5)
|
26-30
|
56 (34.4)
|
31-35
|
28 (17.2)
|
36-40
|
5 (3.1)
|
Above 40
|
5 (3.1)
|
Marital Status
|
Single
|
6 (3.7)
|
Co-habiting
|
31 (19.0)
|
Married
|
126 (77.3)
|
Educational status
|
No Formal education
|
3 (1.8)
|
Primary
|
26 (16.0)
|
Junior High School
|
74 (45.4)
|
Secondary
|
38 (23.3)
|
Tertiary/Commercial
|
22 (13.5)
|
Occupation
|
Public sector
|
7 (4.3)
|
Private sector
|
8 (4.9)
|
Trader
|
64 (39.2)
|
Artisan
|
42 (25.8)
|
Unemployed
|
42 (25.8)
|
Religion
|
Christianity
|
95 (58.3)
|
Islamic
|
68 (41.7)
|
Parity
|
1
|
50 (30.7)
|
2
|
69 (42.3)
|
3
|
36 (22.0)
|
4
|
4 (2.5)
|
>4
|
4 (2.5)
|
Indications for respondents’ CS
|
Big baby
|
33 (20.2)
|
Abnormal presentation e.g breech presentation
|
39 (23.9)
|
Poor obstetric history e.g. pre-eclampsia
|
25 (15.3)
|
Previous caesarean section
|
33 (20.2)
|
Multiple gestation
|
12 (7.4)
|
Post-date
|
21 (12.9)
|
†CS-Caesarean section
Factors influencing acceptance of CS and the decision-making time
Factors which influenced the respondents’ decision to undergo the caesarean section were assessed and the period they took to conclude their decision. The decision-making period for the respondents was between the same day and within one week. Eighty-four (51.5%) of them made their decisions on the same day, and the rest made this between the next day and a week. The decisions were influenced by relatives, respondents’ experience with previous caesarean section, perceived risk to their life and that of the baby among others (Table 2).
Table 2. Factors that influenced respondents’ decision to accept Caesarean Section
Influencing Factors
|
Frequency (N)
|
Percentage (%)
|
My husband/partner/relatives encouraged me
|
64
|
39.3%
|
I do not have an alternative to the †CS
|
33
|
20.2
|
I trusted God for safe delivery
|
34
|
20.9
|
I had previous CS and was no longer afraid
|
32
|
19.6
|
I had previous CS and was informed I will have CS again
|
17
|
10.4
|
The Health professional’s education
|
25
|
15.3
|
My life was at risk
|
25
|
15.3
|
My baby’s life was at risk
|
40
|
24.5
|
†CS-Caesarean section
The association between demographic characteristics and the influencing factors was assessed and age and parity were significant factors however age was only significant for the influence of husband, partner or relative (p<0.01). Three influencing factors were significantly related to the parity of the respondents. These were those who accepted the CS because they felt they did not have an alternative to the †CS (p<0.005), because they had previous CS and were no longer afraid (p<0.001) and those who consented because they felt their life was at risk (p<0.035).
The respondents were requested to indicate how long it took them to make a decision in accepting to undergo the CS after the doctor informed them of the need for the procedure. There were significant differences in decision-making time for those who had previous CS and were informed they will have another CS, those who trusted in God to see them safely through the procedure; and those whose decision was supported by their husbands, partners or relatives (Table 3).
Table 3. Relationship between decision-making time and factors influencing acceptance of CS
Influencing Factors
|
Decision-making time (Days)
|
c2
|
P-value
|
Same day
|
1 – 3 days
|
4 days – 1 week
|
My husband/partner/relatives encouraged me
|
Yes
|
13
|
40
|
11
|
42.53
|
0.001**
|
No
|
71
|
25
|
3
|
I do not have an alternative to the †CS
|
Yes
|
16
|
12
|
5
|
2.28
|
0.32
|
No
|
68
|
53
|
9
|
I trusted God for safe delivery
|
Yes
|
8
|
23
|
3
|
14.85
|
0.001**
|
No
|
76
|
42
|
11
|
Because I had previous CS and was no longer afraid
|
Yes
|
29
|
2
|
1
|
24.48
|
0.001**
|
No
|
55
|
63
|
13
|
Because I had previous CS and was informed I will have CS again
|
Yes
|
16
|
0
|
1
|
14.41
|
0.001**
|
No
|
68
|
65
|
13
|
The Health professional’s education helped me
|
Yes
|
17
|
8
|
0
|
4.55
|
0.103
|
No
|
67
|
57
|
14
|
My life was at risk
|
Yes
|
10
|
14
|
1
|
3.41
|
0.182
|
No
|
74
|
51
|
13
|
My baby’s life was at risk
|
Yes
|
19
|
18
|
3
|
0.59
|
0.745
|
No
|
65
|
47
|
11
|
NB: **p<0.001, †CS-Caesarean section
Respondents’ background characteristics that influenced the duration of the decision-making process to accept the caesarean section were determined and they predicted the levels of variation in the duration of the decision (Table 4). The variations were significantly related to the respondents’ age, experience with previous caesarean section and the parity. Significant difference was observed between those without formal education and those with tertiary education (p<. 05). Regarding occupation, significant differences were noted between the unemployed respondents and the traders or artisans (p<0.03; p<0.01) respectively.
Table 4. Respondents’ background characteristics as predictors of decision-making time (days) to accept caesarean section
Variables
|
Category
|
Unstandardized coefficient (B)
|
Standard error
|
df
|
R2
|
P-value
|
Age (years)
|
Constant
(18 -20)
|
1.00
|
0.19
|
4
|
0.19
|
0.001**
|
21 -25
|
0.83
|
0.19
|
|
|
0.001**
|
26 – 30
|
0.27
|
0.07
|
|
|
0.001**
|
31 – 35
|
0.12
|
0.05
|
|
|
0.023*
|
Above 35
|
0.06
|
0.04
|
|
|
0.142
|
Education
|
Constant
(Tertiary)
|
1.73
|
0.10
|
3
|
0.05
|
0.06
|
SHS
|
-.06
|
0.06
|
|
|
0.32
|
Basic
|
-.31
|
0.16
|
|
|
0.06
|
No formal
|
-.10
|
0.04
|
|
|
0.02*
|
Parity
|
Constant (Parity 1)
|
1.78
|
0.09
|
4
|
0.08
|
0.02*
|
2
|
-.13
|
0.06
|
|
|
0.03*
|
3
|
-.14
|
0.05
|
|
|
0.01*
|
4
|
-.13
|
0.08
|
|
|
0.11
|
Above 4
|
-.04
|
0.07
|
|
|
0.50
|
Occupation
|
Constant
(Unemployed)
|
1.81
|
0.10
|
4
|
0.05
|
0.07
|
Civil servant
|
-.24
|
0.26
|
|
|
0.36
|
Private sector
|
-.22
|
0.12
|
|
|
0.08
|
Trader
|
-.09
|
0.04
|
|
|
0.03*
|
Artisan
|
-.10
|
0.04
|
|
|
0.01*
|
Previous †CS
|
Constant
(No previous CS)
|
1.74
|
0.06
|
1
|
0.14
|
0.001**
|
Had previous CS
|
-.50
|
0.100
|
|
|
|
**p<0.001, *p<0.05, †CS-Caesarean section