Obstetricians' opinions and attitudes toward maternal refusal of recommended cesarean delivery in Nigeria

Objective: To assess the opinions and attitudes of Nigerian obstetricians toward women's refusal of cesarean delivery. Method: We used a questionnaire with 5 clinical scenarios drawn from published cases in which Nigerian women refused to undergo a recommended cesarean delivery. Results: Most obstetricians (84.8%) advocated continuous counseling of these women but, from their response to the scenarios, few (13.7%-16.1%) would actually do so. Insufficient facilities and poor logistics for emergency obstetric care were their stated major reason for not respecting maternal choices in situations where vaginal delivery could have been given a chance. Conclusion: The possibility of providing emergency obstetric care Would remove many indications for cesarean delivery from the list of absolute indications in Nigeria; and management guidelines would protect obstetricians in the event of litigation, and improve their acceptance and respect of maternal choice. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.