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

Objective: To determine the perception of and aversion to cesarean delivery (CD) and their determinants before and after primary CD. Methods: A 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. Results: Of 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% CL1.63-5.69]; 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. Conclusion: Patient education, prenatal care, and previous surgical experiences were important in determining women's perception of and aversion to CD. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.