1.0 Introduction
1.1 Background of Study
The practice of cesarean section (CS) has evolved over centuries, originating as a last-resort procedure aimed at saving the life of the mother or child during complicated childbirth. According to Cunningham et al. (2018), early records of CS date back to ancient civilizations, where the procedure was performed with limited surgical knowledge and often resulted in maternal mortality. Over time, advances in surgical techniques, anesthesia, antisepsis, and obstetric care significantly improved maternal and neonatal survival rates, transforming CS into a safe and medically recommended intervention (Betrán et al., 2016).
In the modern era, CS has become an important component of obstetric care worldwide. Gürsoy, Aksu, and Tiryaki (2018) reported that improvements in medical technology, prenatal monitoring, and surgical procedures have increased the accessibility and safety of CS. Historically, CS was often stigmatized and associated with fear, pain, or failure to deliver naturally, leading many women to prefer vaginal delivery even when surgical intervention was necessary (Ezenwankwo et al., 2019).
Cesarean section (CS) is a surgical procedure used to deliver a baby through incisions in the mother's abdomen and uterus, often employed when vaginal delivery poses risks to the mother or child (World Health Organization, 2020). It is recognized globally as a vital obstetric intervention that significantly reduces maternal and neonatal morbidity and mortality when appropriately indicated (Adewuyi et al., 2017).
Perception according to Ajzen (2005) refers to the way individuals interpret and make sense of information or experiences, while attitude is the learned tendency to respond positively or negatively toward a particular object, idea, or behavior (Ajzen, 2005). In the context of maternal health, women's perception and attitude toward CS significantly impact their willingness to accept the procedure, their emotional response to childbirth, and their overall maternal experience. Studies have shown that misconceptions about CS, fear of post-operative complications, pain, prolonged recovery, and social stigma contribute to negative attitudes among pregnant women (Ezenwankwo et al., 2019).
Adewuyi, Akinyemi, and Afolabi (2017) reported that misconceptions about CS, including fear of prolonged recovery, post-operative complications, and perceived social stigma, contribute to negative attitudes among pregnant women. Ezenwankwo, Chukwuneke, and Ibekwe (2019) asserted that cultural beliefs and previous personal or vicarious experiences with CS strongly influence women's decisions regarding the procedure. Some women view CS as an unnatural form of childbirth, while others perceive it as a safe alternative to avoid labor pain.
On the other hand, Gürsoy, Aksu, and Tiryaki (2018) stated that some women show a positive attitude toward CS due to the perception that it ensures safety for both mother and child, reduces labor pain, and provides a planned delivery schedule. Okafor, Okojie, and Nwosu (2021) affirmed that inadequate patient education during antenatal care often results in women relying on anecdotal evidence from family, friends, or social media, thereby reinforcing misconceptions and fear of CS.
Ajzen (2005) contended that perception and attitude are fundamental determinants of behavioral intentions, suggesting that informed women are more likely to make rational and safe decisions regarding their delivery method. Consequently, understanding the factors that shape perception and attitude toward CS is critical in promoting informed decision-making, improving maternal satisfaction, and optimizing obstetric outcomes. This study is set against the backdrop of assessing the perception and attitude of women attending antenatal clinics at Central Hospital towards cesarean section.
1.2 Statement of Problems
Investigation revealed that the perception and attitude of pregnant women toward CS remain varied, influenced by cultural beliefs, personal experiences, and misinformation (Gürsoy et al., 2018). Many women attending antenatal clinics often perceive CS as an unnatural or risky procedure, leading to fear, anxiety, and reluctance to opt for it even when medically necessary (Adewuyi et al., 2017). Such negative perceptions is not only a barrier to timely medical intervention but also increases maternal and neonatal morbidity in cases of complicated labor.
On the other hand, some women show a preference for CS due to perceived safety, convenience, or avoidance of labor pain (World Health Organization, 2020). Misconceptions about post-operative complications, prolonged recovery, and social stigma often overshadow the medical necessity of the procedure, affecting informed decision-making during pregnancy (Ezenwankwo et al., 2019). Healthcare providers also report challenges in counseling women effectively, as negative perceptions are deeply rooted in cultural narratives and previous personal or vicarious experiences.
Furthermore, many women rely on anecdotal evidence from family, friends, or social media rather than factual medical advice, reinforcing apprehension and shaping their attitude toward the procedure (Okafor et al., 2021). It is against this backdrop that this study seeks to explore the perception and attitude of women attending antenatal clinics at Central Hospital towards cesarean section.
1.3 Aim and Objectives of Study
The aim of the study is to assess the perception and attitude of women attending antenatal clinics at Central Hospital towards cesarean section.
To achieve this aim, the study has the following objectives:
- To assess the role of healthcare providers in shaping women's perception and attitude toward cesarean section.
- To examine women's attitudes towards cesarean section as a method of delivery.
- To identify socio-cultural and personal factors influencing women's perception of cesarean section.
- To determine the level of awareness and knowledge of women regarding cesarean section.
- To recommend strategies for improving maternal awareness and acceptance of cesarean section when medically necessary.
1.4 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level of awareness and knowledge of women attending antenatal clinics regarding cesarean section?
- What are the attitudes of women toward cesarean section as a method of delivery?
- Which socio-cultural and personal factors influence women's perception of cesarean section?
- How do healthcare providers impact women's perception and attitude toward cesarean section?
- What strategies can be implemented to improve maternal awareness and acceptance of cesarean section?
1.5 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between the level of awareness of women attending antenatal clinics and their attitude toward cesarean section
- H1: There is a significant relationship between the level of awareness of women attending antenatal clinics and their attitude toward cesarean section
Hypothesis Two
- H0: The counseling and guidance of healthcare providers do not significantly affect women's acceptance of cesarean section.
- H1: The counseling and guidance of healthcare providers significantly affect women's acceptance of cesarean section.
1.6 Significance of Study
It is believed that at the completion of the study, the findings will enhance the ability of healthcare providers to deliver effective counseling, support informed decision-making, and improve maternal and neonatal outcomes. The study will also guide the development of effective antenatal education programs and awareness campaigns.
Furthermore, this research will increase awareness and knowledge, enabling informed decisions regarding delivery options. Also, the study will provide evidence for designing maternal health policies and programs tailored to women's perceptions and attitudes.
Lastly, this research will serve as a reference point for future studies on maternal health, childbirth practices, and patient education.
1.7 Scope of Study
The scope of this research is focused on the perception and attitude of women attending antenatal clinics at Enugu State Central Hospital toward cesarean section.
1.8 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.9 Definition of Terms
Cesarean Section (CS): A surgical procedure to deliver a baby through incisions in the abdomen and uterus, performed when vaginal delivery poses risks to mother or child (World Health Organization, 2020).
Perception: The process by which individuals interpret information and experiences, forming an understanding that shapes their opinions and reactions (Ajzen, 2005).
Attitude: A learned tendency to respond positively or negatively toward a specific idea, object, or behavior (Ajzen, 2005). In this study, it refers to women's feelings and predispositions toward cesarean section.
Antenatal Clinic: A specialized healthcare setting where pregnant women receive medical check-ups, counseling, and education regarding pregnancy and childbirth (Adewuyi et al., 2017).
Maternal Awareness: The level of knowledge and understanding a woman has regarding pregnancy, childbirth options, and medical interventions (Ezenwankwo et al., 2019).
Socio-Cultural Factors: Cultural beliefs, societal norms, and family influences that shape an individual's decisions and behaviors in health-related contexts (Okafor et al., 2021).
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