Knowledge, Attitude and Preference of Primi Antenatal women towards Caesarean Section and Vaginal Delivery
Objectives: to assess the knowledge, attitude and preference of primi antenatal women towards caesarean section and vaginal delivery and to determine association between knowledge and attitude regarding caesarean section and vaginal delivery with the variables. Methods: A descriptive cross sectional study among 150 samples in the age group of 18-35 years, attending the Antenatal OPD were selected using Non-Probability Convenience sampling technique. The data was collected by using structured knowledgequestionnaire and attitude scale. Results: Findings related to knowledge regarding vaginal delivery showed that 44% of the samples had good Knowledge, 52.67% had average knowledge and 3.33 % had poor knowledge. The study findings also revealed that 60.67% had average, 33% had good and 3.33% had poor knowledge regarding caesarean section. The study findings related to attitude towards caesarean section and vaginal delivery showed thatall the samples had favourable attitude towards both caesarean section and vaginal delivery and majority of the samples 80.67% preferred vaginal delivery over Caesarean section. Conclusion: Althoughmajority of the samples 80.67% preferred vaginal delivery over caesarean section, the percentage of mother who preferred caesarean section is 19.33% which is out of 150 samples which is not to be neglected and being in health profession it is our responsibility to educate the mothers regarding what is caesarean section, its complication and when one should choose caesarean section as a mode of delivery
Delivery is the most awaited moment by the mother after having kept the foetus in her womb for 9 months, at the same time it is important to finish the birth process without complication as it affects the health of both the mother and the baby.According to the WHO published guidelines regarding caesarean section rates in 1985, it states that the proportion of caesarean section birth should range between 10 to 15% in a country1.
Today caesarean section rate is rapidly increasing in developed as well as in developing countries. A study conducted by Mac Dorman et al, on “Caesarean Birth in the United States: Epidemiology, Trends and Outcomes” showed that the proportion of C- Section birth to total births increased from 20.7% in 1996 to 31.1% in 20062.
In Sikkim births delivered by Caesarean section in the year 2005 -2006 was 12.3% and has now rapidly increased to 20.9% in the year 2015-20163.
A Study conducted by SaberAzami-Aghdash et al. In the year 2014 on “Prevalence and Causes of Caesarean Section in Iran: Systematic Review and Meta-Analysis” stated that modernization of society and culture as well as lack of trust in natural custom has influenced women to ignore their ability to tolerate pain to undergo normal delivery4
Another study conducted by SemaDereli Yilmaz et al. (2013) on “Women’s Preferences of Method of Delivery and Influencing Factors”, despite a surgical procedure that is performed to protect maternal and foetal health, C-section has recently become a delivery method preferred by expectant mothers beyond a medical or obstetric modality. Therefore in order to determine the contributing factors for increasing rate of C-section, it is important to know the reasons why women prefer C-section over vaginaldelivery.5
Therefore keeping this in mind the researcher conducted this study to assess the knowledge, attitude and preference of Primi antenatal women towards caesarean section and vaginal delivery.
MATERIAL AND METHODS:
A descriptive cross sectional study was conducted in antenatal OPD of selected hospitals of Sikkim. The samples of the study were the primi antenatal women attending the antenatal OPD belonging to the age group of 18 -35 years. 150 samples were selected using Non-Probability Convenience sampling technique. Primi antenatal women with medical complications and not willing to participate were excluded from the study. Three tools were developed to collect information regarding Baseline data, knowledge, attitude and preference. Interview technique was used for data collection.Permission for the study was obtained from the Principal, Sikkim Manipal College of Nursing, the Institutional Ethics Committee, SMIMS and from the selected college. Descriptive and inferential statistics was used for analysis.
Out of 150 samples, the demographic data shows thatthe majority of the samples 53% of primi antenatal women belonged to the age group of 24 to 29 years, 63.33% were Hindu by religion and 78.66% had monthly family income more than Rupees 10,000(Table I).
Table I. Frequency and percentage distribution of sample
Age in years
No former education
Monthly Family Income (in Rupees)
less than 5000
More than 10000
Knowledge regarding caesarean sectionvaginal delivery:
Structured knowledge questionnaire was used to assess the knowledge of primiantenatal women regarding Caesarean section and vaginal delivery and is presented in Figure 1 and 2 respectively
Figure 1. Percentage distribution of knowledge regarding caesarean section (N=150)
Figure 2. Percentage distribution of knowledge regarding vaginal delivery (N=150).
Attitude towardscaesarean sectionvaginal delivery:
Attitude scale developed to assess the attitude of primi antenatal women regarding Caesarean section and vaginal delivery and is presented in Figure 3 and 4 respectively.
Figure 3. Percentage distribution of attitude towards caesarean section
Figure 4. Percentage distribution of attitude towards vaginal delivery
Preference of primi antenatal women towards caesarean section and vaginal delivery
Figure 4. Pie diagram showing preference towards caesarean section andvaginal delivery
Caesarean section helps to reduce maternal mortality and is recommended when the mother has a complication. But nowadays it has become a choice for the mother . When a mother does not have any complication and she choosecaesarean section she might get into complication of caesarean section thereby increasing the maternal mortality rate. Though all the samples had favourable attitude toward both caesarean section and vaginal delivery most of them preferredvaginal delivery over caesarean section. But the percentage of mother who preferred caesarean section is 19.33% which is out of 150 samples which is not to be neglected.
Being in health profession it is our responsibility to educate the mothers regarding what is caesarean section, its complication and when one should choose caesarean section as a mode of delivery.
We acknowledge our Principal, Professor Mridula Das for her support and guidance. We also extend our heartfelt gratitude to A. Sharma, C.L. Bhutia, C. Bhutia, L. Lepcha, M. Subba, M. Dey, P. Wangmo, P. Gurung, P. Sharma, S. Mukhiya, S. Chettrifor equal participation and data collection.
1. World Health Organization Appropriate technology for birth lancet 1985;2 (8452)
2. MacDorman et.al. “Caesarean Birth in the United States: Epidemiology, Trends and Outcomes”, ClinPerinatol,35:293-307
3. National Family Health Survey-4, State fact sheet- Sikkim, Government of India, Ministry of Health and Family Welfare.
4. SaberAzami-Aghdash et.al, “Prevalence and Causes of Caesarean Section in Iran: Systematic Review and Meta-Analysis”, Iranian J Publ Health, May 2014, Vol. 43, No.5, pp. 545-555.
5. SemaDereli Yilmaz, Meltem Demirgoz Bal, MeziheKizilkaya Beji, Seyfettin Uludag, August 2013, “Women’s Preferences of Method of Deliveryand Influencing Factors”, Iranian Red Crescent Medical Journal; 15(8): 683-689.
Received on 11.06.2018 Modified on 18.08.2018
Accepted on 20.09.2018 ©A&V Publications All right reserved