Knowledge, Attitude and Willingness to Accept Cesarean Section Among Pregnant Women Attending Antenatal Care at Banadir Hospital Mogadishu, Somalia

Abstract

Background: Cesarean section (CS) is the operation for delivering a baby through incisions made in the mother’s abdominal wall and uterus. It is one of the most performed major surgeries in obstetric practice intended to save the lives of the mother and child, significantly reducing the maternal and prenatal mortality. Objective: The objective of this study was to investigate Somali pregnant women’s knowledge, attitude, and willingness to accept cesarean section in Banadir hospital, Mogadishu, Somalia. Methodology: This is a descriptive cross-sectional study conducted at Mogadishu's Banadir Hospital. The study was conducted over a period of 1 month (3rd April to 5th May 2021). The systematic random sampling technique was used to select respondents, with a sample interval of two. The inclusion criteria were met by any pregnant woman who was mentally and physically capable of being interviewed during the time frame specified, while those refusing to participate in the study, non-pregnant women, women with mental illness and severely ill patients were excluded. Data was collected using an interviewer-administered questionnaire. The statistical package for social sciences (SPSS), version 25.0, was used to analyze the data. Result: Of the 208 respondents, 31.7% were within the age group of 25-29 years. Most of the participants 92.8% were married. 76.9% of the women were multigravida. Over two-thirds 78.8% gave birth through normal vaginal delivery. About 67.3% mentioned that CS requires a longer stay in hospital, 51% said CS may lead to admission to ICU, 82% considered that abnormal woman delivered by CS, while 89% mentioned that women who undergo C-section are at risk to die due to this procedure. However, 42.8% were willing to accept CS delivery if indicated, while over half 57.2% responded that they were not willing to accept CS delivery, the main reasons being: fear of death 15.9%, C-section would lead to a disability 12.5%, non-acceptance by the husband 9.1% and CS is an expensive procedure 8.2%. Conclusion and recommendations: The study concluded that most of respondents had inadequate knowledge and negative attitudes about CS. The study also revealed that the refusal rate for CS was high, and was significantly contributing to raising both the prenatal and maternal morbidity and mortality. We accordingly recommend that this issue be addressed through mass awareness to change the attitude of pregnant women towards CS and dispel the myths leading to CS refusal.