Perception and attitude of women with previous caesarean section towards repeat caesarean delivery

Objective. To explore the perception and attitude of women with previous caesarean section towards repeat caesarean section. Method. Observational study of women with prior caesarean delivery using an anonymous semi-structured questionnaire. Information elicited include the socio-demographic characteristics, outcome of the last caesarean delivery, experience of complications or domestic violence, acceptance of repeat caesarean section if advised by the doctor and the reason for any refusal. Results. One hundred thirty-nine parturients participated in the study. Seventy-seven percent had 1 previous caesarean delivery while 24.46% will decline a repeat caesarean section. Major reasons for refusal were postoperative pain, cultural aversion, fear of death, and cost of caesarean delivery. The rate of acceptance was significantly higher amongst those with more than one prior caesarean section while the rate of refusal was significantly higher amongst those who experienced perinatal death in the last caesarean delivery. Twelve percent experienced domestic violence (almost entirely psychological) mainly from the spouse or his relatives. Conclusion. A significant proportion of women with previous caesarean delivery will decline a repeat caesarean section if medically indicated. There is need for bahavior change communication involving the community, improved postoperative pain management, and better counseling especially on safety of the procedure.