ASSESSMENT OF THE KNOWLEDGE AND PERCEPTION OF PREGNANT WOMEN ON CAESAREAN SECTION AT BUEA REGIONAL HOSPITAL

Abstract
This study entitle Assessment of pregnant women’s knowledge and Perception on caesarean section was carried out at Buea Regional Hospital which is located in Buea Health District of Fako division with the objective as To assess pregnant women knowledge on caesarean section, To assess pregnant women perception on caesarean section.

A sampling of 50 pregnant women was selected using the convenient sampling technique and a descriptive cross-sectional study design was used and instrument for data collection was a well structure questionnaire and data was analyzed using Microsoft excel 2010.

The result of the study was 30(60%) defined caesarean section as the delivery of a baby through surgery and 20(40%) said No. 40(80%) said Caesarean section is used only when there is a complication during delivery and 10(20%) said No. 40(80%) out of the population said Caesarean section births are unnatural and reserved also for those having medical conditions, 5(10%) disagree and 5(10%) said they don’t know. 40(80%) said Caesarean section is more dangerous than vaginal delivery and 10(20%) said No.

To conclude base on objective one which talks on the knowledge of pregnant women on caesarean section, it can be concluded that the respondent had good knowledge on caesarean section. Based on objective two which talks on the perception of pregnant women on caesarean section, it can be concluded that the respondent had poor perception of caesarean section.

CHAPTER ONE
INTRODUCTION

This chapter discusses the background of study, the problem statement, the research objective, and research questions, significant and scope of study and definition of terms.

1.1 Background Of The Study

Caesarean section has been around for millennia. Caesarean section is perhaps one of the oldest surgical operations which originated as a post-mortem procedure to separate dead mother and child in ancient India and Egypt (Boley JP, 2010). The early history of Caesarean section remains covered in myths with doubtful accuracy in folklores of ancient societies in Europe, Asia, and the Middle East.

Caesarean section was performed either to rescue a live baby from the womb of a dead or dying mother or to bury the dead mother and dead infant separately and the first living child born by a post-mortem Caesarean section in the ancient world was Gorgias (483-376 BC), a Greek sophist and rhetorician, who was born in Syracuse. (Sewell JE, 2010).

The origin of the term “Cesarean section” has seemingly been debatable in its accuracy over time. The origin of the term Cesarean section is still clearly not known. The term “cesarean”, commonly misperceived that it is derived from the surgical birth of Roman Emperor Julius Caesar 100-44 BC (Boley JP, 2010). It is very unlikely that he was born by CS.

The surgical procedure was performed during that time only when the mother was dead or dying to save the unborn child whereas Julius Caesar’s mother, Aurelia, was alive until when he was an adult (Sewell JE, 2010). There are also no documents from Caesar’s time referring to his birth by abdominal incision. The purpose of performing the Caesarean section was gradually changed towards saving the lives of both mother and child in the modern age.

The indications of Caesarean section have been changed accordingly from ancient to modern times. Since middle of 19th century, both maternal and fetal outcomes of Caesarean section have been significantly increased due to the development in surgical techniques and aseptic environment such as antibiotic, anesthesia, blood transfusion.

Caesarean section is a surgical procedure in which one or more incisions are made through a mother’s abdomen and uterus to deliver one or more babies, or to remove a dead fetus (Van Dongen PWJ, 2011).

Caesarean section requires a preoperative care and done by a team of medical personnel’s which are Surgeons, Assistant surgeon, Scrub nurse, Obstetrician, an Anesthetist (Dickson et al., 2011). There is no greater joy than the birth of a healthy baby and no greater tragedy than the death of a mother and child as a result of complicated pregnancy or difficult labour especially when it occurred as a result of refusal to caesarean delivery. Caesarean section has contributed to the reduction of maternal and neonatal morbidity.

The world health Organization has recommended that Caesarean section should be on a rate of (10%-15%). It was reported sporadically throughout medical history that caesarean section was rendered safe for both mother and foetus during the 20th century (WHO and UNICEF, 2019). It is a commonly performed major obstetric operation in the world and there is no doubt that it has contributed to improve obstetric care throughout the world. Caesarean section is usually performed when vaginal birth is deemed hazardous either to the foetus or the mother.

Latest available data (2010-2018) from 154 countries covering 94.5% of world’s live births shows that 21.1% of women gave birth by caesarean section worldwide (Betran AP, Ye J, Moller A, et al 2021). In Africa only 7.3% of babies are born through caesarean section, but it is a very

mixed picture across the continent. Some countries have very high rate such as Egypt (51.8%) and Mauritius (47%), the highest in Africa (Salome Maswime et al., 2017).

In Cameroon, the rates of Caesarean section is 14.7% and it varies by region; in central (17.5%) and up to (3.3%) in North West (Njim T, C Mbanga, et al., 2020). The perception of women towards Caesarean section influences their acceptance of the procedure and more often than not results in psychological depression that women and family usually experience (Say et al., 2014).

1.2 Problem Statement

Cameroon has been rated the 18th country with the highest mortality rate with 468-469 death per live birth (WHO 2017).Cameroon caesarean section rate is very low despite the well documented records of safety of caesarean section, the strong aversion of women towards the procedure in the presence of life threatening indications is a great concern.

There is a widespread belief that West African women have an aversion for surgical delivery and to have a Caesarean section is regarded as a reproductive failure (Say et al., 2014) and also due to cultural, traditional and socio-cultural belief women tend to refuse to undergo the procedure.

I witnessed a case of a 27 years old pregnant woman coming for her ANC check up at the Great Soppo integrated health center during my community internship, I observed that when the women was informed that she might undergo a caesarean section due to some complication she became very scared that she might loss her life and that of her child and that she might end up having more complications and pain.

Therefore a good level of knowledge is required in order to inform pregnant women about the safety of caesarean section, Hence this study seeks to assess the knowledge and perception of pregnant women towards caesarean section.

1.3 Research Objectives

1.3.1 General Objective

To determine the knowledge and perception of pregnant women attending Buea regional hospital towards Caesarean section.

1.3.2 Specific Objectives

To assess the knowledge of pregnant women attending Buea regional hospital on Caesarean section.
To assess the perception of pregnant women attending Buea regional hospital towards Caesarean section.