Prevalence, Indications, and Community Perceptions of Caesarean Section Delivery in Ngora District, Eastern Uganda: Mixed Method Study

Waniala, Isaac; Nakiseka, Sandra; Nambi, Winnie; Naminya, Isaac; Ajeni, Margret Osuban; Iramiot, Jacob Stanley; Nekaka, Rebecca; Nteziyaremye, Julius

doi:10.1155/2020/5036260

Cited by 29 publications

(47 citation statements)

References 35 publications

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“…Finding 1: Deep rooted fears regarding vaginal birth (High confidence). Some women experienced strong fear of pain and injuries to the mother and child during labor and birth [24,29,30,33,36,41,49,50,52,55,[58][59][60][61]65,[67][68][69][70][71][72]74]. It was described consistently as a reason for CS on maternal request.…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

“…Finding 4: Vaginal birth is the natural way to give birth (High confidence). There was a strong conviction among women who preferred vaginal births that this was the natural way to give birth after a normal pregnancy and that this is the way the bodies were designed [35,38,39,43,44,48,53,59,62,63,66,67,71,72]. Moreover, discomfort was considered as part of becoming a mother, and although most women desired minimal pain, they also welcomed this sensation as a unique and intrinsic part of being a mother.…”

Section: Plos Onementioning

confidence: 99%

“…Other sequalae and problems resulting from CS could be infection, severe abdominal adhesions, improper wound healing, long recovery time, physical side-effects (e.g. back pain and fatigue), risk of rupture of the scar from the previous CS and operation-induced adhesion [31,41,[46][47][48][53][54][55][56]58,64,65,67,71,73].…”

Section: Plos Onementioning

confidence: 99%

“…In many studies CS were viewed as 'coping out of your motherly duties'. Women reported that CS would be an easier alternative when physical integrity was threatened or when fear of childbirth was intense [29,35,46,50,62,63,71].…”

Section: Plos Onementioning

confidence: 99%

“…Finally, inability to fulfill women family roles and responsibilities were also identified as major disadvantages of CS [32,34,35,41,53,55,56,66,67,71,72,73]. Temporary inability to drive and the disruption to family life caused by a longer recovery period after CS were major considerations, as were the need for assistance from family members and difficulties with childcare.…”

Section: Plos Onementioning

confidence: 99%

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Do women prefer caesarean sections? A qualitative evidence synthesis of their views and experiences

Colomar¹,

Opiyo

Kingdon

et al. 2021

PLoS ONE

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Background Caesarean sections (CS) continue to increase worldwide. Multiple and complex factors are contributing to the increase, including non-clinical factors related to individual women, families and their interactions with health providers. This global qualitative evidence synthesis explores women’s preferences for mode of birth and factors underlying preferences for CS. Methods Systematic database searches (MEDLINE, EMBASE, CINAHL, PsycINFO) were conducted in December 2016 and updated in May 2019 and February 2021. Studies conducted across all resource settings were eligible for inclusion, except those from China and Taiwan which have been reported in a companion publication. Phenomena of interest were opinions, views and perspectives of women regarding preferences for mode of birth, attributes of CS, societal and cultural beliefs about modes of birth, and right to choose mode of birth. Thematic synthesis of data was conducted. Confidence in findings was assessed using GRADE-CERQual. Results We included 52 studies, from 28 countries, encompassing the views and perspectives of pregnant women, non-pregnant women, women with previous CS, postpartum women, and women’s partners. Most of the studies were conducted in high-income countries and published between 2011 and 2021. Factors underlying women preferences for CS had to do mainly with strong fear of pain and injuries to the mother and child during labour or birth (High confidence), uncertainty regarding vaginal birth (High confidence), and positive views or perceived advantages of CS (High confidence). Women who preferred CS expressed resoluteness about it, but there were also many women who had a clear preference for vaginal birth and those who even developed strategies to keep their birth plans in environments that were not supportive of vaginal births (High confidence). The findings also identified that social, cultural and personal factors as well as attributes related to health systems impact on the reasons underlying women preferences for various modes of birth (High confidence). Conclusions A wide variety of factors underlie women’s preferences for CS in the absence of medical indications. Major factors contributing to perceptions of CS as preferable include fear of pain, uncertainty with vaginal birth and positive views on CS. Interventions need to address these factors to reduce unnecessary CS.

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