New research from Nigeria suggests that tertiary educated women are more aware of c-section on "demand", and that maternal request is more common in tertiary health care centre'; these women are also more likely to "favor a woman's right of autonomy to choose her mode of delivery."
Against a background of reported increased rates of maternal request cesarean, researchers NS Okonkwo et al set out to "determine the perception and attitudes of Nigerian antenatal clients towards MDCS, their willingness to request MDCS, and the relationship between willingness to request MDCS and sociodemographic characteristics."
They found that:
The proportion of women aware of MDCS was 39.6%.
Doctors were major sources of information on MDCS (30.8%) as well as friends (24.3%). Common reasons reported for MDCS were fear of labor pains (68.9%), and fear of poor labor outcome (60.1%), and fear of fecal (20.2%) and urinary incontinence (16.8%).
However, willingness to request MDCS was low (6.6%).
More than 50% of those willing to request MDCS would likely be criticized, mainly by their husbands.
And they concluded that:
"Provision of epidural anesthesia and improved safety of vaginal delivery is recommended." This may prevent Nigerian women from making a difficult choice for MDCS based on fear of pain and poor labor outcome. The role of the male partner should be taken into consideration in order to make sustainable policies or guidelines for MDCS in developing countries."
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