Enabudoso Ehigha Jude, Ezeanochie Michael Chudi, Olagbuji Biodun Nelson
Department of Obstetrics and Gynecology, University of Benin Teaching Hospital, Benin City, Nigeria.
J Matern Fetal Neonatal Med. 2011 Oct;24(10):1212-4. doi: 10.3109/14767058.2011.565833. Epub 2011 Apr 4.
To explore the perception and attitude of women with previous caesarean section towards repeat caesarean section.
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.
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.
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.
探讨有剖宫产史的女性对再次剖宫产的认知和态度。
采用匿名半结构化问卷对有剖宫产史的女性进行观察性研究。收集的信息包括社会人口学特征、上次剖宫产的结果、并发症或家庭暴力经历、医生建议时对再次剖宫产的接受情况以及拒绝的原因。
139名产妇参与了该研究。77%的产妇有1次剖宫产史，24.46%的产妇会拒绝再次剖宫产。拒绝的主要原因是术后疼痛、文化反感、怕死和剖宫产费用。有多次剖宫产史的产妇接受率显著更高，而上次剖宫产时经历围产期死亡的产妇拒绝率显著更高。12%的产妇经历过家庭暴力（几乎全是心理上的），主要来自配偶或其亲属。
相当一部分有剖宫产史的女性如果有医学指征也会拒绝再次剖宫产。需要开展涉及社区的行为改变沟通、改善术后疼痛管理以及更好地进行咨询，尤其是关于手术安全性的咨询。
