CHAPTER ONE

INTRODUCTIONE

1.1 Background of Study

Pregnancy is the term used to described the period in which a fetus develops inside a Woman’s womb or uterus. Pregnancy usually lasts about forty weeks or just over nine (9) months, as measure from the last menstrual period to delivery.

Health care providers refer to three segments of pregnancy, called trimester. The events in which trimesters are: first trimester begins from week one to twelve week, that is from one to three months

Second trimester from Week 13 to week 28. Third trimester from Week 29 to week 40(Hansen et al 2016) .A Caesarean section is an operative technique by which a fetus is delivered through abdomen and uterine Incision and the Indication Can either be maternal or fetal.

Caesarean section is considered by medical Professionals to be relatively safe, though it does in fact pose a higher risk for complication than vagina delivery (Hall et al 2015). The term “Caesarean’ was derived from a decree in Roman Law, which made it mandatory for children to be cut out of women who had died during childbirth. In fact the term used at the time was “Lex Caesarare” (kwawukume et al 2002.

Furthermore a Caesarean section denotes the use of surgery to deliver one or more babies from a Mother’s womb (Hinkle et Al 2016).

Contrary to Caesarean section, Spontaneous vaginal delivery (SVD) is the most commonly accepted and widely used method for child delivery worldwide. It is the process through which Childbirth naturally occurs through the birth, Canal (Bruner et al 2016).

Several caesarean section are sometimes done for Justifiable medical and non-medical indication. Subsequently the rate of Caesarean in Europe Eastern 25.0% ,Northern 25.3%, Southern 30.1%, Western 24.2% and North America 31.8% in 2020 have been increasing (Declercg et al 2013).

In developed Countries, women often accept Caesarean section because of their improved understanding of its role and safety (Johanson et al 2001).  Contrary to, in many sub Saharan African Countries, where several reports indicates that women are often reluctant to accept Caesarean section delivery (Behaque et al 2002).Conversely, in the developing countries. The Change Caesarean section rate has been dramatic during the same Period. This result from negative perception of Caesarean section among women in the developing countries.

Caesarean section, is still being perceived as an abnormal means of delivery by some women in developing countries, hence caesarean Section rate in sub-Saharan African Country like Burkina Faso and Niger is low. The cesarean section rate in Burkina Faso it increase 1.5 times, from 1.2% in 2005 to 2% in 2017(minitere de la sante de Burkina Faso, 2017). (Sunday et al 2011). Furthermore, among women in the developing countries, Caesarean section is still being perceived as a curse on an unfruitful women and a lot of weak women.In a study among Yoruba women of south Western Nigeria, caesarean section was viewed with suspicious, aversion, misconception, fear, guilt, misery and anger (Sunday et al 2011) .Africa Studies have shown widespread rejection of Indicated caesarean section by women which is viewed by them as a reproductive failure (Fasuba et al 2004).Despite the higher risk of uterine rupture in women with previous Caesarean section scars, some studies have shown a high default rate among these women with some Presenting to hospital only following complication during vagina birth at home, thus contributing to increase maternal and fetal morbidity and mortality, ( Ekanem et al 2001). It has been reported that caesarean section rates at population levels higher than 10% were not associated with reductions in maternal and new-born mortality rates (Torloni et al 2016).

However in Africa where the median Caesarean section rate is estimated to be 8.8% the risk of neonatal death is reported to be lower in settings having higher elective Caesarean section rates (Azad et al 2015).

The national average of Caesarean section rates in Ghana is estimated at 12.8% but it ranges from 11.2-14. 6% (Boerma et al 2018), even then, there are wide disparities in access and uptake of caesarean section in urban and rural areas which may be partly related to perception about caesarean section.

1.2 Statement of Problem.

Caesarean section is now a common surgical operation around the world with many being aware of the existence of his medical Procedure (Williams et al 2016).

The recent rates of delivery by caesarean section continue to rise worldwide, with reported rates of 24.5% in Western Europe, 32% in North America, and 41% in South America ( Betran et al 2014).

Delivery by caesarean section can minimize maternal and perinatal mortality and morbidity when there are maternal or fetal complications (Gibbons et al 2010).

Nigerian has been rated the third country, with the highest mortality rate after India and Sierra Leone with over 40,000 deaths of pregnant women (WHO 2013).

In Cameroon, the World health organisation (WHO) recommends caesarean section rates of 10-15% (Njim et al 2020).

This is based on evidence from several reports suggesting that at 10-15%. Caesarean section are associated with a significant reduction of maternal and perinatal morbidity and mortality (Betran et al 2015).

 Not much information has been reported on this study in Cameroon, therefore, the Investigator wants to assess the Perception and attitude of pregnant women at the antenatal clinic in Mount Mary hospital Buea.

1.3 Research Objectives

1.3.1 General Objectives

This study has as objective to assess the perception and attitudes of pregnant women toward Caesarean section.

1.3.2 Specific Objectives

1: To assess the perception of a pregnant women towards Caesarean section in Mount Mary Hospital Buea

2: To determine the attitude of women towards Caesarean section in Mount Mary Hospital Buea

1.4 Research Questions

1: What is the perception of women about Caesarean Section?

2: What is the attitude of women towards Caesarean Section?