Women’s Preference for Mode of Delivery after a First Delivery by Caesarean Section at a Tertiary Hospital in Port Harcourt, Nigeria

Terhemen Kasso *

Department of Obstetrics and Gynaecology, University of Port Harcourt, Port Harcourt, Nigeria.

Taribo Tubman Amakiri

Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.

*Author to whom correspondence should be addressed.


Abstract

Background: The continuous increase in the rate of repeat caesarean sections after a first prior caesarean delivery is alarming. There is a decrease in the rate of vaginal birth after caesarean delivery (VBAC) and trial of labour after caesarean section (TOLAC) in women with a prior caesarean delivery. However, like other surgical operations, caesarean section puts the woman at risk of various complications and health challenges which can range from immediate to long-term health risks. This can affect her fertility and the outcome of her future pregnancies.

Aim: To determine women’s preference for mode of delivery after a prior caesarean delivery and the reasons for their preferred choices.

Methodology: This was a cross-sectional study of 229 consenting pregnant women with one previous caesarean delivery attending antenatal clinic at the University of Port Harcourt Teaching Hospital (UPTH) from 1st March to 31st May, 2023. Structured interviewer administered questionnaires were used to collect information on participant’s prior caesarean related birth experience, complications and current delivery desires. The data was analysed with SPSS version 25.

Results: The modal maternal and gestational age groups were 30-39years (66.5%) and 24-34weeks (48.5%). Approximately 58.9% were in their second pregnancy and 61.6% experienced labour pain in their previous caesarean delivery. Maternal and neonatal complications documented were wound infection and birth asphyxia respectively. Majority of the respondents (89.1%) had satisfactory overall birth experience. Of the 229 respondents, 82.1% preferred vaginal delivery in the index pregnancy due to the cost of caesarean section and innate desire to experience natural birth while 41(17.9%) of them preferred repeat caesarean delivery due to phobia for labour pain.

Conclusion: Majority of the women with prior caesarean delivery attending the antenatal clinic preferred TOLAC in subsequent pregnancies as against a repeat caesarean delivery. Women with a prior caesarean delivery should be adequately counselled during the antenatal period for possible TOLAC in the cases that meet the eligibility criteria in order to reduce the caesarean delivery rate.

Keywords: Caesarean section, delivery mode, women’s preferences, Port Harcourt


How to Cite

Kasso , T., & Amakiri , T. T. (2024). Women’s Preference for Mode of Delivery after a First Delivery by Caesarean Section at a Tertiary Hospital in Port Harcourt, Nigeria. Asian Journal of Pregnancy and Childbirth, 7(1), 93–100. Retrieved from https://journalajpcb.com/index.php/AJPCB/article/view/135

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References

Cegolon L, Mastrangelo G, Maso G, Dal Pozzo G, Ronfani L, Cegolon A, Heymann WC, Barbone F. Understanding factors leading to primary cesarean section and vaginal birth after cesarean delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015. Scientific reports. 2020;10(1):380.

Suwanrath C, Chunuan S, Matemanosak P, Pinjaroen S. Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand. BMC pregnancy and childbirth. 2021;21: 1-6.

Yaya S, Uthman OA, Amouzou A, Bishwajit G. Disparities in caesarean section prevalence and determinants across sub-Saharan Africa countries. Global health research and policy. 2018;3:1-9.

Verdult R. Caesarean birth: psychological aspects in babies. J Prenat Psychol Med. 2009;21(1/2):29-41.

Cox LM, Blaser MJ. Pathways in microbe-induced obesity. Cell metabolism. 2013;17 (6):883-94.

Kelly S, Sprague A, Fell DB, Murphy P, Aelicks N, Guo Y, Fahey J, Lauzon L, Scott H, Lee L, Kinniburgh B. Examining caesarean section rates in Canada using the Robson classification system. Journal of Obstetrics and Gynaecology Canada. 2013;35(3):206-14.

Programme WH. WHO Statement on caesarean section rates. Reproductive health matters. 2015;23(45):149-50.

Osayande I, Ogunyemi O, Gwacham-Anisiobi U, Olaniran A, Yaya S, Banke-Thomas A. Prevalence, indications, and complications of caesarean section in health facilities across Nigeria: a systematic review and meta-analysis. Reproductive health. 2023;20(1):81.

Eleje GU, Okam PC, Okaforcha EI, Anyaoku CS. Rates and determinants of successful vaginal birth after a previous caesarean section: a prospective cohort study. ARC J Gynecol Obstet. 2019;4(2):1-8.

Anikwe CC, Kalu CA, Okorochukwu BC, Dimejesi IB, Eleje GU, Ikeoha CC. Trial of labour after caesarean section in a secondary health facility in Abakaliki, Nigeria. Nigerian Journal of Medicine. 2021;34(4):406-12.

Wagner SM, Bicocca MJ, Mendez-Figueroa H, Gupta M, Reddy UM, Chauhan SP. Neonatal and maternal outcomes with trial of labor after two prior cesarean births: stratified by history of vaginal birth. The Journal of Maternal-Fetal & Neonatal Medicine. 2022;35(25):6013-20.

Cegolon L, Mastrangelo G, Heymann WC, Dal Pozzo G, Ronfani L, Barbone F. A systematic evaluation of hospital performance of childbirth delivery modes and associated factors in the Friuli Venezia Giulia Region (North-Eastern Italy), 2005–2015. Scientific Reports. 2019;9(1):19442.

Ryan GA, Nicholson SM, Morrison JJ. Vaginal birth after caesarean section: Current status and where to from here?. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2018;224:52-7.

O’Neill SM, Kearney PM, Kenny LC, Khashan AS, Henriksen TB, Lutomski JE, Greene RA. Caesarean delivery and subsequent stillbirth or miscarriage: Systematic review and meta-analysis. PLoS one. 2013;8(1):e54588.

Fattah CN, Jalal H. Vaginal Birth After Previous Caesarean Section. Kurdistan Journal of Applied Research. 2017;2(2):36-44.

Alabrah PW, Abasi IJ, Ozori SE. Caesarean delivery and the attendant FETO-maternal aftermath at a rural hospital in South Southern Nigeria. Age. 2022;13(19):3.

Akinlusi FM, Olayiwola AA, Rabiu KA, Oshodi YA, Ottun TA, Shittu KA. Prior childbirth experience and attitude towards subsequent vaginal birth after one caesarean delivery in Lagos, Nigeria: A cross-sectional study. BMC Pregnancy and Childbirth. 2023;23 (1):82.

Amadi SC, Bademosi A, Kwosah JN, Iwo-Amah RS, Clement Wekere FC. A five- year review of caesarean section at the Rivers State University Teaching Hospital, South-South, Nigeria. Journal of Advances in Medicine and Medical Research. 2021;33 (23):159-67.

Jiang A, Perry T, Walker K, Burfoot A, Patterson L. Surgical sensation during caesarean section: a qualitative analysis. International Journal of Obstetric Anesthesia. 2024;57:103935.