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The burden of caesarean section refusal in a developing country setting
Article first published online: 12 SEP 2007
DOI: 10.1111/j.1471-0528.2007.01440.x
RCOG 2007 BJOG An International Journal of Obstetrics and Gynaecology
Issue
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 114, Issue 10, pages 1261–1265, October 2007
Additional Information
How to Cite
Chigbu, C. and Iloabachie, G. (2007), The burden of caesarean section refusal in a developing country setting. BJOG: An International Journal of Obstetrics & Gynaecology, 114: 1261–1265. doi: 10.1111/j.1471-0528.2007.01440.x
Publication History
- Issue published online: 12 SEP 2007
- Article first published online: 12 SEP 2007
- Accepted 22 May 2007.
- Abstract
- Article
- References
- Cited By
Keywords:
- Burden;
- caesarean;
- country;
- developing;
- refusal
Objective To investigate the prevalence, aetiology and outcomes of caesarean section refusal in pregnant women.
Design A prospective controlled study.
Setting University of Nigeria Teaching Hospital and Aghaeze Hospital, Enugu, Nigeria.
Population A total of 62 Nigerian women who declined elective caesarean section.
Method Interviewer-administered questionnaires at the time of caesarean section refusal and postdelivery. The delivery outcomes of the subjects were compared with that of a matched control group of women who accepted caesarean section.
Main outcome measures Prevalence, maternal reasons for caesarean section refusal and the resultant maternal and perinatal mortality.
Results The prevalence of caesarean section refusal was 11.6% of all caesarean deliveries. Maternal reasons for refusing caesarean section include fear of death, economic reasons, desire to experience vaginal delivery and inadequate counselling. Outcomes were significantly worse among women who refused elective caesarean section than in the controls with a maternal mortality of 15% (versus 2%, P = 0.008) and a perinatal mortality of 34% (versus 5%, P < 0.001).
Conclusion There is a high prevalence of caesarean section refusal in south-eastern Nigeria. Women declining caesareans have very poor maternal and perinatal outcomes and need extra support.