Maternally requested caesarean section among pregnant women and spousal support in Ibadan, Nigeria

Abstract

Caesarean section (CS) is a life-saving surgical intervention performed when vaginal delivery poses a risk for women with pregnancy complications. In Nigeria, maternally requested caesarean section (MRCS) is not widely accepted as a childbirth option despite increasing awareness. Evidence on MRCS spousal support and the factors influencing its uptake remains limited in Nigeria. Therefore, we investigated the factors associated with MRCS uptake among pregnant women and spousal support in Ibadan, Nigeria. This is a cross-sectional study among 1,804 pregnant women and 442 male spouses, recruited from seven selected health facilities in Ibadan, Nigeria, using a multistage sampling approach. Data were collected through structured interviewer-administered questionnaires. The outcome variable was pregnant women’s willingness to demand MRCS. Explanatory variables were sociodemographic characteristics, spousal support, and knowledge of CS. Bivariate and multivariable logistic regression analyses were conducted at 5% level of significance. The mean age of pregnant women was 30.0 ± 5.3 years, and that of spouses was 34.8 ± 6.7 years. The prevalence of willingness to participate in MRCS was 4.8%. Awareness of MRCS was 55.2% among pregnant women, and 31.4% among the spouses. Factors associated with MRCS are graduate-level education (AOR = 2.63; 95% CI: 1.28–5.41), previous CS (AOR = 5.73; 95% CI: 3.32–9.91), gestational age (AOR = 0.54; 95% CI: 0.33–0.89), and knowledge of CS (AOR = 0.55; 95% CI: 0.32–0.94). However, the association with spousal support (AOR = 0.64; 95% CI: 0.19–2.13) was insignificant. The willingness to demand MRCS among pregnant women and spousal support was low, in spite of the awareness. Factors associated with MRCS, including maternal education, previous CS, and good CS knowledge, can be targeted through behavioral change communication and other interventions. So, strengthening antenatal education for women and their spouses would improve informed decision-making regarding childbirth.