Abstract:
Background: Maternal perceptions about caesarean section contribute to delayed presentation of women for
emergency obstetric care. This increases the risks of perinatal and neonatal mortality and slows down the
reductions needed to achieve the sustainable development goal (SDG) target of reducing neonatal mortality and
ending new-born deaths. The aim of the study is to determine maternal perceptions about caesarean section
deliveries and their role in reducing neonatal mortality at a regional and a district hospital in the Upper West
Region of Ghana.
Methods: This descriptive study was carried out at two hospitals in the Upper West Region, the most rural region
in Ghana, between 15th January and 29th June, 2018. Maternal perceptions were examined among antenatal care
attendants at the Upper West Regional Hospital (UWRH) and St Joseph’s Hospital Jirapa (SJH), a district hospital,
using questionnaires administered by trained nurses.
Results: Altogether, 416 completed questionnaires were obtained, comprising 206 from expectant women
attending the UWRH and 210 from SJH. Although the majority of women in this study preferred spontaneous
vaginal delivery (87.4%, n = 348) to caesarean section, most of the respondents (n = 281, 73%) indicated their
willingness to have a caesarean section if necessary. The main reason for not wanting a CS was the long recovery
time (51.8%, n = 148). Almost half of women interviewed, representing 45.1% (180) did not know or feel that CS can
promote child survival and about a fifth, 21.6% (85) believed that CS can have adverse effects on child survival.
Factors associated with poor perception of CS included, no formal education, age less than 19 years and no
employment.
Conclusion: Majority of women in this study had a positive attitude towards the uptake of CS if it becomes
necessary. Lack of formal education, age less than 19 years and unemployment are associated with poor maternal
perception of CS. Education to improve the perception of CS as a promoter of child survival is necessary and to
discourage perceptions that it causes adverse perinatal or neonatal outcome particularly in at risk populations.
