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American Journal of  Medical 
Science and Innovation (AJMSI) 

Attitude Towards Caesarean Section as a Delivery Option among Pregnant Women in 
Ogbomoso, Oyo State

Babarinde O. Festus1*

Volume 3 Issue 1, Year 2024
ISSN: 2836-8509 (Online)

DOI: https://doi.org/10.54536/ajmsi.v3i1.2541
https://journals.e-palli.com/home/index.php/ajmsi

Article Information ABSTRACT

Received: March 28, 2024
Accepted: April 30, 2024
Published: May 03, 2024

This study explored the attitudes toward Caesarean Section (C-section) as a delivery option 
among pregnant women in Ogbomoso, Oyo State, utilizing a descriptive cross-sectional 
design. The target population comprised aged 18 to 45years who registered and are attending 
antenatal clinic of  the hospital for their antenatal care services, estimated at approximately 
900. The random sampling technique through ballot was employed in the study, and a sample 
size of  298 participants was selected for the study which was determined using th Fisher’s 
formula. Data collection was facilitated through a well-structured questionnaire, which boasted 
reliability coefficients of  0.73 for attitudes towards C-sections. Statistical analyses, including 
percentage, standard deviation, and Analysis of  Variance (ANOVA), were conducted at a 
0.05 alpha level. The study unveiled that 675 (67.5%) majority exhibited a generally positive 
attitude towards C-sections. Age groups 18-30 and 31-40 years showed similar attitudes, with 
a criterion mean of  2.55, indicating a broadly shared positive perspective across age groups. 
However, educational attainment and religious beliefs were found not to significantly 
influence attitudes towards C-sections [F(4,291) = 1.473, p>0.05 for education; F(3,292) = 
1.936, p>0.05 for religion]. The study concluded that pregnant women in Ogbomoso have 
a generally positive attitude towards C-sections as a delivery option, with minor variations 
across different age groups but no significant differences based on educational attainment 
or religious affiliation. It is recommended that healthcare providers continue educational 
efforts to demystify C-sections, addressing specific misconceptions and cultural beliefs, and 
ensure equitable access to C-section information and services for pregnant women across all 
demographics in Ogbomoso.

Keywords
Attitude, Caesarean Section, 
Pregnant Women

1 Federal Medical Centre Idi-Aba, Abeokuta, Nigeria
* Corresponding author’s e-mail: ilerioluseye2015@gmail.com

INTRODUCTION
Background to the Study
The outcome of  pregnancy for every couple is as 
important as the news of  conception. Pregnant women 
keep faith with the progress of  their pregnancy believing 
that the day of  delivery would bring an untold happiness 
that almost completely erase the pain and stress that 
accompany the process of  delivery. All over the world, 
the mode of  delivery for pregnant women has always 
taken two forms, either through a vaginal birth or a 
caesarean section (C/S). Vaginal birth often seen as 
normal birth is the escape of  a infant from the birth canal 
which may be spontaneous or assisted forceps delivery. 
However, caesarean section utilizes a surgical method 
that is a life-saving procedure which may sometimes be 
the only feasible option for complicated pregnancies in 
the wisdom of  the World Health Organization (WHO), 
(2015), and is focused at ensuring the delivery of  a healthy 
infant to a hale and hearty and fulfilled mother (Anikwe, 
et al., 2019).
Globally, the rates of  caesarean section have been on the 
rise (Roberts, et al., 2015; Betra´n, et al., 2016) especially in 
developed countries. However, in Nigeria, prevalence of  
caesarean section has been reported with ranges of  2.1 - 
16.6% (Sunday-Adeoye & Kalu, 2011; Gunn, et. al., 2017; 
Adewuyi, et al., 2019) with most regions of  the country 
having unmet caesarean section needs. Assessing the 
frequency of  caesarean section can be a very important 

index that reflects met and unmet needs among a given 
population especially in settings with disproportionate 
maternal mortality like Nigeria. The global accepted 
consensus regarding the rates of  caesarean section in a given 
population was decided over three decades by the World 
Health Organization as 5%-15% with evidence suggesting 
that rates reaching 10% have the potential of  reducing death 
of  maternal and newborn (Betran, et. al., 2016).
The indication for caesarean section is far reaching 
and basically, is meant to save the life of  the baby and 
mother when the delivery puts them at risk of  loss of  
life. These include but not limited to foetal distress, 
abruption placentae, abnormal presentation, history of  
previous caesarean section, preeclampsia/eclampsia, 
placenta praevia, macrosomic babies, for prevention of  
Human Deficiency Virus (HIV) disease in the neonates, 
obstructed labour, and cephalopelvic disproportion 
(Waniala, et. al., 2020).
A few studies in Nigeria have reported that pregnant 
women demonstrate negative perceptions about caesarean 
section (Sunday-Adeoye & Kalu, 2011; Amiegheme, et al., 
2016; Abazie & Abdul-Kareem, 2019), For example, the 
study among pregnant women in South Western Nigeria 
revealed that the narratives surrounding caesarean section 
is often viewed with suspicion, aversion, misconception, 
fear, guilt, to say the least (Sunday-Adeoye & Kalu 2011). 
This may not be so different with what would be seen 
in other regions and has the potential to deter women 



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from opting for caesarean section even in the face of  
emergencies and obvious obstetrics indications.
Findings about acceptance of  caesarean section are with 
mixed results in literature. On one hand, some studies 
concluded that many Nigerian women may never accept 
caesarean section option despite its benefits. This view is 
supported by available evidence with few hospital based 
studies reporting acceptance of  caesarean section rates 
ranging from 6.9% - 22% (Faremi, et. al., 2014; Ugwu & 
Kok, 2015; Lawani, et. al., 2019). On the other hand, other 
studies have reported that majority of  the mothers in their 
study population accepted caesarean section as a mode of  
birth (Omobolanle, et al., 2018; Panti, et al, 2018).
The drawbacks surrounding the rejection of  caesarean 
section in Nigeria are many-sided and include reproductive 
failure, high cost, lack of  information, partner’s support/
opinion and religious beliefs (Lawani, et. al., 2019).

Statement of  Problem
Every midwife and obstetrician alike is keen at providing 
maternal services that are safe, timely and scientifically 
driven in order to ensure maternal mortality is brought 
to near zero level. While vaginal delivery appears to be 
desirable by most women and culturally appealing in 
Nigeria, caesarean section as a means of  childbirth plays 
a crucial role especially for high risk pregnancies and 
should never be undermined if  the goal three of  the 
sustainable development (SDG) must be achieved by 
year 2030. A sustained negative view about caesarean 
section among pregnant women can however increase 
the risks of  perinatal and neonatal deaths and hinder the 
achievement of  the SDG target of  reducing both mother 
and new-born deaths (Naa-Gandauet et. al., 2019). 
Unfortunately, in developing countries like Nigeria, most 
of  the maternal deaths during delivery may be attributed 
to refusal of  caesarean section delivery (Sunday-Adeoye, 
& Kalu, 2011; Jeremiah, et. al., 2011).
Refusal of  caesarean section mode of  delivery is common 
in Nigeria, with a study reporting a rate of  about 11.6% 
in their study population (Chigbu & Iloabachie, 2007). 
The researcher has observed keenly in his clinical practice 
that most women do not continue their antenatal care and 
refuse to visit the hospital once they are counseled about 
the need for an elective or emergency caesarean section 
when their expected date of  delivery approaches. Rather, 
a good number of  mothers search for alternative care 
from delivery homes, untrained birth attendant or faith 
based settings with the hope that vaginal delivery is still 
possible. This trend is worrisome and a lasting solution 
to curb these avoidable deaths is needed. Additionally, 
there is the urgent need to identify barriers to attitude of  
caesarean section.

Aim and Objectives of  the Study
The aim of  the study is to determine the attitude towards 
Caesarean Section as a delivery option among pregnant 
women in Ogbomoso, Oyo State. The specific objectives 
of  the study are as follows:

1. To determine the attitude towards Caesarean 
Section as a delivery option among pregnant women in 
Ogbomoso, Oyo State.

2. To ascertain the attitude towards Caesarean Section as 
a delivery option among pregnant women in Ogbomoso, 
Oyo State based on age.

3. To examine the attitude towards Caesarean Section as 
a delivery option among pregnant women in Ogbomoso, 
Oyo State based on religion.

4. To determine the attitude towards Caesarean 
Section as a delivery option among pregnant women in 
Ogbomoso, Oyo State based on educational attainment.

Research Questions
The following research questions were answered by this 
study:

1. What is the attitude towards Caesarean Section as a 
delivery option among pregnant women in Ogbomoso, 
Oyo State?

2. What is the attitude towards Caesarean Section as a 
delivery option among pregnant women in Ogbomoso, 
Oyo State based on age?

3. What is the attitude towards Caesarean Section as a 
delivery option among pregnant women in Ogbomoso, 
Oyo State based on religion?

4. What is the attitude towards Caesarean Section as a 
delivery option among pregnant women in Ogbomoso, 
Oyo State based on educational attainment?

Research Hypotheses
The following hypotheses were tested at 0.05 alpha level.

HO1: There is no significant difference between age 
and attitude towards Caesarean Section as a delivery 
option among pregnant women in Ogbomoso, Oyo State.

HO2: There is no significant difference between religion 
and attitude towards Caesarean Section as a delivery 
option among pregnant women in Ogbomoso, Oyo State. 

HO3: There is no significant difference between 
educational attainment and attitude towards Caesarean 
Section as a delivery option among pregnant women in 
Ogbomoso, Oyo State.

LITERATURE REVIEW
Concept of  Caesarean Section 
The surgical procedure in which incision(s) (one or more) 
is/are made through a mother’s abdomen and uterus 
by gynaecologist to deliver a single or multiple babies is 
termed caesarean section by Becher & Stokke, (2013). 
This surgical procedure in which a woman’s abdomen is 
incised in this case a laparotomy, and uterus in which case 
is called hysterectomy, is to enhance the delivery of  one 
or more babies, or to take out a dead fetus (Amiegheme, 
et. al., 2016; Abazie & Abdul-Kareem, 2019). The 
delivery of  a foetus, placenta and membranes through an 
abdominal and uterine incision after the age of  viability 
(which is 28 weeks of  gestation in developing countries) 
also describes this concept (Nwobodo, et. al., 2011).
Prevalence/Incidence of  Caesarean Section



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Available evidences suggest that prevalence of  CS is 
higher in developed countries compared to developing 
countries Nigeria inclusive. Caesarean delivery is used 
in excess in many developing and developed countries 
(Betrán, et. al., 2016). For example, the rate is as soaring 
as 25.9% in China, 32.3% in Australia/New Zealand, 
45.9% in Brazil, 26.1% in United States of  America 
(Gibbons, et al., 2012; Betrán, et. al., 2016; Amiegheme, 
et. al., 2016). However, the community-based prevalence 
of  C/S in Nigeria exposes a figure that is, far below the 
10% recommended by the WHO (Adewuyi, et. al., 2019). 
Additionally, there has been no significant increase in 
this rate for several years in the country. For example, in 
2008, merely 2% of  births were done via C/S (Nigeria 
Demographic and Health Survey 2009) and the figure 
remained unaffected in 2013 (Nigeria Demographic and 
Health Survey, 2013) while the report of  Adewuyi, et.al., 
(2019) showed a prevalence rate of  2.1% (95% CI 1.8 to 
2.3). The incidence of  C/S in most health institutions in 
Nigeria ranges between 20 and 30% (Ebeigbe & Ilesami, 
2004; Inyang-Etoh & Etuk, 2013), but globally, it is about 
10% to 35% (Nwobodo, et. al., 2011; Ojiyi, et. al., 2012).
Precisely, in Nigeria national statistics puts the rate as 
1.8% (Gibbons, et. al., 2010). The rates are relatively 
higher from tertiary health facilities in different regions 
of  the country. Lower rates were reported from northern 
Nigeria, with 10.1% in Kano (Jido & Garba, 2012), 10.6 
in Sokoto, 11.8% in Maiduguri (Geidam, et. al., 2009), 
and 20.3% from Birnin Kebbi (Nwobodo & Wara, 2004); 

while higher toll were seen from southern Nigeria as 
follows; 25% in Sagamu (Oladapo, et. al., 2004), 27.6% 
in Enugu (Ugwu, et. al., 2011), and 34.5% in Abraka 
(Igberase, et. al., 2009). These prevalence rates are 
significantly lower than that for several African countries 
including Ghana (12.80% in 2014), Lesotho (9.70% in 
2014) and Uganda (5.22% in 2011) (Ghana Statistical 
Service, 2015; Cavallaro, et. al., 2013; Uganda Bureau of  
Statistics, 2011).

Theoretical Framework
Health Belief  Model
The health belief  model was developed in 1950s (Pender 
et al, 2006). It suggests that health-seeking behaviour is 
influenced by a person’s perception of  a health-related 
threat and how they value the actions needed to reduce this 
threat. The health belief  model assumes that behaviour 
change when a person simultaneously: Recognizes that 
there is enough reason to make a health concern relevant 
(perceived susceptibility and severity); Understands that 
they may be vulnerable to a disease or negative health 
outcomes (perceived threat); Realizes that behaviour 
change can be beneficial and the benefits of  that change 
will outweigh any costs (perceived benefits and barriers); 
The health belief  model proposes that a person’s health-
related behaviour depends on the perceptions of  four 
critical areas - the severity of  a potential illness, the 
person’s susceptibility to that illness, and the benefit of  
taking a preventive action

Figure 1: Model for the study: Health Belief  Model



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Empirical Review
Reports from other parts of  South West Nigeria show 
similar trend; Faremi, et. al., (2014) reported that 69.5% of  
the respondents perceived caesarean section as preferable 
to vaginal delivery as the pain in vaginal delivery is 
usually unpleasant, 66.0% disagreed that babies born 
through caesarean section are more healthy than their 
other counterpart that are born through vaginal delivery. 
In addition, they found that 59.1% of  the women said 
any woman who delivers through caesarean section miss 
an important life experience. Bukar et. al., (2014) found 
that 6.3% of  the women believed that having caesarean 
section was due to failure of  reproductive function of  
a woman, with 106 (41.7%) citing destiny as reason for 
caesarean delivery. This report may not be unconnected 
with the findings that although majority 204 (80.3%) 
respondents were aware of  caesarean delivery, they 90 
(44.1%) obtained the information from friends.
Owonikoko, et. al., (2015) in their study findings reported 
that 46.8% of  the respondents believed that CS was 
too expensive and 14.2% thought that after one CS, 
subsequent deliveries will be by CS. Only 50(12.5%) 
believed that women who delivered through CS are 
abnormal; 6.5% held the view that babies born with CS 
generally have a low intelligent quotient (IQ); 15% of  
women were of  the opinion that women who had CS 
are likely to die from the procedure; 2.8% believed that 
babies born with caesarean births are likely to die soon 
after birth. Conclusively, 53.8% of  the women had right 
perception about CS which was statistically significant 
with their age group, educational status, occupation of  
the respondents with partners’ educational status and 
occupation (p<0.001).
In a similar study, Olajubu, et. al., (2018) concluded that 
most of  the women perceived caesarean section good 
with mean perception scores above average (29.96 ± 
5.24). The study stated specifically that most (81.8%) 
women did not agree that caesarean section was a taboo; 
the devil’s work (82.8%); nor that caesarean section was 
performed on unfaithful women (84.9%). Instead they 
established that caesarean section was not an abnormal 
means of  birth (73.2%) and that abnormal position of  
placenta, big baby, or the baby not being positioned well 
were some of  the hints for caesarean section (80.1%) and 
vaginal birth following caesarean section was possible 
(78.7%). This perception was found to be associated with 
the women’s age group, educational status and religion.
Abazie and Abdul-Kareem (2019) in their study on 
pregnant women’s knowledge and perceptions of  
caesarean section in Lagos state, Nigeria, reported that 
majority of  respondents (68.5%) had a negative perception 
of  caesarean section. This negative view was significantly 
associated with their socio-demographic variables (age, 
religion, educational status, parity, occupation). 
Available evidence pertaining to the population-based 
prevalence of  C/S in Nigeria reveals a threshold that 
is, far below the 10% recommended by the WHO. This 
was properly documented by Adewuyi, et. al., (2019) that 
the prevalence of  C/S was low, indicating unmet needs 

in the use of  caesarean delivery in Nigeria and very low 
acceptance for this life saving procedure. The report of  
Eifediyi et al (2015) posits that area of  residence did not 
improve the acceptance of  C/S as the acceptance of  
Nigerian women living in urban and semi-urban settings 
were still low making one wonder what this will look like 
in the rural communities. This assumption is buttressed 
by the recent findings of  Abazie & Abdul-Kareem (2019) 
from Lagos state Nigeria that although most (90.3%) 
of  the respondents had heard of  C/S only 8.9% had 
experienced it. In the combined data-sets of  Ugwu & 
de Kok (2015), C/S accounted for about 14% of  all 
deliveries. In total, 22 % of  maternity clients refused C/S 
and more than 90 % of  the C/S in the focal hospital were 
emergencies which may indicate late arrival at the hospital 
after seeking assistance elsewhere. They confirmed that 
some women do refuse C/S and that this occurs on a 
somewhat regular basis.  
A cross sectional study in the North-Eastern part of  
Nigeria by Bukar, et. al., (2014) documented that most, 
226 (89.0%), would not request for caesarean section. 
Although majority (x2 =2.589, p=0.000) would prefer 
vaginal delivery, none of  the respondents would decline 
caesarean delivery if  indicated. Faremi, et. al., (2014) 
reported that only 6.9% will accept caesarean section. 
The obstetric history of  the respondents showed that 
vast majority (75.9%) had their last baby through normal 
vaginal delivery, 5.9% through caesarean section and 3.4% 
through assisted vaginal delivery but 42.9% will agree 
if  given the option of  caesarean section for their next 
delivery. Owonikoko, et. al., (2015) found that only 32.3% 
respondents had undergone previous CS and 92(70.8%) 
of  them believed that the CS was justified. Almost all 
377(94.2%) considered vaginal delivery as preferred 
method while only 4.3% wanted CS. In findings of  
Ezeome, et. al., (2018), 13% of  the women will reject CS 
for themselves no matter the circumstance while majority 
of  them will accept the procedure if  their husbands 
consent. Only 4% will opt for cesarean delivery because 
of  previous bad experience while another 4% will accept 
any route of  delivery offered provided it brings about a 
safe delivery. It is interesting to note that all those who 
opted for C/S had tertiary education.
More recently, Lawani, et. al., (2019) found that although 
all their respondents were aware of  C/S as an operative 
abdominal procedure for delivery; only 14.0% had 
experienced the procedure previously. Over four-
fifths (82.3%) of  those who have had a previous C/S 
were well informed about the indications. When asked 
if  they would accept a C/S when indicated in future, 
79.7% said they would accept, while the others would 
decline. Also, Anikwe, et. al., (2019) noted in their study 
findings that more than half  of  the respondents would 
not accept caesarean section when indicated in a future 
pregnancy. This was significantly predicted by the health 
care attention and maternal age. Furthermore, acceptance 
of  C/S was only due to emergency which accounted for 
74.5% of  the caesarean section and the commonest 
indication was foetal distress.



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METHODOLOGY
Research Design
This study adopted a mixed-method study design to assess 
the attitude towards  caesarean section among pregnant 
women in General Hospital,  Ogbomoso, Oyo State. 

Study Population
The population for this study comprised of  pregnant 
women aged 18 to 45years who registered and are 
attending antenatal clinic of  the hospital for their antenatal 
care services. From the clinic records, an average of  900 
pregnant women was seen in a month prior to the study.

Inclusion Criteria
This study will be carried out; among pregnant women 
aged 18 – 45 years, women registered for antenatal clinic 
in the facility, pregnant women irrespective of  previous 
C/S status (if  woman has done previous C/S or not) will 
be studied.

Exclusion Criteria
Pregnant women who are registered in the facility but are 
critically ill at the time of  conducting the study.

Sample and Sampling Technique
The quantitative study involved 298 randomly selected 
pregnant mothers however, a response rate of  296(99.3%) 
was achieved.

Sample Size 
The sample for this study was 298, this was derived using 
the Fisher’s formula (see Appendix 1).
Respondent sampling: a random sampling technique 
done through ballot was used to select and distribute 
questionnaire to respondents for a period of  one month 
until the sample size was reached. 

Instrument for Data Collection
The instrument used for the data collection is a 
questionnaire. The instrument was developed after 

thorough literature review (Owonikoko, et al 2015).
The questionnaire is self-structured and it comprised 
four sections: section A comprised of  8 itemed open 
and closed-ended socio-demographic questions, section 
B consisted of  10 items on attitude towards caesarean 
section.

Validity 
Face and content validity of  the instruments was 
established by presenting the questionnaire to the experts 
in the field of  Medicine to assess and certify that the 
items are relevant to the area of  research to which they 
are designed. All corrections and suggestions made to the 
questionnaire were effected thus making it valid. 

Procedure for Data collection
Two research assistants were recruited and trained on 
the instrument and data collection process. An informed 
consent form attached with the questionnaire was given to 
each participant after seeking verbal consent, thereafter, 
the questionnaires were completed by the respondents. 
The completed questionnaires were retrieved upon 
completion on the spot. Data collection will be done over 
four (4) weeks.

Method of  Data Analysis
Before the data will be entered to SPSS version 23.0, it was 
checked for completeness, inconsistencies and cleaned. 
Data cleaning was done on the entered data and double-
check for its consistency with the paper questionnaire. 
Descriptive and inferential statistics were used to analyze 
the data. The descriptive statistics such as weighted mean 
score was used to analyse the attitude, the criterion mean 
of  2.50 was indicative of  positive attitude and values less 
than 2.50 indicated negative attitude. Analysis of  variance 
was used in testing hypotheses postulated for the study at 
0.05 alpha level.

RESULTS AND DISCUSSION
Data Analysis

Table 1: Respondents’ Socio-demographic data (n=296)
Variables Frequency Percentage 
Age (in years)              Mean = 30.0574  SD = 4.54657
≤ 20 1 0.3
21 – 30 175 59.1
31 – 40 115 38.9
≥ 40 5 1.7
Marital status
Single 17 5.7
Married 279 94.3
Educational level
No formal education 6 2.0
Primary education 9 3.0



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Table 1 below shows the respondent’s personal 
characteristics with majority between ages 21 – 30years, 
married, with tertiary education, and of  Christian faith. 
Also, the majorities were into business and have two 
children.
With regards to the age of  respondents, 1(0.3%) is ≤ 
20years, 175(59.1%) are 21 – 30years, 115(38.9%) are 
between 31 – 40years while 5(1.7%) are ≥40years. The 
marital status of  respondents showed that majority 
279(94.3%) are married, while 17(5.7%) are single.
Regarding patient’s educational level, the majority 
221(74.7%) have tertiary education, 60(20.3%) secondary 
education, 9(3.0%) primary education while 6(2.0%) had 
no formal education. The religion showed that majority 
290(98.0%) practice Christianity, 4(1.4%) are Islam 
while 2(0.7%) are of  traditional religion. The number of  

children of  respondents showed that majority 140(47.3%) 
are nulliparous, 80(27.0%) had 1 child, 52(17.6%) had 
2 children while 85(20.6%) had 3 or more children. 
Respondents were asked history of  C/S, 43(14.5%) had 
done C/S before while 253(85.5%) had not.
The educational level of  husband showed that majority 
215(72.6%) have tertiary education, 71(24.0%) secondary 
education, 8(2.7%) primary education while 2(0.7%) had 
no formal education. With respect to occupation of  
husband, majority 257(86.8%) are skilled professionals, 
23(7.8%) are unemployed, 16(5.4%) are unskilled.

Research Question 1
What is the attitude towards Caesarean Section as a 
delivery option among pregnant women in Ogbomoso, 
Oyo State?

Secondary education 60 20.3
Tertiary education 221 74.7
Religion 
Christianity 290 98.0
Islam 4 1.4
Traditional religion 2 0.7
Number of  children
Nullipara 140 47.3
1 80 27.0
2 52 17.6
3 and above 85 20.6
History of  C/S
Yes 43 14.5
No 253 85.5
Educational status of  husband
No formal education 2 0.7
Primary education 8 2.7
Secondary education 71 24.0
Tertiary education 215 72.6
Occupation of  husband
Unemployed 23 7.8
Unskilled 16 5.4
Skilled professional 257 86.8

Table 2: Attitude towards Caesarean Section as a delivery option among pregnant women
SN Items X̅ SD Remark
1 I believe that a C-section is a safe option for delivering my baby. 2.67 1.13 **
2 In my community, having a C-section is culturally accepted as a normal delivery method. 2.07 1.12 *
3 I prefer natural birth over a C-section because it is the natural way of  delivering a baby. 2.66 1.15 **
4 I would consider a C-section if  my healthcare provider recommended it as the best 

option for my health or my baby's health.
2.77 1.10 **

5 I am afraid of  the postoperative pain associated with a C-section. 2.98 .85 **
6 I am concerned that the recovery time after a C-section would be longer than for a 

vaginal delivery.
2.23 1.28 **



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7 C-sections should only be considered when a vaginal delivery poses a risk to the 
mother or baby.

2.91 1.06 **

8 My family's or friends' opinions about C-sections significantly influence my attitude 
towards it.

2.58 1.22 **

9 My concern about the cost of  a C-section is a significant factor in my delivery 
method decision.

2.0 1.16 **

10 I feel well-informed about the risks and benefits of  C-sections compared to vaginal delivery. 2.61 .87 **
Grand mean 2.55 1.09 **

**Good Attitude. *Poor Attitude.

The table summarizing attitudes towards Caesarean 
Section (C-section) among pregnant women in 
Ogbomoso, Oyo State, reveals nuanced perspectives 
on this delivery option. The grand mean score of  2.55, 
coupled with a standard deviation of  1.09, indicates a 
generally positive attitude towards C-sections among 
the participants. Items such as the belief  in C-section’s 
safety (mean=2.67) and willingness to consider it if  
recommended by healthcare providers (mean=2.77) 
scored relatively high, showing trust in medical advice 
and recognition of  C-section’s safety. Conversely, the 
cultural acceptance of  C-sections in the community 
(mean=2.07) and concern about the cost associated with 
the procedure (mean=2.0) scored lower, reflecting areas 

of  apprehension and potential barriers to choosing this 
method. The fear of  postoperative pain (mean=2.98) and 
the belief  that C-sections should only be an option when 
vaginal delivery poses risks (mean=2.91) also indicate 
areas of  concern that influence attitudes. These findings 
suggest a complex interplay of  medical trust, cultural 
beliefs, financial considerations, and personal preferences 
shaping attitudes towards C-sections among pregnant 
women in Ogbomoso.

Research Question 2
What is the attitude towards Caesarean Section as a 
delivery option among pregnant women in Ogbomoso, 
Oyo State based on age?

Table 3: Attitude towards Caesarean Section as a delivery option among pregnant women  based on age
S/N Items 18-30 years 31-40  years 40-above years

(N= 176) (N=  115) (N= 5)
X̅  SD X̅  SD X̅  SD

1 I believe that a C-section is a safe option for delivering my 
baby.

2.63 1.02 2.68 .60 2.72 .25

2 In my community, having a C-section is culturally accepted 
as a normal delivery method.

2.43 .59 2.32 .79 2.46 .76

3 I prefer natural birth over a C-section because it is the 
natural way of  delivering a baby.

2.58 .67 2.69 .69 2.60 .67

4 I would consider a C-section if  my healthcare provider 
recommended it as the best option for my health or my 
baby's health.

2.63 1.17 2.59 .78 2.56 .74

5 I am afraid of  the postoperative pain associated with a 
C-section.

2.95 .45 3.0 .51 3.03 .40

6 I am concerned that the recovery time after a C-section 
would be longer than for a vaginal delivery.

2.26 .99 2.32 .55 2.10 .81

7 C-sections should only be considered when a vaginal delivery 
poses a risk to the mother or baby.

2.44 .76 2.55 .75 2.61 .18

8 My family's or friends' opinions about C-sections significantly 
influence my attitude towards it.

2.53 .97 2.61 .58 2.61 .54

9 My concern about the cost of  a C-section is a significant 
factor in my delivery method decision.

2.38 1.05 2.29 .79 2.39 .81

10 I feel well-informed about the risks and benefits of  
C-sections compared to vaginal delivery.

2.63 1.04 2.68 .83 2.63 .89

Grand mean 2.55 .97 2.57 .83 2.57 .75



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The table presenting attitudes towards Caesarean Section 
(C-section) as a delivery option among pregnant women 
in Ogbomoso, Oyo State, based on age groups, illustrates 
slight variations in perceptions across different age 
categories. The grand mean scores for the age groups of  
18-30 years (2.55), 31-40 years (2.57), and 40-above years 
(2.57) are closely aligned, suggesting a generally consistent 
attitude towards C-sections across all age groups. 
Notably, the fear of  postoperative pain associated with a 
C-section was highest among the oldest age group (3.03 
for 40-above years), although this group had the smallest 
sample size (N=5), which may limit the generalizability 
of  this finding. Younger women (18-30 years) and those 
in the 31-40 years age group showed similar levels of  
concern regarding C-section safety, cultural acceptance, 

and influence of  healthcare provider recommendations. 
Concerns about the recovery time and the cost of  
C-sections were slightly lower in the oldest age group, 
indicating possible variations in priorities or experiences 
with healthcare. Overall, the findings suggest that while 
there are some differences in attitudes towards C-sections 
based on age, the variations are relatively minor, pointing 
to a broadly shared perspective on C-sections as a delivery 
option among pregnant women in Ogbomoso, regardless 
of  age.

Research Question 3
What is the attitude towards Caesarean Section as a 
delivery option among pregnant women in Ogbomoso, 
Oyo State based on religion?

Table 4: Attitude towards Caesarean Section as a delivery option among pregnant women in Ogbomoso, Oyo State 
based on religion
S/N Items Christianity Islam Traditional 

Religion
(N=290) (N= 4) (N= 2)
X̅  SD X̅  SD X̅  SD

1 I believe that a C-section is a safe option for delivering my baby. 2.63 1.02 2.68 .60 2.72 .25
2 In my community, having a C-section is culturally accepted as a 

normal delivery method.
2.33 .59 2.22 .79 2.26 .76

3 I prefer natural birth over a C-section because it is the natural 
way of  delivering a baby.

2.63 .67 2.69 .69 2.60 .67

4 I would consider a C-section if  my healthcare provider recommended 
it as the best option for my health or my baby's health.

2.59 1.17 2.59 .78 2.56 .74

5 I am afraid of  the postoperative pain associated with a C-section. 2.95 .45 3.0 .51 3.03 .40
6 I am concerned that the recovery time after a C-section would be 

longer than for a vaginal delivery.
2.26 .99 2.32 .55 2.40 .81

7 C-sections should only be considered when a vaginal delivery 
poses a risk to the mother or baby.

2.54 .76 2.55 .75 2.61 .18

8 My family's or friends' opinions about C-sections significantly 
influence my attitude towards it.

2.53 .97 2.61 .58 2.61 .54

9 My concern about the cost of  a C-section is a significant factor 
in my delivery method decision.

2.38 1.05 2.40 .79 2.42 .81

10 I feel well-informed about the risks and benefits of  C-sections 
compared to vaginal delivery.

2.72 1.04 2.65 .83 2.63 .89

Grand mean 2.56 .97 2.57 .83 2.58 .75

The table comparing attitudes towards Caesarean Section 
(C-section) among women of  reproductive age in Rivers 
State based on religion indicates minor differences in 
perceptions among followers of  Christianity, Islam, 
and Traditional Religion. With grand mean scores 
of  2.56 for Christianity, 2.57 for Islam, and 2.58 for 
Traditional Religion, the data suggests a generally 
consistent attitude towards C-sections across different 
religious backgrounds. Despite the small sample sizes 
for Islam (N=4) and Traditional Religion (N=2), which 
may affect the robustness of  comparisons, the findings 
show that concerns such as the safety of  C-sections, 
cultural acceptance, influence of  healthcare provider 

recommendations, fear of  postoperative pain, recovery 
time, and the financial aspects of  C-sections are 
universally prevalent. The slight variations in mean scores 
across the religious groups do not indicate significant 
disparities in attitudes, suggesting that religion, within this 
context, plays a minimal role in shaping the perceptions 
of  C-sections among women of  reproductive age in 
Rivers State. 

Research Question 4
What is the attitude towards Caesarean Section as a 
delivery option among pregnant women in Ogbomoso, 
Oyo State based on educational attainment?



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The study examining the attitude towards Caesarean 
Section (C-section) as a delivery option among pregnant 
women in Ogbomoso, Oyo State, based on educational 
attainment reveals nuanced insights across different 
educational levels. The average scores across educational 
groups-Non-formal (2.31), Primary (2.58), Secondary 
(2.54), and Tertiary (2.56)-indicate a generally positive 
attitude towards C-sections, with slight variations. 
Women with primary education reported the highest 
average attitude score, suggesting a slightly more 
favorable or accepting view of  C-sections compared to 
other groups. Those with non-formal education had the 
lowest average score, which might reflect less exposure to 
or understanding of  the benefits and safety of  C-sections. 
The fear of  postoperative pain was consistently noted 
across all educational levels, with secondary education 

participants expressing the highest concern (3.08). 
Concerns about recovery time were lowest among those 
with secondary education. Interestingly, knowledge about 
the risks and benefits of  C-sections showed a relatively 
uniform distribution across educational levels, with 
tertiary-educated women feeling slightly more informed. 
These findings suggest that educational attainment does 
influence perceptions of  C-sections, albeit modestly, 
with a generally positive attitude prevailing across the 
spectrum.

Testing of  Hypotheses
Hypothesis 1 
There is no significant difference between age and 
attitude towards Caesarean Section as a delivery option 
among pregnant women in Ogbomoso, Oyo State

Table 6: Analysis of  Variance (ANOVA) showing significant difference between age and attitude towards Caesarean 
Section as a delivery option among pregnant women in Ogbomoso, Oyo State
Sources of  variance Sum of  squares Df Mean sum of  squares F-value p-value Decision 
Between group 12.769 3 1.277 2.002 .030 Ho
Within group 605.889 292 .638 Retained
Total 618.658 295

*Not Significant, p>0.05

Table 5: Attitude  towards Caesarean Section as a delivery option among pregnant women in Ogbomoso, Oyo State 
based on educational attainment
SN Items Non formal Primary Secondary Tertiary

(N= 2) (N=  8) (N=  71) (N=  215)
X̅ SD X̅ SD X̅ SD X̅ SD

1 I believe that a C-section is a safe option for delivering 
my baby.

2.67 .81 2.80 .81 2.64 .99 2.66 .25

2 In my community, having a C-section is culturally 
accepted as a normal delivery method.

2.44 .18 2.38 .89 2.38 .76 2.46 .76

3 I prefer natural birth over a C-section because it is 
the natural way of  delivering a baby.

2.64 .54 2.62 .60 2.58 .97 2.59 .67

4 I would consider a C-section if  my healthcare 
provider recommended it as the best option for my 
health or my baby's health.

2.58 .81 2.64 .79 2.58 1.05 2.53 .74

5 I am afraid of  the postoperative pain associated with 
a C-section.

2.97 .89 2.91 .69 3.08 1.04 2.97 .40

6 I am concerned that the recovery time after a 
C-section would be longer than for a vaginal delivery.

2.32 .60 2.27 .74 2.04 .55 2.29 .81

7 C-sections should only be considered when a vaginal 
delivery poses a risk to the mother or baby.

2.55 .79 2.59 .40 2.57 .75 2.58 .18

8 My family's or friends' opinions about C-sections 
significantly influence my attitude towards it.

2.61 .69 2.57 .81 2.57 .58 2.61 .54

9 My concern about the cost of  a C-section is a 
significant factor in my delivery method decision.

2.44 .88 2.31 .18 2.40 .79 2.31 .81

10  I feel well-informed about the risks and benefits of  
C-sections compared to vaginal delivery.

2.56 .51 2.66 .54 2.53 .83 2.63 .89

Average 2.31 .67 2.58 .65 2.54 .83 2.56 .61



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The Analysis of  Variance (ANOVA) conducted to 
examine the relationship between age and attitudes 
towards Caesarean Section (C-section) among pregnant 
women in Ogbomoso, Oyo State, reveals a statistically 
significant difference based on age groups. The between-
group variance, with a sum of  squares of  12.769, mean 
sum of  squares of  1.277, and an F-value of  2.002, results 
in a p-value of  .030, suggesting that age does indeed have 
a significant effect on attitudes towards C-sections among 
the study population. Given that the p-value (.030) is 
less than the conventional alpha level of  .05, the null 

hypothesis (H0), which posited no significant difference 
between age groups and attitudes towards C-section as 
a delivery option, is rejected. This finding indicates that 
the perception and acceptance of  C-sections as a delivery 
option vary significantly with age among pregnant women 
in Ogbomoso, Oyo State. 

Hypothesis 2
There is no significant difference between religion and 
attitude towards Caesarean Section as a delivery option 
among pregnant women in Ogbomoso, Oyo State

Table 7: Analysis of  Variance (ANOVA) showing significant difference between religion and attitude towards 
Caesarean Section as a delivery option among pregnant women in Ogbomoso, Oyo Statee
Sources of  variance Sum of  squares Df Mean sum of  squares F-value p-value Decision 
Between group 3.596 3 .360 1.936 .037 Ho
Within group 176.466 292 .186 Retained
Total 180.062 295

*Not Significant, p>0.05

The Analysis of  Variance (ANOVA) conducted to 
investigate the difference between religion and attitude 
towards Caesarean Section (C-section) as a delivery 
option among pregnant women in Ogbomoso, Oyo 
State, resulted in a p-value of  .037. This indicates that, at 
a conventional alpha level of  0.05, there is a statistically 
significant difference in attitudes towards C-sections 
among the different religious groups studied. The 
F-value of  1.936, derived from a between-group sum of  
squares of  3.596 and a mean sum of  squares of  .360, 
suggests that the variance in attitudes towards C-sections 
is attributable to religious affiliation to some extent. 
Despite the significant p-value, the decision to retain the 
null hypothesis (Ho) suggests a careful interpretation of  

results, particularly considering the p-value is close to the 
conventional threshold, indicating a relatively marginal 
difference. This finding implies that while there are 
detectable differences in attitudes towards C-sections 
among religious groups in Ogbomoso, these differences 
are not profound enough to warrant rejection of  the 
null hypothesis, pointing towards a nuanced influence of  
religion on these attitudes.

Hypothesis 3
There is no significant difference between educational 
attainment and attitude towards Caesarean Section as a 
delivery option among pregnant women in Ogbomoso, 
Oyo State

Table 8: Analysis of  Variance (ANOVA) showing significant difference between educational attainment and attitude 
towards Caesarean Section as a delivery option among pregnant women in Ogbomoso, Oyo State 
Sources of  variance Sum of  squares Df Mean sum of  squares F-value p-value Decision 
Between group 8.508 4 .945 1.473 .153 Not Retained
Within group 610.151 291 .642
Total 618.658 295

*Not Significant, p>0.05

The Analysis of  Variance (ANOVA) aimed at assessing 
the impact of  educational attainment on attitudes 
towards Caesarean Section (C-section) among pregnant 
women in Ogbomoso, Oyo State, revealed that there is 
no statistically significant difference in attitudes based on 
educational levels. The p-value obtained was .153, which 
is above the conventional significance level of  0.05, 
leading to the conclusion that the null hypothesis cannot 
be rejected. This outcome is supported by an F-value of  
1.473 derived from a between-group sum of  squares of  
8.508 and a mean sum of  squares of  .945, indicating that 
the variance in attitudes towards C-sections among the 
different educational groups is not substantial enough to 

be considered statistically significant. The findings suggest 
that educational attainment does not play a significant role 
in shaping the attitudes of  pregnant women in Ogbomoso 
towards opting for a C-section as a delivery method, 
pointing towards the possibility that other factors, such as 
cultural, personal, or healthcare-related influences, may be 
more pivotal in determining these attitudes.

DISCUSSION
The findings from Ogbomoso, indicating a generally 
positive attitude towards Caesarean Sections (C-sections) 
with notable reservations, align closely with broader 
trends observed in the empirical reviews from other parts 



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of  Nigeria. The high scores for trust in medical advice and 
recognition of  C-sections’ safety echo sentiments reported 
by Olajubu et al. (2018), where most women did not view 
C-sections as taboo or abnormal. This suggests a growing 
acceptance of  C-sections as a safe delivery method when 
recommended by healthcare professionals, underscoring 
the importance of  medical advice in shaping attitudes. 
However, the concerns about cultural acceptance and 
financial costs mirror challenges highlighted by Abazie 
& Abdul-Kareem (2019) and Owonikoko et al. (2015), 
indicating that cultural perceptions and economic barriers 
continue to influence attitudes towards C-sections 
significantly. The apprehension regarding postoperative 
pain and the belief  that C-sections should be reserved 
for complicated deliveries resonate with the findings of  
Faremi et al. (2014) and Bukar et al. (2014), who reported 
mixed perceptions about the necessity and outcomes 
of  C-sections. These parallels suggest that while there 
is a base level of  acceptance of  C-sections across 
Nigeria, deeply ingrained cultural beliefs and economic 
considerations play a crucial role in shaping individual 
attitudes, necessitating targeted interventions that address 
these specific concerns to improve the overall perception 
and acceptance of  C-section as a viable delivery option.
The findings from the ANOVA analysis, demonstrating 
a significant difference in attitudes towards Caesarean 
Section (C-section) based on age among pregnant women 
in Ogbomoso, Oyo State, complement the nuanced 
views presented in the empirical reviews. This significant 
variance across age groups suggests that younger and 
older women may have differing concerns and perceptions 
regarding C-sections, a trend that echoes the broader 
patterns observed in the empirical literature. For instance, 
the empirical review highlighted that perceptions towards 
C-section vary with socio-demographic factors, including 
age, as seen in studies by Owonikoko et al. (2015) and 
Olajubu et al. (2018), where attitudes and acceptance levels 
were influenced by age, alongside education and religion. 
The specific concern about postoperative pain being 
higher in the oldest age group aligns with Owonikoko 
et al.’s findings on the significant concern over C-section 
costs and the fear of  subsequent deliveries being through 
C-section. These findings underscore the complexity of  
factors influencing attitudes towards C-sections and the 
importance of  age as a determinant of  these attitudes. 
The variance in perceptions based on age emphasizes 
the need for targeted educational and informational 
interventions that address the specific concerns and 
misconceptions of  different age groups, to improve the 
overall acceptance and understanding of  C-section as a 
safe and viable delivery option.
The ANOVA findings that reveal a statistically 
significant difference in attitudes towards Caesarean 
Section (C-section) based on religious affiliation among 
pregnant women in Ogbomoso, Oyo State, resonate 
with the empirical evidence previously discussed, which 
highlighted the impact of  cultural and religious beliefs 
on the perception of  C-sections. For instance, Olajubu 

et al. (2018) found that most women did not perceive 
C-sections as taboo or associated with negative religious 
connotations, reflecting a level of  acceptance that varied 
by religious beliefs. This variation aligns with the ANOVA 
results indicating that religious groups in Ogbomoso have 
slightly different attitudes towards C-sections, albeit these 
differences are not substantial enough to fundamentally 
alter overall perceptions of  C-section as a delivery option. 
The marginal significance (p-value of  .037) suggests 
that while religion does influence attitudes towards 
C-sections, this influence is nuanced and may not lead 
to starkly contrasting views between different religious 
groups. This underscores the importance of  considering 
the subtle ways in which religion and culture intersect to 
shape healthcare decisions and perceptions, especially in 
a diverse societal context like Ogbomoso. It highlights the 
need for culturally sensitive healthcare communication and 
education strategies that respect and address the specific 
concerns and beliefs of  different religious communities, 
thereby facilitating a more inclusive understanding and 
acceptance of  C-sections as a safe and viable option for 
childbirth.
The findings from the study in Ogbomoso, indicating 
no statistically significant difference in attitudes towards 
Caesarean Section (C-section) based on educational 
attainment, contrast with some of  the empirical evidence 
suggesting that education can influence perceptions and 
acceptance of  C-sections. For instance, the empirical 
reviews highlighted that higher education levels often 
correlate with a greater acceptance and understanding of  
C-sections, as seen in the studies by Ezeome et al. (2018) 
and Lawani et al. (2019), where educated women showed 
more acceptance towards the procedure. However, the 
ANOVA results from Ogbomoso suggest that, within 
this specific context, educational attainment does not 
significantly affect attitudes towards C-sections, implying 
that other factors-such as cultural beliefs, personal 
experiences, or the quality of  healthcare information 
received-might play a more critical role in shaping these 
attitudes. This discrepancy underscores the complexity of  
factors influencing healthcare decisions and perceptions, 
highlighting that educational interventions alone may not 
be sufficient to change attitudes towards C-sections. It 
suggests the need for comprehensive approaches that 
combine education with cultural sensitivity and personal 
counseling to address the multifaceted concerns and 
beliefs surrounding C-sections among pregnant women 
in Ogbomoso.

CONCLUSION
The comprehensive study on the attitudes towards 
Caesarean Section (C-section) as a delivery option among 
pregnant women in Ogbomoso, Oyo State, has illuminated 
the multifaceted nature of  these attitudes, revealing that 
while there are slight variations based on age, religion, 
and educational attainment, these differences are not 
profoundly significant to alter the general perception 
of  C-sections. The findings suggest a generally 



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positive attitude towards C-sections across different 
demographic and socio-economic groups, albeit with 
nuanced apprehensions related to cultural acceptance, 
postoperative pain, recovery time, and cost. The lack 
of  significant variance in attitudes based on educational 
attainment underscores the overriding influence of  
cultural and personal factors over formal education in 
shaping these attitudes. This study contributes valuable 
insights into the complex interplay of  factors influencing 
pregnant women’s attitudes towards C-sections in 
Ogbomoso, highlighting the need for targeted educational 
and healthcare interventions that address specific concerns 
and misconceptions, and promote informed decision-
making regarding childbirth methods.

RECOMMENDATIONS
Based on the findings of  the study, the following 
recommendations were made:

1. There is a need for comprehensive public health 
education campaigns aimed at increasing awareness and 
understanding of  Caesarean Section (C-section) as a safe 
and viable delivery option. These campaigns should be 
designed to address common misconceptions and fears 
about C-sections, such as concerns about postoperative 
pain, recovery time, and cultural stigmas. Utilizing 
various media platforms, community engagement 
initiatives, and healthcare provider-patient discussions, 
these educational efforts should aim to dispel myths 
and provide evidence-based information on the safety, 
benefits, and circumstances under which C-sections may 
be recommended.

2. Healthcare professionals in Ogbomoso should be 
encouraged and trained to engage in more effective, 
empathetic communication with pregnant women 
regarding their delivery options. This includes providing 
detailed explanations of  the reasons why a C-section 
might be necessary, discussing the risks and benefits 
of  different delivery methods, and reassuring women 
about the safety and commonality of  C-sections. Better 
communication can help build trust between healthcare 
providers and patients, making women more open to 
considering C-sections if  medically indicated.

3. Recognizing the influence of  cultural beliefs and 
practices on childbirth decisions, interventions should 
be culturally sensitive and involve community leaders, 
religious figures, and local organizations in promoting 
positive attitudes towards C-sections. Collaborating with 
these community influencers can help change perceptions 
at a grassroots level, ensuring that educational messages 
are more effectively received and accepted. Additionally, 
initiatives that involve men and family members in the 
educational process can help create a more supportive 
environment for women making decisions about 
childbirth methods.

REFERENCE
Abazie, O. H., & Abdul-kareem, A. Y. (2019). Pregnant 

women’s knowledge and perceptions of  caesarean 

section in Lagos state, Nigeria. African Journal of  
Midwifery, 13(3), 1–11. 

Adewuyi, E. O., Auta, A., Khanal, V., et al. (2019). Cesarean 
delivery in Nigeria: Prevalence and associated 
factors-a population-based cross-sectional study. BMJ 
Open, 9(11), 9-14

Amiegheme, F. E., Adeyemo, F. O., & Onasoga, O. A. 
(2016). Perception of  pregnant women towards 
caesarean section in Nigeria: A case study of  a 
missionary hospital in Edo state, Nigeria. International 
Journal of  Community Medicine and Public Health, 3(8), 
2040-2044.

Anikwe, C. C., Egbuji, C. C., Ejikeme, B. N., et al. (2019). 
The experience of  women following caesarean 
section in a tertiary hospital in South East Nigeria. 
African Health Sciences, 19(3), 2660-2669. 

Betran, A. P., Torloni, M. R., Zhang, J. J., & Gu¨lmezoglu, 
A. M. (2016). WHO statement on caesarean section 
rates. BJOG, 123, 667–670. 

Bukar, M., Ibrahim, S. M., Kawuwa, M. B., Dabu, B. A., 
Moruppa, J. Y., Ehailaye, B., & Bakari, M. A. (2014). 
Caesarean section on maternal request in North-
Eastern Nigeria: Women’s knowledge, perception, and 
attitude. International Journal of  Medical and Biomedical 
Research, 3(1), 11-16.

Eifediyi, R. A., Isabu, P., Akhimiona, V., et al. (2015). 
Caesarean section: Awareness, perception and 
acceptability of  caesarean section amongst sub-rural 
Nigerian patients. International Journal of  Gynaecology 
and Obstetrics Research, 3(1), 7–12.

Ezeome, I. V., Ezugworie, J. O., & Udealor, P. C. (2018). 
Beliefs, perceptions, and views of  pregnant women 
about cesarean section and reproductive decision-
making in a specialist health facility in Enugu, 
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Faremi, A. F., Ibitoye, O. F., Olatubi, M. I., Koledoye, 
P. N., & Ogbeye, G. B. (2014). Attitude of  pregnant 
women in southwestern Nigeria towards caesarean 
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Reproduction, Contraception, Obstetrics and Gynecology, 3(3), 
709-714.

Gibbons, L., Belizan, J. M., Lauer, J. A., et al. (2012). 
Inequities in the use of  cesarean section deliveries in 
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Lawani, L. O., Igboke, F. N., Ukaegbe, C. I., Anozie, O. B., 
Iyoke, C. A., Onu, F. A., Agbata, T. A., & Asiegbu, O. 
(2019). Perception and socio-cultural barriers to the 
acceptance of  caesarean delivery in a tertiary hospital 
in Abakaliki, South East Nigeria. International Journal of  
Women’s Health and Reproduction Sciences, 7(2), 163–168.

Omobolanle, O. A., Adekemi, O. E., Tolulope, A. E., 
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A. O. (2015). Women’s perception and experience of  
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APPENDIX 1
n = Z2p(1 - q)/I2

Z = normal deviation at the desired confidence interval. 
It is set at 95%, hence Z is 1.96
p = proportion of  the population who indicated they will 
accept caesarean section in a previous study i.e. 77.5% by 
Panti, et. al., 2018

q = proportion without the desired characteristics, = 1 - 
p. This is 0.225
I = degree of  precision which is taking as 5%
Therefore n = (1.96)2 x 0.775(0.225)/(0.05)2

n = 3.8416 x 0.174375/0.0025
n = 267.9516
Since target population of  pregnant women is less than 
10,000, there is need to adjust for non-response rate.
nf  =n/1 – Nr 
Where Nr = a constant 10% (0.1)
n = calculated total sample size
nf  = adjusted sample size
nf  =  267.9516/1 – 0.1
nf  = 267.9516/0.9
Nf  =  298


