title: Evaluation of parturient perception and aversion before and after primary cesarean delivery in a low-resource country.
abstract: OBJECTIVE
  To determine the perception of and aversion to cesarean delivery (CD) and their determinants before and after primary CD.
  
  
  METHODS
  A prospective cross-sectional survey of pregnant women undergoing primary CD (elective or emergency) was conducted in six health facilities in Ilorin, Nigeria. All participants completed an interviewer-administered questionnaire before the operation and 3-4days thereafter. The statistical analysis included the calculation of odds ratios (ORs) with 95% confidence intervals (CIs) and a logistic regression.
  
  
  RESULTS
  Of the 254 participants, 182 (71.7%) and 53 (20.9%) had an aversion to CD before and after the procedure, respectively. A woman's personal decision was the overriding factor influencing acceptance of the operation. Preoperative predictors of aversion were prenatal admission (OR 2.86 [95% CI,1.07-7.66]; P=0.030) and a history of previous surgery (OR 0.42 [95% CI, 0.24-0.75]; P=0.003), whereas postoperatively a low number of prenatal clinic visits (less than four; OR 3.05 [95% CI,1.63-5.69]; P=0.001) and a history of previous surgery (OR 0.51 [95% CI, 0.27-0.96]; P=0.034) were significant. Postprocedure, 164 (64.6%) women said they would accept a repeat CD.
  
  
  CONCLUSIONS
  Patient education, prenatal care, and previous surgical experiences were important in determining women's perception of and aversion to CD.
authors.affiliation: Department of Obstetrics & Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria. Electronic address: acrowncord@hotmail.com.
authors.forename: Abiodun S
authors.initials: AS
authors.lastname: Adeniran
authors.affiliation: Department of Obstetrics & Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria; Royal Care Hospital, Ilorin, Nigeria.
authors.forename: Abiodun P
authors.initials: AP
authors.lastname: Aboyeji
authors.affiliation: Department of Obstetrics & Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria; Anchormed Hospital, Ilorin, Nigeria.
authors.forename: Adegboyega A
authors.initials: AA
authors.lastname: Fawole
authors.affiliation: Department of Obstetrics & Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria; Surulere Medical Centre, Ilorin, Nigeria.
authors.forename: Olayinka R
authors.initials: OR
authors.lastname: Balogun
authors.affiliation: Department of Obstetrics & Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Kikelomo T
authors.initials: KT
authors.lastname: Adesina
authors.affiliation: Kwara State Specialist Hospital, Ilorin, Nigeria.
authors.forename: Salamat
authors.initials: S
authors.lastname: Isiaka-Lawal
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D009549:Nigeria; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010465:Perception; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D011295:Prenatal Care / Q000523:psychology; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Aversion; Cesarean delivery; Delivery; Low-resource country; Parturient; Perception