| dc.description.abstract | Introduction; Uganda witnessed an increase in caesarean sections, as a mode of delivery, from 3% 2006 to 28% in 2016. This increase is attributed to elective C-sections, although available data does not disaggregate which percentage is by elective caesarean section (ECS). Current trends in utilisation of ECS do not show pregnant women’s knowledge, attitudes and practices towards it. In addition, majority of the existing research has been conducted in urban health centres less accessed by pregnant women living in rural areas. The research was carried out in Nakaseke, one of Uganda’s rural districts. Objectives: To determine pregnant women’s antenatal and birth experiences; to assess the awareness of pregnant women about elective caesarean section; to identify the attitudes of pregnant women towards elective caesarean section and ascertain the practice of elective caesarean section. Methods: The study employed a cross-sectional design using mixed methods. Quantitative data was collected using questionnaires, while qualitative used interview guides for key informants and other participants including pregnant women. FGDs were also conducted using FGD guides. Sample size consisted of 136 respondents, 100 of which were pregnant women attending antenatal at Nakaseke hospital while 36 were qualitative that included health workers, husbands of pregnant women, village health teams, local leaders, a traditional birth attendant, the district health team (DHT) and community members. For quantitative data, validation, editing, coding, entry and analysis was done using SPSS. For descriptive statistics tables, percentages and frequencies were used to interpret and present the data. Qualitative data was audio recorded, transcribed and thematically analysed. Themes were generated through coding and in relation to study objectives. Key Findings: A large proportion (64%) of pregnant women had ever heard of ECS as a mode of delivery and were not aware of it being an option to vaginal delivery. A few of them (10%) would consider having it. Determinants for potential use of ECS include previous birth experience, fear of labour pains and safety of the baby. Majority (90%) would not consider having ECS due to fear of being cut, longer stay in hospital, permanent damage and the procedure being perceived as unnatural. This study established that elective caesarean practice is not common in Nakaseke, although a few expectant mothers utilize it. Conclusion and Recommendations: Pregnant women are aware of elective caesarean; however, their preferred mode of the delivery is vaginal delivery. The study recommends that women should be included in decision making and equipped with information about the different modes of delivery. Service providers should recommend C-section for some medically-recommended cases like HIV positive mothers and “precious” babies | en_US |
