Journal of Medical Sciences and Health

Socio-Demographic Information

This provides a comprehensive overview of the demographic characteristics of the 203 participants in our research study focusing on perceptions among pregnant women towards Caesarean section at Tamale Teaching Hospital in the Northern Region of Ghana. In terms of age distribution, the majority of participants fall within 31-35 age range, with 50% aged 26-30 and 49% aged 21-25. Women below 20 and those aged 41 and above represent smaller percentages, at 20% and 9%, respectively.

Religious diversity is evident among the participants, with Islam being the dominant religion, representing 72.9% of respondents, followed by Christianity at 25.6%. A small percentage, 1.5%, ascribes to traditional beliefs.

Marital status reveals that the majority of participants are married (84.7%), while 13.8% are single, and 1.5% is divorced.

Parity, or the number of previous pregnancies, varies among participants, with 28.1% having four or more previous pregnancies. The largest group is those with 2 previous pregnancies (24.1%), followed by those with 3 previous pregnancies (17.2%).

Ethnicity reflects the diverse composition of the Northern Region, with the Dagomba ethnic group being the most prevalent (68.0%), followed by Akan (16.3%), Hausa (8.4%), and smaller groups like Fulani and Frafra.

Participants' level of education ranges from primary education (6.4%) to tertiary education (32.0%), with 24.6% having no formal education. The occupational distribution shows that 36.5% are self-employed, 22.7% are employed, 21.7% are unemployed, and smaller percentages are housewives (8.9%) and students (10.3%).

The diverse demographic profile of participants used in this study provides valuable context for understanding the multifaceted factors that influence pregnant women's attitudes and perceptions regarding Caesarean sections in TTH. These demographic variables are also essential for interpreting and contextualizing the research findings.

Perceptions of Pregnant Women Towards CS:

Table 1 provides offers a comprehensive overview of respondents' attitudes and beliefs regarding Caesarean sections (CS), particularly focusing on negative perceptions and misconceptions surrounding this medical procedure. These findings shed light on the diverse range of opinions within the surveyed group.

In the first statement, "CS is an abomination," it becomes evident that a significant majority of respondents, 75.9% (154 individuals), disagree or strongly disagree with this notion. However, there is a notable minority, 18.2% (37 respondents), who express agreement or strong agreement with the belief that CS is an abomination, while 5.9% (12 respondents) remain neutral.

Moving to the second statement, "CS-delivered mothers have a tag 'not a real woman,'" the data reveals that the majority, 76.3% (155 respondents), disagree or strongly disagree with this stigmatizing belief. However, 21.6% (44 respondents) express agreement or strong agreement with this perception, indicating that a considerable portion of respondents associates a negative label with mothers who have undergone CS. Only 2.0% (4 respondents) remain neutral.

The third statement, "CS increases maternal foetal mortality," highlights a misconception. A majority, 71.0% (144 respondents), disagree or strongly disagree with this false belief. Nevertheless, a significant minority 24.7% (50 respondents), express agreement or strong agreement with this misconception, while 4.4% (9 respondents) remain neutral.

The fourth statement, "CS is associated with complications," shows that 63.1% (128 respondents) agree or strongly agree that CS is linked to complications. On the other hand, 15.3% (31 respondents) disagree or strongly disagree, and 21.7% (44 respondents) remain neutral.

In the fifth statement, "CS is a sign of reproductive failure," the majority, 74.3% (151 respondents), disagree or strongly disagree with the belief that CS signifies reproductive failure. However, 20.7% (42 respondents) express agreement or strong agreement with this notion, while 4.9% (10 respondents) remain neutral.

The final statement, "After having CS, women can never deliver vaginally," reveals that the majority, 73.3% (169 respondents), disagree or strongly disagree with the misconception that women who have had CS can never deliver vaginally. Conversely, only 7.3% (15 respondents) express agreement or strong agreement with this misconception, while 9.4% (19 respondents) remain neutral.

Figure 1 below shows how women who have underdone CS are viewed.

Association Between Respondents’ Characteristics and Knowledge on Caesarean Section:

Table 3 shows the association of each variable to the dependent variable. The multivariate regression analysis shows a significant relationship between the dependent variable and corresponding independent variables, F (3,198) (AOR) =0.033 p<0.05.This indicates that marital status, parity and level of education play a significant role in the knowledge levels of women undertaking caesarean section (b = 1.08 p-value < .001) delivery where P>0.05.

Determinants of Pregnant Women Towards CS:

The data was structured into several statements or beliefs about CS, and respondents' responses are categorized as strongly agree or agree (SA/A), strongly disagree or disagree (SD/D), and neutral (N). Each statement's mean score and standard deviation are also provided, offering valuable insights into the level of consensus and variability among the surveyed women.

One notable finding from the data is that a substantial proportion of respondents expressed negative views regarding CS. For instance, 18.2% of respondents indicated agreement with the statement that "CS is an abomination," with a mean score of 2.76. Similarly, 21.6% of participants agreed with the statement that "CS-delivered mothers have a tag ‘not a real woman’," with a mean score of 2.63. These findings suggest that a significant portion of the surveyed women hold unfavorable perceptions of CS, highlighting potential misconceptions or stigma associated with this medical procedure.

On the contrary, there were statements with a higher level of agreement among respondents. For instance, a substantial 63.1% of participants expressed agreement with the statement that "CS is associated with complications," and the mean score for this statement was 3.57, indicating a relatively high level of agreement. This finding suggests that a majority of respondents hold the belief that CS is linked to medical complications, signifying a common perception among the surveyed women.

Another noteworthy observation is the variability in responses. For example, while 7.3% of respondents agreed with the statement that "After having CS, women can never deliver vaginally," those who disagreed or were neutral made up a significant portion of the sample. The mean score for this statement was 3.00, indicating a relatively high level of agreement among those who agreed, but the standard deviation of 0.847 suggests that there is still notable variability in this perception. Gauging from the grand mean averages in Table 1, it can be realized that the individual mean of this statement is far greater than the GMA which concludes that the majority of respondents do agree that women can deliver vaginally even after undergoing CS and this shows a positive perception towards the surgical procedure. The findings in this study corroborate with research findings conducted in the Obstetrics Unit at the Korle-Bu Teaching Hospital where respondents showed a positive degree of perception towards CS.

7 Argue that sometimes doctors advise CS depending on convenience, schedule, or concern about litigation should issues arise.8 Opined that higher demand for elective CS results from some societies' view of CS as a modern and safer delivery technique. On the other hand, because of conventional ideas about natural childbirth, vaginal birth is highly favoured in other societies. Pre-existing maternal health issues include diabetes, hypertension, or past uterine surgeries can call for CS for the safety of mother and child 9. Complications including foetal pain, aberrant placement (such as breech presentation), or multiple pregnancies (such twins or triplets) raise the risk of CS 10.

Factors That Influence the Perception of Women About CS:

Majority of respondents had a good perception about CS as respondents agreed that even there are complications associated with the surgical procedure (63.1%), one can still deliver vaginally after undergoing CS (73.3%). Both variable items also recorded a mean greater than the GMA. The regression analysis conducted revealed that knowledge about the procedure shaped respondent’s perception about CS AOR=0.23 (CL=95%) p<0.001. This shows that knowledge significantly affects perceptions as one of the major factors. The knowledge could have been gained at school, antenatal visits where women are educated on the birthing process and medical options available. It could also have come about through the media where health talks are held regularly to sensitize the general public about medical procedures. Previous CS was also a factor identified that influences perceptions about CS. The current study findings corroborate with previous research conducted where a previous experience of CS was significantly associated with pregnant women’s knowledge on CS. They stated that pre-operation preparations for CS played a key role in women knowledge level the procedure 11.

Women can be deterred from entering the technology industry by society preconceptions that view CS as a field dominated by men. Media, family, and the classroom help to reinforce these preconceptions.12 Underline how cultural preconceptions about who belongs in CS produce a "masculine" image of the profession, therefore reducing women's interest and self-efficacy. Even if women have aptitude for computer science, the belief that it is not a "feminine" area can discourage them from investigating it. To challenge these preconceptions, CS has to be rebranded as inclusive and diverse. Women's impressions of the discipline might be much influenced by early exposure to CS ideas and favourable learning environments. Many women, meanwhile, say they feel lonely or unsupported in CS classrooms. Women who attended coding camps or had access to CS classes in high school were more likely, according to 13, to view CS as a career path. Including CS into K–12 courses and designing encouraging learning settings would help to normalise women's involvement in the sector and lower isolation levels.

One major obstacle is the belief of CS as a hostile or unwelcome surroundings for women. Typical reported problems are gender bias, unequal opportunity, and a lack of work-life balance.14 Explore how women's marginalisation in tech's workplace culture frequently results in lower retention rates and job satisfaction. Changing views and keeping women in CS professions depend on policies that support diversity, equity, and inclusion (DEI) thereby addressing workplace culture. Media and popular culture's representation of women sometimes supports preconceptions about CS being a field dominated by males. Accurate and positive depictions of women in technology will help change impressions. Media portrayals of women in STEM raised girls' desire in following STEM professions, according to 15. Media campaigns, films, and TV shows including women in CS roles can help to normalise the concept of women as technologists and inventors.