Preferred mode of delivery and its determinants among nulliparous women attending antenatal clinic in a secondary health facility in south-south Nigeria

Abstract

Background: Multiparous women’s preferred mode of delivery is partly influenced by their experiences in their previous deliveries. For the nulliparous women, the possible influencers of their preferred mode of delivery could be multifactorial including narrations from multiparous women regarding their experiences in previous deliveries.

Objective: The aim of the study was to evaluate the preferred mode of delivery and its determinants among nulliparous women attending Antenatal clinic (ANC) in a secondary health facility in south-south Nigeria.

Materials and methods: This was a cross sectional study conducted at the antenatal clinic of Central Hospital Agbor, Delta state, Nigeria. A total of 221 consecutive consenting nulliparous women who came for ANC registration were recruited for the study after obtaining their informed written consent. Questionnaire was used to seek for their sociodemographic characteristics, their preferred mode of delivery and possible influencers of their decision.

Results: The preference for vaginal delivery (VD) was 70.6% while 5.4% preferred Caesarean section (CS). Twenty four percent (24.0%) had no preference and will accept CS if advised by the Doctor. Factors significantly associated with preference for CS were advanced maternal age, occupation and a previous history of miscarriage. Reasons given by women for preferring VD were to experience labour, avoid CS pain, fear of death, avoid CS scar and delayed recovery while those who preferred CS cited advanced maternal age, to avoid labour pain, for the safety of baby and mother and to avoid multiple vaginal examinations and episiotomy.

Conclusion: The preference for CS was 5.4% while 24.0% had no preference and would accept CS following Doctors advice despite the policy of free maternity care. There is the need to address non-cost barriers through ANC health education to improve acceptance of CS