Adequacy of maternal counseling for caesarean section in teaching hospitals in Enugu state, south-East Nigeria: A cross-sectional study.

Abstract

Objective: This study assesses the process and adequacy of informed consent for elective and emergency caesarean section in two teaching hospitals in Enugu, South-East Nigeria.

Methods: This was a descriptive cross-sectional study. Pre-tested questionnaires were administered to consenting 386 mothers after caesarean sections at the postnatal wards of University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, and Enugu State University Teaching Hospital (ESUTH), Enugu. The adequacy of maternal counseling was assessed by evaluating the basics of the consent process for caesarean section. Descriptive statistics, including counts and percentages, were used to summarize the data, and 95% confidence intervals (CIs) were calculated to assess the precision of the estimates using the IBM Statistical Product and Service Solutions (IBM-SPSS) Statistics for Windows, version 25.

Results: Of the 386 respondents, the majority (29.8%) were in the 31-35 age group and most of the respondents (56.7%) had tertiary level of education. The proportion of women who received adequate counseling for caesarean section was 41.7%. The prevalence of adequate informed consent among women who had elective versus emergency caesarean section was 67.9% and 39.9%, respectively, (OR = 3.2, CI 95% [2.40-4.28]). Only 20.2% (78) of the respondents had full documentation of the consent process in their case notes, including the patient's response after being given the relevant information.

Conclusion: Overall, there was inadequate maternal counseling at the two teaching hospitals in Enugu State, Nigeria, which provide are the highest level of health care in the state. Adequate and consistent counseling for caesarean section can be achieved in the study area using standardized consent forms and healthcare workers' training in patient communication and counseling.