Attitude and subjective norms as predictors of intention of married men and women to accept caesarean section delivery in Lagos, Nigeria.

backgroundDespite its life-saving benefits, there is reluctance among Nigerian women and their husbands to have a caesarean section (CS) when indicated. This study assessed attitude and associated subjective norms involved in resolving whether to accept CS delivery among married men and women in Lagos, Nigeria.

methodsThis was a cross-sectional survey. A validated questionnaire was used to collect data from 422 consenting respondents who were selected through a systematic sampling technique. Attitudinal disposition was measured on15-point rating scale; subjective norms influence was on a 27 point-rating scale and intention to accept CS was measured on 10-point-rating scale. Data were transformed from response items into weighted-aggregate scores for moderating variables. Descriptive and Multiple regression analysis was conducted. All tests were conducted at p ≤ 0.05 level of significance.

resultsThe mean age of the respondents for males and females were 38.7 ± 11.6 years and 37.4 ± 9.8 years respectively. The male and female respondents had a mean score of 7.78 ± 2.82; 8.56 ± 3.08; 15.41 ± 6.97 and 13.66 ± 7.10 computed for attitudinal disposition and subjective norms respectively. About 30% of male respondents and 20% female respondents were likely to accept CS if the need arose. Fear of being mocked by friends (male: 42.0%; female: 42.9%) and risk/complications of the method (male: 30.3%; female: 23.7%) were barriers the respondents reported. There was a significant association between the subjective norm considerations of both the male (β = 0.19; p = 0.007) and female (β = 0.29; p = 0.001) respondents regarding their intention to accept CS. Male and female respondents with a master’s degree showed higher intention to accept CS compared with those with primary education (β = 0.27, p = 0.026; β = 0.23, p = 0.044).

conclusionThe respondents had positive attitude toward CS, with moderate subjective norm considerations in accepting CS. Education, Spouse, family, friends, and cultural beliefs played a major role in decision-making, reinforcing societal expectations regarding childbirth delivery options. These factors, in turn, contributed to intention to accept CS delivery among the respondents in the study. Integrating CS education into antenatal care, while ensuring that partners are also engaged, may enhance overall acceptance of caesarean section.