SOCIO-CULTURAL AND ECONOMIC DRIVERS OF CAESAREAN SECTION HESITANCY AMONG PREGNANT WOMEN ATTENDING A TERTIARY HOSPITAL IN SOUTHERN NIGERIA

Abstract

Caesarean section (CS) is a life-saving obstetric intervention that reduces maternal and neonatal morbidity and mortality when vaginal delivery presents significant risks. Despite increasing awareness of its benefits, the acceptance of medically indicated Caesarean delivery remains a challenge in many low- and middle-income countries, including Nigeria. This study examined the socio-cultural and economic drivers of Caesarean Section Hesitancy among pregnant women attending antenatal clinic at the University of Benin Teaching Hospital, Benin City, Nigeria. A descriptive cross-sectional survey design was adopted, and data were collected from 150 pregnant women (this study was conducted from August-September, 2025) using a structured questionnaire. Descriptive statistics and Pearson’s Chi-square test were used for data analysis at a significance level of p < 0.05. Findings revealed that 50.0% of respondents had good knowledge of Caesarean section, while and 60.0% expressed willingness to accept medically indicated Caesarean delivery. However, the fear of adverse outcomes (68.0%), financial constraints (65.3%), and family-related beliefs (52.7%) emerged as major barriers to acceptance. A statistically significant relationship was observed between the knowledge and acceptance of Caesarean section (χ² = 8.806; p = 0.013), indicating that women with better knowledge were more likely to accept the procedure. The findings demonstrate that knowledge alone does not guarantee acceptance, as social and economic influences continue to shape maternal decision-making. Addressing these barriers through antenatal education, family-centered counseling, and financial protection could enhance acceptance of medically indicated Caesarean delivery and improve maternal health outcomes in Nigeria.