Involvement of Women with the Decision of Caesarean Section and their Degree of Satisfaction for Post-operative Care and Pain Management

Abstract

Background: Most women who undergo Caesarean birth experience a feeling of resentment towards the physicians, profound disappointment at treatment expectation, and the loss of the happy moment of natural birth. So addressing women's views and concerns should be recognized as being integral to the decision making process. Objective: The objectives of this research were to investigate women’s involvement with the decision of Caesarean Section and their degree of satisfaction about the decision, post-operative care and pain management. Methodology: This study was a descriptive-comparative in nature and was conducted at King Fahd Medical City, Women’s Specialized Hospital, Department of Obstetrics and Gynecology in 2017. All women who underwent cesarean section during the study period either emergency or elective and agreed to participate were enrolled in the survey after signing written informed consent. They were given a questionnaire to be filled by them in their preferred language English or Arabic on day three post cesarean section before the discharge from the hospital. Data was collected by a questionnaire that has been designed by having a complete view from different researchers performed earlier. The questionnaire contains both types of questions, i.e. open and close ended. The data was analyzed using Fisher exact test to compare categorical variables and 2 sample t-tests to compare continuous variables. Consent was obtained. Main results: The total number of study population involved in this study was 200. Planned CS was performed for 91 (45%) while emergency CS was performed for 109 (54.5%). The only significant finding between indication of CS and satisfaction was maternal request (P-value 0.001). Regarding satisfaction of involvement in the decision; most of them were fairly satisfied 82 (41%), very satisfied 68 (34%), fairly unsatisfied 32 (16%), very unsatisfied 13 (6.5%) and no strong feelings 5 (2.5%). Most of them were anesthetized by epidural or spinal 162 (81.4%) and majority were given a choice of anesthesia 192 (96.0%). Those who were satisfied with their choice of anesthesia were 172 (88.7%). Most of them had enough information about recovering from CS 189 (94.5%), about 182 (91.5%) had enough help with recovering from CS. Regarding their feeling having had a Caesarean delivery most of them felt fair 63 (31.5%) and 71 (35.5%) felt excellent towards post-operative care, and 70 (35.0%) answered that they will definitely prefer a Caesarean delivery. When the pain score was assessed, the mean was 2.1, SD 1.7 (min 0-max 8). Conclusion and recommendations: The general satisfaction rate was found to be 96%. The level of satisfaction with the involvement of the respondents in decision-making was approximately 39.5%. The results of this study suggest that strategies are necessary to improve the quality of informational satisfaction.