Abstract:
Background: With the increasing rates of the caesarean deliveries, understanding of the
empowerment provides by the maternal knowledge and attitudes in making the choice of having
abdominal delivery is crucial.
Objective: To evaluate the maternal knowledge and attitudes in clinical decision-making of
elective caesarean section surgery in the German-Sri Lanka Friendship Hospital for Women, Galle
Methods: A descriptive cross-sectional study was conducted among 106 postnatal women who
had undergone Elective Lower Section Caesarean Section (EL/LSCS) in the hospital, with their
consent. A pre-tested interviewer administered questionnaire was used to gather data. Data were
analysed using SPSS version 26.0 and interpreted using appropriate descriptive statistics. Chi-
square test was used to determine the association between categorical variables.
Results: The majority (97.2%) of women were knowledgeable about caesarean section. A smaller
number of women (13.2%) had undergone a caesarean section upon their own request. The
majority (75.5%) of the women agreed that they were aware of their right to make decisions about
EL/LSCS. A mass preponderance (78.3%) of women had made their decision on the same day. A
significant proportion (77.4%) of women had received enough opportunity to receive balanced
information, to discuss and clarifications, to get timely information and to involve support persons
when making their decision about EL/LSCS. The most of the postnatal women in the sample
(91.5%) had agreed with their medical care provider about how to proceed with the procedure.
The women which had been undergone only a past caesarean delivery is 34%. A few numbers of
women (16%) had undergone two caesarean deliveries or more. The attitudes that showed a more
significant association (p<0.05) with their decision of caesarean delivery was level of anxiety and
fear (p=0.012) and the educational status (p=0.013). Fear of pain (p<0.001), sexual problems
(p<0.001), organ prolapse (p=0.01), and safety issues (p<0.000) were the other attitudes associated
with considered decision-making aspects.
Conclusions: This study shows high maternal knowledge of caesarean section and strong
awareness of decision-making rights to involve in the decision-making process along with their
consultant. It highlights the importance of providing balanced information and emotional support
to the women when the decision is made to select elective caesarean delivery.
