THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE

2023, VOL. 36, NO. 2, 2278019

https://doi.org/10.1080/14767058.2023.2278019

RESEARCH ARTICLE

Knowledge, attitude and perception of cesarean section among pregnant

women attending antenatal clinic at Babcock University Teaching Hospital,
Ilishan-Remo, Ogun State
Bukola Titilope Maitanmia , Oluwasinmibo Victoria Oluyomib, Inioluwa Omowumi Aderemic,
Julius Olatade Maitanmid , Abdulmajeed Aminue , Margaret Olutosin Ojewalef,
Ogechukwu Emmanuel Okondug and Oluwadamilare Akingbadec,h,i
a
Department of Mental Health Nursing, School of Nursing, Babcock University, Ilishan-Remo, Nigeria; bSchool of Nursing, Babcock
University, Ilishan-Remo, Nigeria; cInstitute of Nursing Research, Osogbo, Osun State, Nigeria; dDepartment of Community/Public
Health Nursing, School of Nursing, Babcock University, Ilishan-Remo, Nigeria; eSchool of Nursing and Midwifery Gusau, Gusau
Nigeria; fDepartment of Health, The Nigerian Army, Nigeria; gDepartment of Human Kinetics and Health Education, Nnamdi Azikiwe
University, Faculty of Education, Awka, Nigeria; hThe Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
SAR, China; iInstitute of Nursing Research Nigeria, Osogbo, Nigeria

ABSTRACT ARTICLE HISTORY

Background: While the rate of Cesarean Section (CS) has been increasing in developed coun­ Received 4 May 2022
tries, the same cannot be said about developing countries, especially Nigeria. Despite the vari­ Revised 10 April 2023
ous indications of CS that may arise, the CS rate in Nigeria has remained as low as 2.7% as Accepted 27 October 2023
against the 15% acceptable upper limit according to the World Health Organization. The level
KEYWORDS
of knowledge, perception, and attitude toward CS among pregnant women have been found to Attitude; cesarean section;
significantly influence the women’s decision to utilize this life-saving means. Hence, the knowledge; perception;
researchers conducted this study among pregnant women attending the antenatal clinic at women
Babcock University Teaching Hospital (BUTH), Ogun State, to assess their level of knowledge,
perception and attitude toward CS.
Methodology: A descriptive cross-sectional design was utilized. A questionnaire designed by
the researchers was used to collect data from 200 respondents, and the data were analyzed
with Statistical Package for the Social Sciences version 25. Results were reported with frequen­
cies, mean scores and percentages.
Results: Findings of the study showed that 78.5% had a high level of knowledge of CS, 67.5%
had a good perception of CS, and 93% had a positive attitude toward CS. Around average
(52.5%) considered CS a safe procedure, and 78.5% would agree to have CS if medically indi­
cated. The majority (76.5%) believed that opting for a CS could save the life of the mother or
the child.
Discussion: In conclusion, the findings of this study show that although majority of the respond­
ents had good knowledge and perception of CS, and were willing to accept CS when medically
indicated, around one-third had poor perception of CS and around two-tenths would not agree to
have it if medically indicated. Hence, nurses and other stakeholders are thus encouraged to always
include CS lessons in antenatal teachings to ensure that every woman is knowledgeable enough
to accept CS, especially when medically indicated.

Introduction recommended that primary cesarean section should be

Cesarean Section (CS) is usually indicated, in situations
where a vaginal delivery would put the baby or
mother at risk [1], such as pelvic abnormalities, cardiac
conditions, fetal distress, malpresentation of the fetus,
infection, abnormal placentation or situations in which
vaginal birth is generally contraindicated [2]. Otherwise,
the American College of Obstetricians and Gynecologists
safely prevented [3,4]. WHO reported that Nigeria
accounts for 34% of maternal deaths worldwide, and the
risk of having maternal death in Nigeria is 1 in 22 as
against 1 in 4900 in developed countries [5]. Another
study conducted in Ogun State, Nigeria, reported that
the leading contributory factors of maternal deaths
include inadequate human resources for health, delay in

CONTACT Inioluwa Omowumi Aderemi iaderemi608@stu.ui.edu.ng Institute of Nursing Research, Osogbo, Osun State, Nigeria
� 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the
posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
2 B. T. MAITANMI ET AL.
seeking care, inadequate equipment, lack of ambulance
transportation, and delay in referral services [6].
The trend of acceptability and the rate of CS has
been on the increase in developed countries in the
past two decades. According to Martin et al. [7], in
2019, the CS rate in the United States was 31.9%. In
most European countries, one-third of the women are
delivered by CS [8]. In Australia, there was a high
cesarean rate of about 34% in 2016 [9]. Report from
The Lancet data from WHO and the United Nations
Children’s Fund shows that in 2013, CS in Venezuela
was 52.4%; in 2014, it was 55.5% in Egypt, and as of
2015, it was 53.1% and 55.5% in Turkey and Brazil
respectively [10]. When the data were examined by
region, the researchers found that CS birth rates in
2015 were: 4.1% in West and Central Africa, 6.2% in
Eastern and Southern Africa, 29.6% in the Middle East
and North Africa, 18.1% in South Asia, 28.8% in East
Asia and the Pacific 44.3% in Latin America and the
Caribbean, 27.3% in Eastern Europe and Central Asia,
32% in North America, 26.9% in Western Europe [10].
Meanwhile, in developing countries, the rate of CS
has remained on the low side. In Ethiopia, for
example, the CS rate, according to a systematic
review, was 29.55% [11]. In Nigeria, the rate was 1.8%
in 2008 [12] and 2.7% in 2018 [12], whereas the upper
limit of the eight critical thresholds of CS, according to
WHO, is 15% [13]. The WHO estimated that in 15.5%
of pregnancies in Nigeria, a CS is medically necessary,
based on rates of fistula incidence. However, CS is
being underutilized in Nigeria [14]. Lower rates were
recorded in northern Nigeria, while higher rates were
recorded in the south [15]. In Enugu, there is an over­
all underutilization of cesarean section, especially in
rural areas where only 5.55% of all births are delivered
via cesarean section [14,16].
CS is perceived as an abnormal means of delivery
by some women in developing countries. This nega­
tive view and perception of CS by women in develop­
ing countries has led to gross underutilization of the
procedure compared to the large burden of obstetric
morbidity requiring resolution by CS [17]. In a study
among Yoruba women of southwestern Nigeria, CS
was viewed with suspicion, aversion, misconception,
fear, guilt, misery and anger [18]. Some other women
perceived it as something for weak women, while
others considered it a curse [18]. In Usmanu
Danfodiyo Teaching Hospital, respondents of a study
stated the reasons for not accepting CS as; perception
of denial of womanhood, pain, high cost and fear of
death and pain [15]. In a study conducted in Jos,
Nigeria, while some women feared CS because they
thought it could harm the mother, others thought it
could harm the baby and cause pain during and after
the procedure [19]. The study conducted in Lagos
showed that the majority of the respondents would
not undergo a CS even if medically indicated. Most of
them believed CS to be very dangerous [20]. 94%
of respondents of a study conducted in Cape Coast of
Ghana among pregnant women preferred vaginal
delivery over CS, stating that it was safer, natural and
had less pain after delivery and early discharge [21].
Inadequate knowledge and poor perception of CS
greatly impact the attitude and acceptance of CS
among pregnant women [17]. The respondents in a
study conducted in Ghana had poor knowledge of CS
and thus had poor acceptance of CS [22]. In the study
conducted at Usmanu Danfodiyo Teaching Hospital,
85.5% of the respondents had good knowledge, and
77.5% of them would agree to a CS if indicated [15].
Another study showed that among its respondents,
women who had up to four antenatal visits had
higher odds of utilizing CS compared to those who
did not attend antenatal clinics [23]. Other factors
affecting CS acceptance include residence in rural
areas, lack of husband/partner’s formal education,
birth order, women’s low level of education and past
successful vaginal deliveries [23,24]. A study by
Maduka and Enaruna in 2022 reported that 46% of
their respondents refused to have a repeat CS if med­
ically indicated, stating postoperative pain and dis­
comfort, being labeled a failure, and fear of death as
their reasons [25].
A study conducted among women living in a
Obogun village of Ogun state reported that 51. 9% of
the women earned less than the minimum wage of
#30,000 monthly, 35.1% had tertiary education, and
41.6% were traders [26]. Apart from this, there is min­
imal data and research on CS in Ogun state and across
Nigeria. Also, the low rate of CS in the country
prompted the researcher to conduct this study. Hence,
the study aims to assess the knowledge, attitude, and
perception of CS among the pregnant women attend­
ing the antenatal clinic at Babcock University Teaching
Hospital, Ilishan-Remo, Ogun state.
Materials and methods
Research design, sampling and participants
A descriptive cross-sectional design was adopted for
the study. The sample size for this study was the 200
pregnant women attending the antenatal clinic in
Babcock University Teaching Hospital, Ilishan Remo,
Ogun state, at the time of data collection. Data on the

number of clinic attendees was obtained from the
clinical attendance register. All the 200 pregnant
women attending the antenatal clinic at Babcock
University Teaching Hospital at the time of data collec­
tion were selected for the study in accordance with
the total sampling method [27,28]. The total sampling
method justifies the selection of all members of a
population if the population is small (below 300) and
well-defined [29]. The respondents of this study fell
into this category as there were just 200 of them
attending the antenatal clinic at the facility during the
data collection period and were all pregnant as
required by the study. Furthermore, they were all will­
ing to participate in the research.
Instrument for data collection
A questionnaire designed by the researcher was used
as an instrument of data collection. It consisted of
four sections: demographic variables, knowledge of
cesarean section, perception of cesarean section and
attitude toward cesarean section. The knowledge sec­
tion contains nine questions with a ’Yes/No’ response.
A correct answer was scored 1 point, while an incor­
rect answer was scored 0. The highest obtainable
score was 9, while the least obtainable score was 0.
The total of each respondent’s scores was converted
to percentage. The knowledge score of participants
below 50% was categorized as poor, the knowledge
score of participants between 50%-–70% was catego­
rized as average, and the knowledge score above 70%
was categorized as good [30].
The section on respondent’s perception contained 13
questions, on a five-point Likert scale ranging from 1 to
5 per question. Total obtainable scores were 65 as the
highest and 5 as the lowest. The total score of each
respondent was converted into percentages. The percep­
tion score below 50% was considered poor, while the
perception score above 50% was considered good [30].
The section on respondents’ attitudes contained seven
questions also on a five-point Likert scale with scores
ranging from 1 to 5. Total obtainable scores were 35 as
the highest and 5 as the lowest. The total score of each
respondent was also converted into percentages. An atti­
tude score below 50% was considered negative, while an
attitude score above 50% was considered positive [30].
Validity and reliability of the instrument
Validity of the instrument was ascertained by two
nursing professors, one midwife and a research
THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE 3
analyst. They evaluated the questionnaire and deemed
it valid for data collection.
The reliability of the instrument was tested using a
total of 20 respondents attending antenatal clinic in
Olabisi Onabanjo Teaching Hospital. The Cronbach’s
alpha reliability coefficient was calculated to be 0.755.
Hence, the instrument was considered reliable.
Procedure for data collection
A letter of introduction was obtained from the School
of Nursing, Babcock University, which was taken to
the management of Babcock University Teaching
Hospital, Ilishan Remo, Ogun State to obtain permis­
sion to conduct the study. The nurse in charge of the
antenatal clinic was met and necessary information
was obtained.
The respondents were given full information about
the purpose and significance of the study. Informed
consent was obtained before the questionnaires were
administered. The respondents were made anonymous
as no identification detail was requested or recorded.
The researcher, however, stayed close to the respond­
ents to ensure that the questionnaires were com­
pleted correctly. The questionnaires were then
retrieved after completion.
Method of data analysis
The data was processed and analyzed using Statistical
Package for the Social Sciences (SPSS) version 25. The
data was presented in frequency tables. The three
research questions were answered using descriptive sta­
tistics of mean, standard deviation and percentages.
Ethical consideration
Ethical clearance to conduct this study was first
obtained from the Babcock University Health Research
Ethics Committee (BUHREC) following which permis­
sion to collect data was obtained from the manage­
ment of Babcock University Teaching Hospital. After
that, permission was sought from each participant
after they had been informed about the research and
consents were obtained from them. They were
allowed to voluntarily agree to participate and were
assured that their refusal to participate would not
affect them. Right to privacy, autonomy, benevolence,
non-maleficence, and respect for each subject were
maintained throughout the research study.
4 B. T. MAITANMI ET AL.

Table 1. Socio-demographic characteristics of the respondents.

Respondents ¼200
DEMOGRAPHIC CATEGORY FREQUENCY (n) PERCENTAGE (%)
Age 18–24years 56 28
25–35years 100 50
36 and above 44 22
Religion Christianity 140 70
Islam 56 28
Traditionalist 4 2
Tribe Yoruba 122 61
Igbo 57 28.5
Hausa 12 6
Others specify 9 4.5
Education Illiterate 16 8
Primary 16 8
Secondary 52 26
Tertiary 116 58
Marital status Single 39 19.5
Married 148 74
Divorced/Separated 13 6.5
Employment status Employer 89 44.5
Employee 60 30
Unemployed 51 25.5
Previous of mode of delivery Vaginal delivery 136 68
Cesarean section 64 32

Results Table 2. Knowledge of pregnant women toward Cesarean

section.
Socio-demographic data Respondents 119
Frequency
The result from Table 1 reveals that 50% of the Category n (%)
respondents were between the ages of 25–35 years, Can a woman have vaginal delivery after Yes 179 (89.5%)
and the majority (70%) of them were Christians. Also, cesarean section? No 21 (10.5%)
Do you think it’s normal for a woman to Yes 182 (91%)
the analysis shows that 61% of the respondents were give birth through cesarean section? No 18%)
Yoruba, the majority (74%) were married, 44.5% were Do you think cesarean section limits the Yes 146 (73%)
number of child? No 54 (27%)
employers, and 68% of them had their previous deliv­ Does a woman’s health determine the mode Yes 160 (80%)
eries through the vagina. More findings are presented of delivery? No 40 (20%)
Is cesarean section done due to Yes 173 (86.5%)
in detail in Table 4.1. complications? No 27 (13.5%)
Do you think cesarean section can lead to Yes 94 (47%)
bladder problems? No 106 (53%)
Do you think cesarean section prevents Yes 55 (27.5%)
future sexual problems for the mother? No 145 (72.5%)
Do you think mothers recover sooner after a Yes 93 (46.5%)
Knowledge of pregnant women toward Cesarean cesarean section that vaginal delivery? No 107 (53.5%)
section Compared with vaginal delivery, do you think Yes 145 (72.5%)
cesarean section is safer for the baby? No 55 (27.5%)
Of the 200 respondents recruited for the study, about
89.5% of the respondents knew that a woman could
have a vaginal delivery after CS. The majority (91.5%)
thought it was normal for a woman to give birth Perception of pregnant women toward Cesarean
through CS, and 73% of the respondents thought CS lim­ section
its the number of children. Furthermore, about the Responses of the respondents in this section were cate­
majority (80%) of the respondents knew that a woman’s gorized into Strongly Agree (SA), Agree (A), Undecided
health determines the mode of delivery, and 86% (U), Disagree (D) and Strongly Disagree (SD). The analysis
affirmed that CS is done when complications arise. 53.5% shows that the majority (D − 32%, SD − 23.5%) of the
did not think that mothers recover faster after CS, and respondents did not agree that women who deliver
only 27.5% think CS is safer for the baby (See Table 2). through CS would miss an important life experience.
Based on the predetermined scoring of the level of While 33.5% of the respondents were undecided about
knowledge, 78.5% of the respondents were found to whether CS enhances a more affectionate mother-baby
have a good level of knowledge, while 12% had an relationship, the majority (D − 22%, SD − 14.5%) dis­
average level of knowledge. agreed. Also, 30% of the respondents strongly disagreed
 THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE 5

that CS was performed for weak women. Most of them
(A − 32%, SA − 20.5%) agreed that CS was a safe pro­
cedure. (D- 35.5%, SD − 37.5%) disagreed that CS would
reduce a woman’s dignity. 37.5% could not decide
whether CS would prevent mother and child bonding.
38% preferred CS over the pain of vaginal delivery.
A larger number of the respondents (SD − 29.5%,
D − 19%) disagreed that having a CS automatically
means one must have CS for subsequent pregnancies.
The majority (A − 42%, SA −34.5%) agreed that CS
could prevent the mother and baby’s death. Most
respondents (D − 31.5%, SD − 16.5%) also disagreed
that having a CS could make mothers less confident
about their ability to give birth (See Table 3).
Based on the above responses, with a score of 50–
100, 67.5% of the respondents were judged to have a
good perception of CS.
Attitude of pregnant women toward Cesarean
section
Responses of the respondents in this section were also
categorized into Strongly Agree (SA), Agree (A),
Undecided (U), Disagree (D) and Strongly Disagree
(SD). About 74% (A − 40.5%, SA − 33.5%) of the
respondents agreed that it is their right to choose a
CS. The majority (D − 30%, SD − 34.5%) also dis­
agreed that CS was an abnormal mode of delivery.
While 28.5% of the respondents strongly agreed that
cesarean section was not an accepted mode of deliv­
ery in their culture or religion, about 34.5% strongly
disagreed. About 78.5% (A − 42%, SA − 36.5%) agreed
they would undergo a CS if indicated. The majority of
the respondents (73.5%) disagreed that cesarean sec­
tion could be embarrassing and 29.5% strongly agreed
that they considered CS as a way of reducing maternal
and infant mortality, and 51% of them agreed that CS
was expensive (See Table 4).
Based on the above responses, with a score of 50–
100, 93% of the respondents were judged to have a
positive attitude toward CS.
Discussion
This study was conducted to assess the knowledge,
attitude, and perception of CS among the 200 pregnant
women attending the antenatal clinic at the time of
data collection.
The findings of the study showed that the majority
of the respondents had good knowledge of CS. This is
in congruence with the findings of two previous stud­
ies by Panti et al. and Abazie & Abdul-Kareem [15,20],
where more than half of the respondents also had
good knowledge of CS. It is, however, different from
the findings of the study conducted in Northern
Ghana by Afaya et al. [22], where the majority of their

Table 3. Perception of pregnant women toward Cesarean section.

VARIABLE SA A UN D SD
n(%) n(%) n(%) n(%) n(%)
Women who deliver through cesarean section miss an important life experience 12(6) 40(20) 37(18.5) 64(32) 47(23.5)
Cesarean section creates a more affectionate mother-baby relationship. 6(3) 54(27) 67(33.5) 44(22) 29(14.5)
Cesarean section is performed for weak women 14(7) 47(23.5) 22(11) 57(28.5) 60(30)
Cesarean section is a safe procedure 41(20.5) 64(32) 22(11) 50(25) 23(11.5)
Cesarean section reduces a woman’s dignity 13(6.5) 18(9) 24(12) 70(35) 75(37.5)
Cesarean section helps prevent mother and child bonding 34(17) 37(18.5) 75(37.5) 18(9) 36(18)
Cesarean section is preferable as pain of vaginal delivery is unpleasant. 25(12.5) 76(38) 34(17) 32(16) 33(16.5)
Babies born by cesarean section are healthier than those delivered through vaginal delivery 22(11) 30(15) 56(28) 44(22) 48 (24)
Previous use of cesarean section indicates that all other deliveries will be done by cesarean section. 14(7) 51(25.5) 38(19) 38(19) 59(29.5)
Cesarean section causes a long and unusual stay at the hospital. 39(19.50) 69(34.5) 27(13.5) 51(25.5) 14(7)
Cesarean section helps prevent mother and child death 69(34.5) 84(42) 12(6) 24(12) 11(5.5)
Husbands should be the one to give consent for cesarean section 12(6) 61 (30.5) 20(10) 59(29.5) 48(24)
Cesarean section could make mothers feel less-confident in their ability to give birth. 28(14) 37(18.5) 39(19.5) 63(31.5) 33(16.5)
Key: SA: strongly agree; A: Agreed; U: undecided; D: disagreed; SD: strongly disagree.

Table 4. Attitude of pregnant women toward Cesarean section.

VARIABLE SA A UN D SD
n(%) n(%) n(%) n(%) n(%)
It’s my right to choose a cesarean section, even if there are no medical measures to have it 67(33.5) 81(40.5) 12(6) 28(14) 12(6)
Cesarean section is an abnormal mode of delivery 15(7.5) 28(14) 34(17) 60(30) 63(31.5)
Cesarean section is not an accepted mode of delivery in my culture or religion 22(11) 36(18) 16(8) 57(28.5) 69(34.5)
Are you willing to undergo a cesarean section if indicated? 73(36.5) 84(42) 20(10) 19(9.5) 4(2)
I consider cesarean section in reducing maternal and infant mortality 59(29.5) 69(31) 40(20) 26 (13) 6(3)
Cesarean section can be embarrassing 11 (5.5) 29(14.5) 12(6) 87(43.5) 61(30.5)
I consider cesarean section very expensive 37(18.5) 65(32.5) 39(19.5) 43(21.5) 16(8)
Key: Strongly Agree SA; A: Agreed; U: undecided; disagreed D; and SD: strongly disagree.
6 B. T. MAITANMI ET AL.
respondents (48%) had only fair knowledge and of the
studies conducted among pregnant women in Cape
Coast of Ghana by Prah et al. [21] and in India by
Sultana et al. [31] where 60.4% and 55.4% of the
respondents had inadequate knowledge respectively.
The differences could be due to the higher level of
education of respondents as the majority of respond­
ents in this study had up to the tertiary level of edu­
cation, while the majority of the respondents of the
studies conducted in Ghana [21,22] had low or no for­
mal education. Abazie and Abdul-Kareem [20] also
showed in their study that the level of education was
significantly associated with knowledge of CS.
The majority of the respondents of this study also
displayed a good perception of CS, similar to the
study conducted by Panti et al. [15], where 96.5% of
the respondents recorded a good perception.
However, respondents in the studies conducted in
Lagos state of Nigeria and Cape Coast of Ghana,
among pregnant women [20,21], were found to have
a poor perception of CS. Respondents of this study
believed CS to be a safe procedure. Respondents in
Jos, Nigeria [19] also thought CS was a safe procedure,
while 40% of those in Ghana [21] thought it was a
dangerous procedure and that women would die after
the procedure. Furthermore, similar to the perception
of respondents in Northern Ghana [22], the majority of
the respondents in this study also perceived that a
vaginal birth could still be achieved after a previ­
ous CS.
This study also shows that majority of our respond­
ents had good attitudes toward CS. Majority were will­
ing to undergo CS if medically indicated and did not
think it embarrassing. In similar studies, while the
respondents preferred to give birth per vagina, over
50% of them agreed to do a CS if medically indicated
[19,21,22]. In Sultana et al.’s, even though the
respondents had inadequate knowledge about CS,
about 70% were more willing to do a CS than to have
a vaginal delivery [31]. However, respondents in Lagos
State [20] had poor attitudes toward CS, so much that
68.5% were unwilling to undergo CS even if medically
indicated. Furthermore, the respondents of our study
believed they had the right to request for CS, as did
women in India [31], who believed that a woman had
the right to choose her mode of delivery.
Furthermore, it is important to note that nurses and
midwives can utilize the antenatal clinics to address
gaps in knowledge, perception and willingness to
undergo CS if needed. This is important as a previous
study observed that pregnant women in Nigeria were
satisfied with the antenatal care received from nurses
[32]. Similarly, this can be an avenue to dispel myths
regarding CS, as a previous study among pregnant
women in Nigeria found that some African cultures for­
bid women from undergoing CS [33]. Additionally, it is
crucial to note that first-time mothers can face psycho­
logical issues during their treatment [34], which can
influence their willingness to undergo CS and their
experience after the procedure. Thus, the antenatal
clinic can also be an avenue to address these issues.
Also, as mobile phones have been reported to be help­
ful in supporting pregnant women psychologically [32],
and as psychological benefits have been reported
among women through mHealth alongside high mobile
phone usage among Nigerian women [35,36], mHealth
can also be considered as a tool for addressing gaps in
knowledge, attitude and willingness to undergo CS.
In conclusion, the findings of this study show that
majority of the respondents had good knowledge of
CS, had good perceptions and were willing to accept
CS when medically indicated. However, around one-
third had poor perception of CS and around two-
tenths would not agree to have it if medically indi­
cated. Hence, nurses should always include lessons on
CS in antenatal teachings to ensure that every woman
is knowledgeable enough to accept CS, especially
when medically indicated.
Strengths and limitations of the study
As little was known about the CS acceptance rate in
Ogun State, the study has added to the limited body
of evidence on the knowledge, attitude and percep­
tion of pregnant women in Ogun State about CS.
However, the study has some limitations. As the study
was conducted in just one center, it is difficult to gen­
eralize to Nigeria’s entire southwest or other geopolit­
ical zones. Similarly, the data collection was based on
self-report; social desirability bias might play out,
wherein participants respond in a manner favourably
perceived by others. These limitations should be taken
into consideration when interpreting the findings.
Recommendation for further studies
We recommend that further studies collect data on
the number of respondents who had a previous vagi­
nal birth and previous CS to explore the relationship
between these variables and the level of knowledge,
perception and attitude of the respondents. Also, we
recommend conducting further research to explore
other determinants of CS acceptance, such as financial

capacity, availability and accessibility, and misconcep­
tions about the procedure.
Acknowledgement
None.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Funding
The author(s) reported there is no funding associated with
the work featured in this article.
ORCID
Bukola Titilope Maitanmi http://orcid.org/0000-0002-2618-
3381
Julius Olatade Maitanmi http://orcid.org/0000-0001-9136-
6603
Abdulmajeed Aminu http://orcid.org/0000-0002-3544-7510
Ogechukwu Emmanuel Okondu http://orcid.org/0000-
0003-0872-7581
Oluwadamilare Akingbade http://orcid.org/0000-0003-
1049-668X
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