The Preference of Sudanese Ladies Regarding the Mode of Delivery and the Attitude of Obstetricians towards C/S on Request

This study on the preference of the mode of delivery among Sudanese ladies was carried out with the objectives to find out which type of delivery is preferred by the Sudanese ladies, and to define the main factors affecting the choice, also to know weather our doctors are ready, in the absence of a medical indication, to perform C/S on demand, and to know weather the ladies attending the antenatal clinics were well informed about the pros and cons of each delivery. One-forty ladies in Khartoum State were included in this study; the majorities were attendants of antenatal Clinics, in the period from April-June 2002 and the rest were from the general population, and inpatients in obstetric wards. According to parity (19.3%) were PG. The remainders were multiparous women, (72.9%) of them were pregnant. The age and level of education were the two demographic factors studied to show their impact on preference. The majority of the ladies were university graduates and above, comprising (34.3%). The age was found to influence significantly the preference with increasing tendency towards C/S, with increasing age. The age group (35-39yrs) comprising the largest of all to request C/S; while there was no effect of the level of education on preference. VI The most preferred method of delivery was V.D (68/6%) while only (31.4%) preferred C/S. The commonest causes for choosing V.D were because it is natural (24.9%), faster recovery (15.7%) and safe (12.9%). There was no effect of previous complication due to C/S on future preference but this relation ship was found to be significant in those with previous complication due to vaginal delivery (P: 0.02) when most of them go for C/S for future delivery. The type of previous delivery (deliveries) will affect the choice, significantly (P= 0.008) in those with previous C/S. Where (45%) of them prefer C/S again for future delivery. There was no effect of being PG or not on the preference. The majority of the study population will go for V.D (70.4%). The bulk of patients (66.3%) admit to not being involved in the decision regarding their delivery nor well informed about its advantages and disadvantages. The majority of obstetricians (74.7%) will not agree to do C/S on request, while only (23.3%) will do it. The main reasons behind refusal were the belief it is a major surgery with very drastic complications (56%) and that there should be an indication to do it (24%),(17.3%) want to avoid litigation. VII Those who agreed think that the patient choice should be respected (21.3%), (4%) want to avoid litigation. (2.7%) will like to evade the patient possible complications following V.D