Abstract
Background: Caesarean section (CS) is a life-saving obstetric intervention that prevents
maternal and neonatal morbidity and mortality. Despite its proven benefits, acceptance of CS in
many low- and middle-income settings is hindered by persistent religious and social
misconceptions.
Methods: A descriptive cross-sectional study was conducted among 148 women aged 18–49
years attending antenatal and postnatal clinics at Chukwuemeka Odumegwu Ojukwu University
Teaching Hospital (COOUTH), Amaku Awka. Data were collected using structured
questionnaires assessing knowledge, religious and social misconceptions, decision-making
influences, observed outcomes, and suggested interventions. Data were analyzed using SPSS
version 25 and presented as frequencies and percentages.
Results: Awareness of CS was high (93.9%), and most respondents considered CS safe (92.6%).
However, 57.4% reported exposure to negative religious or social beliefs about CS, including
perceptions that CS is unnatural (27.0%), that women who undergo CS are not “real” mothers
(23.0%), or are weak (17.6%). Although only 14.9% reported direct religious influence on
personal views, 77.7% had witnessed women delay or refuse medically indicated CS due to fear
or beliefs. Among these cases, 62.2% reportedly resulted in complications, including maternal
death (31.1%) and neonatal death (16.9%). Most respondents supported strategies to address
misconceptions, including sharing real-life experiences (95.3%), community forums (91.9%),
antenatal education (87.8%), and male partner involvement (83.1%). Nearly all agreed that
collaboration between health workers and religious leaders is essential (98.7%).
Conclusion: Despite high awareness of caesarean section, religious and social misconceptions
remain prevalent and contribute to delayed or refused care with serious maternal and neonatal
consequences. Integrated, culturally sensitive interventions involving healthcare providers,
religious leaders, male partners, and communities are urgently needed to improve acceptance of
medically indicated CS.