Communication Between Healthcare Providers and their Clients: How Accurately do Mothers Remember the Indications for the Caesarean Section that they had?

  • EJ Enabudoso
  • LE Ajakaiye
  • CEM Okoror
Keywords: Communication, Indications for Caesarean section, Parity, Post-operative debrief, Vaginal Birth After Caesarean section


Background: The indication for Caesarean delivery is one of the most important information required in the antenatal care and delivery mode for women with previous Caesarean section(s).

Objective: To assess the level of agreement/disparity between mothers’ report and the actual medical indication for Caesarean delivery and to explore factors associated with it.

Methods: This cross-sectional study was carried out among 248 women who were delivered by Caesarean section. A comparison was done between the patient's report of the indication for the Caesarean section and the physician's record and the level of similarity was recorded.

Results: More than half (126; 50.7%) of the respondents reported indications that were classified as complete similarity [Group A] while Groups B to E had 54 (21.8%), 21 (8.5%), 26 (10.5%) and 21 (8.5%) responses respectively. Of the group with “non-similar” responses, foetal indication accounted for 36.1% of them. Parity was the only predictor of “similarity”. Compared to para 0, para 1-4 were more likely to report “similarity” in the indications for the Caesarean section (AOR = 3.370; 95% CI = 1.277-8.888).

Conclusion: While the past obstetric history is an important aspect of the evaluation of the pregnant woman, it is important to attempt greater verification of facts at history taking for the indications for previous Caesarean section, especially when it has to do with foetal health as the indication, and in the nulliparae.


Dougan C, Smith E, Ploski J, Mc Nally A, Johnston K. Patients at the centre of care: Debriefing patients after Caesarean section. BMJ Open Quality 2019; 8: e000454.

Begum T, Rahman A, Nababan H, Hoque DME, Khan AF, Ali T, et al. Indications and determinants of Caesarean section delivery: Evidence from a population-based study in Matlab, Bangladesh. PLoS One 2017; 12: e0188074.

Royal College of Obstetricians and Gynaecologists. Green-top guideline No. 45: Birth after previous Caesarean birth. London, UK: RCOG; 2015.

Gardner K, Henry A, Thou S, Davis G, Miller T. Improving VBAC rates: The combined impact of two management strategies. Aust N Z J Obstet Gynaecol 2014; 54: 327–332.

Folsom S, Esplin MS, Edmunds S, Metz TD, Jackson GM, Porter TF, et al. Patient counseling and preferences for elective repeat Cesarean delivery. AJP Rep 2016; 6: e226–e231.

Nilsson C, van Limbeek E, Vehvilainen-Julkunen K, Lundgren I. Vaginal birth after Cesarean: views of women from countries with high VBAC rates. Qual Health Res 2017; 27: 325–340.

Naa Gandau BB, Nuertey BD, Seneadza NAH, Akaateba D, Azusong E, Yirifere JY, et al. Maternal perceptions about Caesarean section deliveries and their role in reducing perinatal and neonatal mortality in the Upper West Region of Ghana; a cross-sectional study. BMC Pregnancy Childbirth 2019; 19: 350.

Prah J, Kudom A, Lasim O, Abu E. Knowledge, attitude and perceptions of pregnant women towards Caesarean section among antenatal clinic attendants in Cape Coast, Ghana. Texila Int J Public Health 2017; 5.

Tunçalp O, Stanton C, Castro A, Adanu R, Heymann M, Adu-Bonsaffo K, et al. Measuring coverage in MNCH: validating women's self-report of emergency Cesarean sections in Ghana and the Dominican Republic. PLoS One 2013; 8: e60761.

Liu J, Tuvblad C, Li L, Raine A, Baker LA. Medical record validation of maternal recall of pregnancy and birth events from a twin cohort. Twin Res Hum Genet 2013; 16: 845–860.

Quigley MA, Hockley C, Davidson LL. Agreement between hospital records and maternal recall of mode of delivery: Evidence from 12,391 deliveries in the UK Millennium Cohort Study. BJOG: Int J Obstet Gynaecol 2007; 114: 195–200.

Elkadry E, Kenton K, White P, Creech S, Brubaker L. Do mothers remember key events during labor? Am J Obstet Gynecol 2003; 189: 195–200.

Puia DM. The Cesarean decision survey. J Perinat Educ 2013; 22: 212–225.

National Population Commission (NPC) [Nigeria] and ICF. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA. 2019.

Githens PB, Glass CA, Sloan FA, Entman SS. Maternal recall and medical records: an examination of events during pregnancy, childbirth, and early infancy. Birth 1993; 20: 136-41.

Catov JM, Newman AB, Kelsey SF, Roberts JM, Sutton-Tyrrell KC, Garcia M, et al. Accuracy and reliability of maternal recall of infant birth weight among older women. Ann Epidemiol 2006; 16: 429–431.

McCarthy KJ, Blanc AK, Warren CE, Kimani J, Mdawida B, Ndwidga C. Can surveys of women accurately track indicators of maternal and newborn care? A validity and reliability study in Kenya. J Glob Health 2016; 6: 020502.

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