An Uninformed Decision-Making Process for Cesarean Section: A Qualitative Exploratory Study among the Slum Residents of Dhaka City, Bangladesh

Abstract

The decision-making process and the information flow from physicians to patients regard- ing deliveries through cesarean section (C-section) has not been adequately explored in Bangladeshi

context. Here, we aimed to explore the extent of information received by mothers and their family

members and their involvement in the decision-making process. We conducted a qualitative ex- ploratory study in four urban slums of Dhaka city among purposively selected mothers (n = 7), who

had a cesarean birth within one-year preceding data collection, and their family members (n = 12). In most cases, physicians were the primary decision-makers for C-sections. At the household level,

pregnant women were excluded from some crucial steps of the decision-making process and infor- mation asymmetry was prevalent. All interviewed pregnant women attended at least one antenatal

care visit; however, they neither received detailed information regarding C-sections nor attended any counseling session regarding decisions around delivery type. In some cases, pregnant women and their family members did not ask health care providers for detailed information about C-sections. Most seemed to perceive C-sections as risk-free procedures. Future research could explore the best ways to provide C-section-related information to pregnant women during the antenatal period and develop interventions to promote shared decision-making for C-sections in urban Bangladeshi slums.