Knowledge, practices, and barriers among mothers and midwives towards proper informed consent for caesarean sections at Kisubi hospital. A cross-sectional study.
DOI:
https://doi.org/10.51168/znqazd05Keywords:
Knowledge, Wakiso district, practices, barriers, proper informed consent, Caesarean sectionsAbstract
Background:
Informed consent is a foundational ethical and legal requirement in maternal healthcare, especially for caesarean sections (CS). In settings with constrained resources, many women undergo CS without a full understanding of possible risks, advantages, or alternatives that could affect their choices. This study investigated knowledge, practices, and impediments to a proper informed consent process among mothers and midwives at Kisubi Hospital in Wakiso District, Uganda.
Methodology:
A descriptive cross-sectional study using quantitative methods was employed. Thirty-two participants (16 post-caesarean mothers and 16 midwives) completed the developed semi-structured questionnaires. The initial calculated sample of 384 was reduced to 32 due to limited eligible cases and logistical limitations, a change that could influence the study’s validity and the extent to which findings can be generalized.
Results:
A proportion of mothers were in the 18-29 age bracket (44%), while most midwives were aged 20-29 (37%). Most mothers had completed secondary school: 31% A Level, 25% O level, 12% held certificates, 13% had diplomas or higher, and 19% had only primary education. Findings reveal that 81% of mothers had heard of informed consent; however, only 69% fully understood the procedure before signing, and merely 44% knew they could refuse it. While most mothers had signed consent forms, only a smaller proportion received detailed explanations about the surgery. Midwives were actively engaged in obtaining consent, but faced obstacles including limited time, lack of standardized procedures, linguistic challenges, and insufficient training. Cultural norms and low health literacy further undermined effective communication and voluntary decision-making.
Conclusion:
Informed consent practices are uneven and often undermined by institutional and social barriers at Kisubi Hospital.
Recommendation:
Standardized consent procedures should be adopted. Implementing focused training for midwives and using culturally attuned communication approaches to strengthen ethical practice and support patient autonomy in maternal healthcare.
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Copyright (c) 2026 Innocent Aganzu, George Masete, Hasifa Nansereko, Immaculate Prosperia Naggulu, Jane Frank Nalubega (Author)
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