Abstract
BACKGROUND: A caesarean delivery without maternal involvement in decision-making reduces the quality of health care and breaks women's autonomy. However, the involvement of women in decision-making to have a caesarean delivery is minimal. Still, now paternalism is widely practised. The study aims to assess women's involvement in decision-making and associated factors among women who underwent a caesarean delivery. METHODS: Institutional-based cross-sectional study was conducted in Sidama region Public hospitals from June 22/2022-August 5/2022, among women who underwent a caesarean delivery. The total sample size was 457. The collected data was exported from the ODK toolbox server to excel and then to SPSS version 26 for further data cleaning and analysis. The variables with a p-value ≤ 0.25 in the bivariable analysis were included in a multivariable ordinal logistic regression model to control possible confounders. The resulting odds ratio and 95% confidence interval were computed, and a p-value of less than 0.05 is considered statistically significant. RESULTS: Women's agreed decision-making involvement to have a caesarean delivery is 165(37.9%). Women who had an scheduled caesarean delivery [AOR: 7.6; 95% CI: 3.3, 17.8], had adequate information about caesarean delivery [AOR: 5.7; 95% CI:3.3, 10.0], had adequate time for decision-making [AOR: 4.6; 95% CI:2.09, 6.4], language of consent [AOR: 1.9; 95% CI: 1.2, 3.1], and women-healthcare providers relationship [AOR: 5.2; 95% CI: 3.2, 8.6]are higher odds of being involved in decision-making, but women's being primary school [AOR: 0.53; 95% CI: 0.3,0.97] are lower odds of involvement in decision-making to have a caesarean delivery. CONCLUSION AND RECOMMENDATION: In this study, women's agreed decision-making involvement to have a caesarean delivery is low compared with other studies. Women-healthcare providers' relationship and an unscheduled caesarean delivery are highly affect their involvement in decision-making. Therefore, hospitals should translate and prepare the consent form in an understandable way for women and families, and healthcare providers should develop good relationship and encourage her involvement.