FEAR, PAIN, AND THE DRIP: KNOWLEDGE, ATTITUDES, AND ETHICAL DETERMINANTS OF INDUCED LABOUR AMONG PREGNANT WOMEN IN NIGERIA

Abstract

Background: Induction of labour is a common obstetric intervention that can reduce perinatal mortality when medically indicated, yet its acceptability among Nigerian women remains poorly understood. Nigeria recorded a maternal mortality ratio of 1,047 deaths per 100,000 live births in 2023, one of the highest globally, making understanding of obstetric interventions critical.

Objective: This study assessed knowledge, attitudes, and ethical determinants of induced labour among pregnant women in Nigeria.

Methods: A descriptive cross-sectional study was conducted among 421 pregnant women attending antenatal care in Nigeria. A structured, interviewer-administered questionnaire was used to collect data on sociodemographic characteristics, knowledge and sources of information, attitudes and perceptions, cultural beliefs, and ethical concerns. Content validity was established by expert review, and a pilot study was conducted with 20 women. Data were analysed using IBM SPSS Statistics. Descriptive statistics, chi-square tests, independent-samples t-tests, and binary logistic regression were used. Statistical significance was set at p < 0.05.

Results: All 421 respondents (100%) had heard of induced labour. Nurses, co-pregnant women, and antenatal clinics were universal sources of information. While 77.0% believed induction is costly and 68.9% feared losing their lives, 100% agreed that induction saves the lives of mother and child. Prior induction experience was significantly associated with caesarean concern (p = 0.015). Belief that induction results from a curse was associated with fear of death (p = 0.016). Insurance burden (70.1%), lack of full consent (65.1%), and fear of provider abuse (60.1%) were prevalent. Women who had never undergone induction were less likely to prefer traditional birth attendants (OR = 0.457, p = 0.003).

Conclusion: Despite universal awareness, knowledge of induced labour is limited and shaped by fear, cultural beliefs, and ethical concerns about consent and cost. Antenatal education and consent practices require strengthening.

Keywords: induction of labour, knowledge, attitudes, informed consent, maternal health, Nigeria