Maternal Satisfaction with the Process of Informed Consent for Cesarean Delivery in two Public Hospitals in Mekelle City, Ethiopia: A cross-sectional Study

Abstract

Background Caesarean delivery (CD) is a critical intervention for reducing maternal and neonatal morbidity and mortality. However, the process of informed consent (IC) often remains suboptimal in many low-resource settings. Inadequate time for counselling and limited discussion of procedure details can undermine patient autonomy and satisfaction. This study aimed to assess maternal satisfaction with the informed consent process for Cesarean delivery in two public hospitals in Mekelle City, Ethiopia. Methods A cross-sectional study was conducted among women who underwent Cesarean delivery at Ayder Comprehensive Specialized Hospital and Mekelle General Hospital. A structured questionnaire was administered on the first or second postoperative day, capturing data on sociodemographic characteristics, obstetric factors, components of the consent process, and satisfaction measures. Cronbach’s alpha assessed internal reliability of satisfaction items. Binary logistic regression identified independent predictors of maternal satisfaction, with a significance level of p < 0.05. Results A total of 354 participants were included. The majority (60.2%) were aged 25–34 years, 88.1% lived in urban areas, and 77.1% underwent emergency Cesarean delivery. About 22.6% signed a consent form in their mother tongue, and 64.4% reported receiving less than five minutes of counselling. Overall, 55.7% of mothers were categorized as “satisfied” with the informed consent process (score above the mean). Two factors independently predicted higher satisfaction: having >10 minutes of explanation (adjusted odds ratio [AOR] = 0.3 for <5 minutes vs. >10 minutes) and knowing the surgeon’s name (AOR = 2.5). The model fit was good (Hosmer-Lemeshow p = 0.905) with no multicollinearity issues (maximum VIF = 1.58). Conclusion Just over half of the women were satisfied with their Cesarean consent process, indicating moderate overall performance. Critical gaps include insufficient counselling time and limited interaction or familiarity with the operating surgeon. Strengthening communication—by allocating more time for counselling and ensuring meaningful patient-provider introductions could significantly enhance maternal satisfaction with the informed consent process.