A cesarean section delivery is a medical technique in which the uterus and belly are incised to deliver the baby when vaginal delivery is not feasible, safe, or poses a risk to the mother's or the child's health, it is carried out. moms, family members, and medical professionals must decide on this treatment(1).
When faced with the task of making decisions, patients and clinicians share the best available evidence in a process known as "shared decision-making," which helps patients decide on options that align with their values and the best available science. patients are assisted in making well-informed choices through this two-way process(2, 3). Women differ in their attitudes and concepts around chemotherapy. Some believe that CSs are done on indolent women, or that they put the mother and child in danger, some believe that CSs are solitary operations carried out to preserve the lives of expectant mothers and their babies (4–6).
The World Health Organization suggests that the rate of cesarean sections should be between 10% and 15%, however, the current global rate is 21%. When performed without a clear reason, cesarean sections do not provide any additional benefits to the mother or the child; rather, they increase the risk of wound infection, urinary tract infection after discharge, blood loss, fever, and death in cesarean mothers, as well as low Apgar scores and neonatal complications in newborns, they also lengthen hospital stays (7–11).
Involving a mother in the decision-making process is one of the requirements for a positive childbirth experience. According to WHO guidelines and recommendations on intrapartum care, effective communication with healthcare providers to accomplish this is a crucial component of patient-centered care in clinical practice (12–15).
Shared decision-making is a way to increase information regularity in healthcare services however, deficiency of knowledge flow to patients from physicians during healthcare service provision can create distrust in health provider-patient relationships, and lack of information regularity in healthcare services is often associated with misconduct, dissatisfaction, costly and low-quality services (15–17).
The patient has the right to obtain clear, honest, and extensive information in a manner and language understandable to the patient, about all proposed procedures, whether diagnostic, preventive, curative, rehabilitative, or therapeutic. the person who will perform the procedure shall provide the patient with his or her name and credentials, the possibility of mortality risk or serious side effects, problems associated with recovery, and the likelihood of success and reasonable risks involved(18). Involvement in decision-making has a constructive impact on their childbirth experience. decision-making is an essential element of feeling in control for most women (19).
According to ACOG ethical obligations of informed consent require that an obstetrician-gynecologist gives the patient passable, precise, and understandable information and that the patient can understand and reason through this information and is free to ask questions and to make an intentional and voluntary choice, which may include refusal of care or treatment. shared decision-making is a patient-centered, individualized approach to the informed consent process that involves discussion of the benefits and risks of available treatment options in the context of a patient's values and priorities(20). some informed consent challenges are universal to medicine, whereas other challenges arise more commonly in obstetrics and gynecology than in other specialty areas(21).
The patient is not exposed to any procedure without the patient's written informed consent (18). Even if patients have the right to decide on the choice of treatment and surgical procedures, the shared decision-making practice is very low in developing countries, including Ethiopia, which leads to patient dissatisfaction with healthcare services (22–24). different studies have shown that involvement in decision-making increases patient satisfaction(25). An increase in patient satisfaction has a role in increasing institutional delivery rates and a decrease in maternal and neonatal morbidity and mortality(23, 26). some factors affect involvement in shared decision-making like counseling skills of health care providers, and having adequate time for decision-making(24), the maternal mortality rate in Ethiopia is very high so shared decision-making practices increase patient satisfaction and decrease maternal and neonatal complications. As far as our findings there are no studies conducted in the Amhara region about shared decision-making and associated factors that lead to the client being dissatisfied with the services and it violates the right of the patient as well as it is important to accept the complication related to the cesarean section. Knowing the status of women's participation in shared decision-making practice provides clues for policymakers and different stakeholders to improve services and enhance patient satisfaction. Nonetheless, little study has been done on Ethiopian women who had cesarean sections and their participation in shared decision-making the study aimed to assess the status of women's involvement in shared decision-making and associated factors among women who underwent a cesarean section in Ethiopia at Amhara region referral hospitals.