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Summary: Amidst Nigeria’s growing maternal deaths, a medical procedure offers a tool to curb this tragedy. Yet, women who choose to undergo this surgery are shamed and stigmatised. In this story, Naija Feminists Media highlight the experiences of CS mothers, revealing how stigmatisation intercepts women’s access to lifesaving care.
For 48 hours, childbirth held Onyinyechi Blossom hostage. The contractions were painful and persistent, yet her cervix remained stalled at five centimetres. Exhaustion overwhelmed her. The doctor warned that the baby was already tired and a decision had to be made quickly: emergency caesarean section (CS). Cesarean section, or C-section, is the surgical delivery of a baby through a cut (incision) made in the mother’s abdomen and uterus. Doctors usually recommend the procedure when complications like prolonged labour, fetal distress, placental abruption, breech position, heavy bleeding, and heart disease could make vaginal delivery unsafe for the mother and the baby.
At the time Onyinyechi was in labour, the first-time mom desired only one thing — an end to the pain.
“I was extremely tired with so much pain and stress. I just wanted to get it over with,” she told Naija Feminists Media in an interview.
But outside the operating room, another battle quietly awaits her. Shame disguised as concern. Stigmatisation rooted in fear of people’s opinions when they discovered her birth method.
“I felt sad; my family wanted me to cover the fact that I gave birth through CS so the world would not judge me or see me as less of a woman,” Onyinyechi narrated.
Stigmatisation of mothers who undergo Cesarean Sections (CS) is a prevalent issue in Nigeria. Many CS mothers reported being subjected to labels of weakness, laziness, and failure of womanhood.
According to Dr Natasha Oyibo, a public health specialist and Executive Director of Arieli Foundation for Maternal and Child Health, the stigmatisation of CS mothers is a serious under-discussed contributor to maternal health complications in Nigeria and Africa. She added that while the stigma is rooted in cultural expectations surrounding womanhood, strength, endurance, and motherhood, it has dangerous consequences.
Another CS mother of four, Oluwajerimi Adewale, shared with Naija Feminists Media that she engaged in fasting and prayers to change her baby’s breech position during her first pregnancy. This was primarily due to her family’s standard prayer against C-Section. However, her effort led to a diagnosis of an ulcer. Even after she accepted and tried to get more information from mothers who might have undergone the procedure, it was met with silence due to the stigma. Despite this, visitors who congratulated her quickly concluded that she chose the easy way out and did not belong to the league of real women.
“When the stigmatisation started during my first baby, I went into postpartum depression. I felt very bad, and the words kept ringing in my head,” she recollected.
The Burden of the Hebrew Women Ideology
Globally, Nigeria is the 4th country with the highest rate of maternal deaths, and one of the contributors to this tragedy is the rejection of Caesarean birth. According to a clinical review published on PMC, a significant number of pregnant women, roughly 22% (1 in 5), facing severe complications during delivery actively resist recommended C-sections. A major contributor to this resistance is the nationwide acclaimed “Hebrew Women Ideology”.
The Hebrew women ideology is a pervasive religious and cultural birth phenomenon that originated from a passage in the Bible (Exodus 1:19). The passage tells the story of two Hebrew midwives, Shiphrah and Puah, who used the protective statement of “Hebrew women are not like Egyptian women; they are vigorous and give birth before the midwives arrive,” to protect themselves and save Hebrew infants’ sons from Pharaoh’s royal execution. Centuries later, the statement became misinterpreted and turned into the popularised statement of “You will deliver like a Hebrew woman” as commonly uttered by pastors and church leaders in their standard prayers against C-Section, discriminately validating vaginal delivery (VD) as the only blessed option. Gradually, the discrimination moved beyond spiritual spaces and entered Nigerian homes. Consequently, women who deliver through CS are subtly mocked by their in-laws, friends, and family members.
In a chat with Naija Feminists Media, Dr Irene Udebuana, a medical doctor at Lagos University Teaching Hospital, explained that this ideology is one of the biggest dangers in maternal health. It pressured women to delay or reject C-section even though their doctors recommended it to avoid a sad end.
“Society romanticised vaginal delivery without acknowledging that some women cannot give birth without a surgical procedure. Motherhood is not defined by the route of delivery, but by care, sacrifice, and love,” she added.
Maryam Ibrahim, a registered nurse and midwife, opined that the ideology negatively portrays “CS as a spiritual or reproductive failure, a punishment for marital infidelity, lack of spiritual faith and an indication of physical laziness or weakness.”
“Some religious teachings unintentionally reinforce fear around Caesarean birth, leading women to delay or refuse medically indicated care,” Dr Angelica Chinecherem Uwaezuoke, a Nigerian medical doctor and founder of Gynopod Care, also said.
Effects of stigmatising CS mothers
Speaking on the effects of stigmatisation on the overall well-being of CS mothers, Dr Angelica emphasises that this discrimination can lead to postpartum depression among new mothers. She continued that when a CS mother is stigmatised, she might isolate herself, engage in harmful self-criticism, or even harm herself and the baby.
“As a result of this stigmatisation, some women may struggle with bonding, develop anxiety and depressive symptoms or experience feelings of inadequacy during the postpartum period,” she said.
Like her counterpart, maternal researcher Dr Natasha continued that many women delay consent for medically necessary Cesarean sections due to this stigmatisation, leading to prolonged obstructed labour, complications such as uterine rupture, severe haemorrhage, fetal distress, sepsis, or even death. She revealed that her doctoral research also highlighted how community perceptions and misinformation influence health-seeking behaviour among women.
The myth of the easy way out
One of the biggest stereotypes against caesarean delivery is that women who undergo the procedure do not experience the pains of childbirth; hence, they are labelled weak and accused of being fake mothers who chose the easy way out. However, the reality of caesarean birth tells a different story.
Ms Cynthia Awosogbon, a CS mother of two and a teacher, narrated to Naija Feminists Media that while her first CS was an emergency due to prolonged labour and fetal distress, it was smooth and painless. This experience naturally shaped her perception that the procedure was not as frightening as many people portrayed it. However, her second Caesarean delivery became a traumatic experience complicated by fibroids, prolonged pain, failed spinal anaesthesia attempts, and a difficult recovery period that lasted for months after childbirth.
“They gave me almost five to six injections,” she recalled, describing the repeated failed attempts to administer spinal anaesthesia. “Immediately after they finished the surgery, the pain started. I stayed in the hospital for four days, but the pain never stopped. Even after I got home, I could not sleep through the night. I was struggling with the pain for months,” the educator added.
Corroborating with Cynthia’s pain and distress, Dr Irene called the “easy way out” stereotype a medically inaccurate and unfair narrative. She described a C-section as a major surgery where women undergo anaesthesia and incision of multiple tissue layers. While the recovery process is demanding and may take months, many women experience pain at the slightest movement of the body.
“Recovery can take weeks, sometimes months. It’s not an escape from labour, it’s simply a different medical pathway to delivery,” she stated.
For Ms Sarah Okoye, who underwent CS for her third child, she described the effects of the surgery as a persistent discomfort that can linger for years, such that it makes it difficult to carry heavy objects or return to normal activities immediately.
“People think it’s easy because you don’t push, but that’s not the reality. The pain doesn’t end after the operation. The recovery is the long-term challenge,” she said.
While Cynthia’s and Sarah’s stories highlight the different realities of Caesarean birth, it is important to mention that CS is a major abdominal surgery that involves cutting through skin, fat, muscle, and the uterine wall, making postoperative pain an expected physiological response. The 2023 statement of American Society of Anesthesiologists (ASA) emphasises that managing the pain during and after the procedure is a critical component of obstetric care. Although the pain is underreported, the body advises clinicians to actively monitor and treat patients to ensure their comfort and safety.
Beyond this easy-way-out narrative lies layers of misinformation about caesarean birth. Some women fear the procedure because they have been told it permanently damages the body, prevents future vaginal delivery, and makes them less capable as mothers. Others believe children born through caesarean delivery are weaker or less healthy. However, medical experts debunk these claims, saying they are medically inaccurate.
“There is something called Vaginal Birth After Caesarean (VBAC),” maternal expert Oluwafunmilayo Adewunmi explained. “Having one Caesarean section does not automatically mean a woman can never deliver vaginally again. It depends on the mother’s condition, healing, and medical assessment.”
She also dismissed the belief that Caesarean birth reduces a woman’s worth or strength, stressing that the goal of maternal healthcare is “A healthy mother and child.”
For mothers like Cynthia, the most painful scars are not the postoperative pain; they’re the societal expectations that praise women for surviving childbirth, yet shame them for the very procedures that kept them alive.
Changing the narrative; Breaking the Stigma
To promote a positive response towards caesarean section, and curb stigmatisation against CS, Maternal Health Initiative for Mothers carried out awareness campaigns, community outreach, and educated members of the communities on the importance of safe delivery and antenatal care.
“We support mothers with practical interventions like distributing birth kits in underserved communities,” Ms. Sandra Uzodimma, the NGO founder, shared.
She further recommended a partnership between the government and maternal health NGOs, open conversations about the harmful effects of stigmatising CS mothers, religious and community sensitisation, and health experts should dutifully explain the need for Caesarean section if the situation arises.
Dr Angelica advised that amplifying the stories of CS mothers in the media is a good way to openly advocate and “normalise CS as a legitimate, important and lifesaving mode of delivery.”
Nurse Adewunmi proposed public education, community engagement, and positive storytelling. According to her, the portrayal of CS as a sign of weakness or failure stems from fear and cultural belief. To change these perceptions, healthcare professionals, journalists, religious leaders, families, and social media advocates must work together to educate the public about what CS truly involves.
“We need to normalise conversations around safe childbirth and stop treating C-sections as a source of shame. Health providers should communicate more openly and compassionately about why a C-section may be necessary,” Dr Irene suggested.
Dr Natasha added that many women avoid CS due to financial incapacity, so economic empowerment for families with low income might curb this stigmatisation.
“Expanding health insurance coverage, subsidising maternal healthcare, and strengthening emergency referral systems would reduce delays and improve outcomes,” she continued.
On her part, Nurse Mariam opined that women should be made the sole legal authority required to consent to the surgical procedure, as this will reduce family interference in a woman’s life and stop her from passively participating in her own delivery.
