Effect of Counseling in Patients Booked for Elective Caesarean Section Delivery as Choice of Anesthesia

Abstract

Background: Cesarean section rates are rising globally, yet many women remain inadequately informed about anesthesia options, contributing to anxiety and potentially suboptimal choices in elective procedures. Addressing this gap, structured preoperative counseling may improve knowledge, reduce anxiety, and influence anesthesia preferences in women scheduled for elective cesarean delivery. Objective: This randomized controlled trial aimed to evaluate the effect of structured preoperative counseling on anesthesia choice, procedural knowledge, and preoperative anxiety among women undergoing elective cesarean section. Methods: In this single-center, single-blind RCT, 100 term pregnant women aged 19–40 years scheduled for elective cesarean section were randomized into structured counseling (n = 50) and standard counseling (n = 50) groups. Women with obstetric emergencies, contraindications to anesthesia, or spontaneous vaginal delivery were excluded. Counseling protocols included standardized leaflets and face-to-face education, with data collected on sociodemographics, anesthesia preference, anxiety, and knowledge using validated tools. Ethical approval was obtained per the Declaration of Helsinki. Statistical analyses were performed using SPSS version 23, with chi-square and t-tests applied as appropriate. Results: Regional anesthesia was chosen by 58% in the structured counseling group versus 34% in standard care (p = 0.013). The structured group demonstrated significantly lower mean anxiety scores (20.53 ± 0.74 vs. 27.86 ± 3.21; p < 0.001) and higher procedural knowledge (25.23 ± 2.14 vs. 14.07 ± 1.96; p < 0.001). Conclusion: Structured preoperative counseling significantly increases preference for regional anesthesia, enhances procedural knowledge, and reduces anxiety in women undergoing elective cesarean section. Integrating comprehensive counseling into routine obstetric care can optimize informed decision-making and improve perioperative outcomes in real-world clinical practice.