Breaking myths and building awareness: spinal anesthesia for cesarean section in Palestine-what women know and what holds them backs- a cross- sectional study.

BACKGROUND

Cesarean section (CS) is one of the most frequently performed surgical procedures worldwide. Spinal anesthesia (SA) has become the preferred anesthesia technique for CS due to its advantages over general anesthesia, including better maternal hemodynamic stability and improved neonatal outcomes. However, maternal knowledge and attitudes toward SA significantly influence decision making and perioperative experiences. This study aimed to assess the knowledge, awareness, and attitudes of Palestinian women toward SA during CS.

METHODS

A cross-sectional study was conducted among Palestinian women aged 18-60 years who met the inclusion criteria and voluntarily provided informed consent. Data were collected using a structured, validated questionnaire distributed through social media platforms and maternity wards in Palestinian hospitals. A sample size of 384 participants was calculated using OpenEpi, with a 95% confidence level and a 5% margin of error. Statistical analysis was performed using SPSS version 26.

RESULTS

A total of 415 Palestinian females were included. The mean age was 27.3 ± 6.8 years. More than half expressed a preference for spinal anesthesia (SA) over general anesthesia (GA) for cesarean delivery. Knowledge levels were generally low, with less than 10% demonstrating high awareness. Although 63% had heard of regional anesthesia, fewer were familiar with SA specifically. Misconceptions were frequent; the majority failed to identify the correct injection site, and over half were unaware that SA could be used during active labor. While most participants recognized that SA allows maternal consciousness during surgery, less than one-third correctly identified its reduced fetal exposure compared to GA. Among those expressing concerns, the most commonly reported barriers were fear of chronic back pain, headaches, permanent paralysis, painful injection, intraoperative awareness, nausea or vomiting, and hypotension.

CONCLUSION

Although a significant proportion of Palestinian women were willing to receive spinal anesthesia, many exhibited concerns and misconceptions about its safety and effects. These findings highlight the need for improved patient education and counseling on SA to enhance maternal confidence and decision-making. Addressing these concerns through targeted awareness programs could lead to better patient experiences and outcomes in cesarean deliveries.