The impact of civil war on medical training in Sudan after 2 years- a questionnaire-based survey.

Caesarean section is one of the oldest procedures, and the commonest major obstetric surgical procedure currently done globally, and there are trends towards increasing Caesarean section rates worldwide []. Though over the years it has become a relatively safe procedure, there still remain concerns about it and a cultural aversion for it; with associated misgivings and misconceptions, especially in low-middle income countries (LMIC) like Nigeria [, ]. Prominent among these concerns are the exaggerated assumptions that there is always lengthening of hospital stay after Caesarean delivery compared to vaginal delivery, and an undue incapacitation associated with the procedure [–]. This is especially a relevant concern among the womenfolk who play important and prominent roles in the household where they supervise and are involved with most domestic activities [, , ]. Societal roles are also not excluded from these concerns. It is therefore important to examine post-operative management protocols that can reduce length of hospital stay and review their effects on the return to domestic and societal functions following uncomplicated Caesarean delivery, and possibly make the operation more acceptable when indicated [, ]. The psychosocial implication of the length of hospital stay following uncomplicated Caesarean delivery is also very important [, ]. Most studies have not detected an increased rate of morbidity associated with early discharge following Caesarean delivery [–]. Therefore, protocols that reduce duration of hospital stay following Caesarean delivery, will probably also enhance patients’ timely return to domestic and societal functions, and this may also help to allay the concerns about the perceived compulsory prolonged hospital stay after every Caesarean delivery and therefore make the operation more acceptable, when indicated; especially in Sub-Saharan Africa where there still exists some aversion for Caesarean delivery []. Recovery after any major surgical procedure is gradual and varies with different factors like individual intrinsic factors, type of anaesthesia and analgesia, type and extent of surgery, surgical techniques and skill of surgeon, duration of surgery, presence/absence of surgical complications, and very importantly the post-operative management protocols like early ambulation, early feeding and perhaps length of hospital stay. Though many guidelines suggest that full recovery after a Caesarean delivery may take 4 to 6 weeks, it varies with individuals [–]. Surgery is a known physiologic stress, and preoperative preparation, the intra-operative procedure and very importantly, postoperative rehabilitation, are other important factors affecting the health, well-being and return to function of women after Caesarean delivery [–].