Experiences and perceptions of birth companions supporting women in labour at a District Hospital in Limpopo, South Africa.

Joy V Summerton,Maphei E Moshabela,Tsakani R Mtileni

doi:10.4102/curationis.v44i1.2186

Abstract

BackgroundSouth Africa has included birth companions in its national guidelines for maternity care and the revised Maternity Case Record, in and effort to improve the quality and experience of care. However, reservations amongst healthcare providers remain about the acceptability of birth companions in the labour ward.ObjectivesTo document the experiences and perceptions of birth companions who supported women in labour in a rural hospital in Limpopo Province where a Respectful Maternity Care (RMC) project was piloted.MethodAn institution-based cross-sectional study design was employed. Purposive sampling was employed where all birth companions who supported a woman during labour and birth were included in the study. The experiences and perceptions of birth companions were captured using a birth companion feedback book during the period of 1st April to 30th August 2019. Thematic analysis was used to analyse the data.ResultsSeventy-one (71) of the 73 birth companions only had positive responses about the birthing experience and how both the birth companion and woman in labour were treated. Two birth companions were dissatisfied with the treatment provided by the midwife that supported the birth.ConclusionIt is important for healthcare providers to understand the far reaching emotional and psychological impact of their attitudes and behaviour on, not only women in labour but also on others who witness their (healthcare providers) behaviour. Mechanisms to obtain feedback from birth companions should be integrated into strategies to improve the quality and experience of care for women during childbirth.

Highlights

Childbirth is a highly stressful event for many women, which requires the constant involvement of the mind and body, and evoking a wide range of positive and negative emotions (Carlson & Pettersson 2009; Story et al 2012)
The low response rate can have multiple interpretations, namely that the majority of mothers during the study period did not have a birth companion to support them during labour and birth or not all birth companions documented the birthing experience in the birth companion book
The findings of the study are not generalisable in terms of the proportion of birth companions that had a positive experience versus the proportion of birth companions that had a negative experience during labour and birth

Summary

Introduction

Childbirth is a highly stressful event for many women, which requires the constant involvement of the mind and body, and evoking a wide range of positive and negative emotions (Carlson & Pettersson 2009; Story et al 2012). A Cochrane review of continuous support during labour and childbirth revealed that women who received continuous support were more likely to have shorter labour, experience improved satisfaction with care and have spontaneous unassisted (no use of forceps or vacuum) vaginal delivery, reducing the need for caesarian sections. It reduced the need for pain medication during labour, and their babies were less likely to have low (less than 7) 5-min Apgar scores (Afulani et al 2018; Bohren et al 2017; Hodnett et al 2013; Kabakian-Khasholian & Portela 2017). Reservations amongst healthcare providers remain about the acceptability of birth companions in the labour ward

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