Childbirth Supporters’ Experiences in a Built Hospital Birth Environment

Abstract

Suggested design guidelines to facilitate supporters' well-being and their roles in designed hospital birth spaces are provided.

Perceptions and experiences of labour companionship: a qualitative evidence synthesis

“…Thirteen studies were conducted in 11 middle‐income countries: Syria (Abushaikha 2012; Abushaikha 2013), Ghana (Alexander 2014), Brazil (Brüggemann 2014; Dodou 2014; de Souza 2010), Mexico (Campero 1998), South Africa (Chadwick 2014), , Jordan (Khresheh 2010), Kenya (Afulani 2018), Iran (Fathi 2017), and China (Qian 2001); and one multi‐country study conducted in Syria, Egypt and Lebanon (Kabakian‐Khasholian 2015). Thirty‐three studies were conducted in six high‐income countries: Sweden (Akhavan 2012a; Akhavan 2012b; Bäckström 2011; Berg 2006; Ledenfors 2016; Lundgren 2010; Premberg 2011; Thorstensson 2008), Finland (Bondas‐Salonen 1998), Canada (Chandler 1997; Lagendyk 2005; Price 2007), USA (Chapman 1990; Coley 2016; Gentry 2010; Hardeman 2016; Horstman 2017; Hunter 2012; Koumouitzes‐Douvia 2006; LaMancuso 2016; Schroeder 2005; Shlafer 2015; Torres 2013; Torres 2015), United Kingdom (Darwin 2016; Longworth 2011; McGarry 2016; McLeish 2018; Somers‐Smith 1999), and Australia (Harte 2016; Maher 2004; Stevens 2011), and one multi‐country study conducted in the USA and Canada (Gilliland 2011). Of the 33 studies conducted in high‐income countries, 21 studies focused on doula models of companionship (Akhavan 2012a; Akhavan 2012b; Berg 2006; Coley 2016; Darwin 2016; Gentry 2010; Gilliland 2011; …”

“…Seven studies were conducted in Africa (Afulani 2018; Alexander 2014; Chadwick 2014; Kaye 2014; Kululanga 2012; Pafs 2016; Shimpuku 2013); two in Asia (Qian 2001; Sapkota 2012); 14 in Europe (Akhavan 2012a; Akhavan 2012b; Bäckström 2011; Berg 2006; Bondas‐Salonen 1998; Darwin 2016; Ledenfors 2016; Longworth 2011; Lundgren 2010; McGarry 2016; McLeish 2018; Premberg 2011; Somers‐Smith 1999; Thorstensson 2008); five in the Middle East (Abushaikha 2012; Abushaikha 2013; Fathi 2017; Kabakian‐Khasholian 2015; Khresheh 2010); 17 in North America (Campero 1998; Chandler 1997; Chapman 1990; Coley 2016; Gentry 2010; Gilliland 2011; Hardeman 2016; Horstman 2017; Hunter 2012; Koumouitzes‐Douvia 2006; Lagendyk 2005; LaMancuso 2016; Price 2007; Schroeder 2005; Shlafer 2015; Torres 2013; Torres 2015); three in South America (Brüggemann 2014; Dodou 2014; de Souza 2010); and three in Oceania (Harte 2016; Maher 2004; Stevens 2011). …”

“…Providers, women and male partners highlighted physical space constraints of the labour wards as a key barrier to labour companionship as it was perceived that privacy could not be maintained and wards would become overcrowded (moderate confidence; Abushaikha 2013; Afulani 2018; Brüggemann 2014; Harte 2016; Kabakian‐Khasholian 2015; Qian 2001; Sapkota 2012; Shimpuku 2013). Labour wards often had open floor plans, possibly with only a curtain to separate beds (Abushaikha 2013; Brüggemann 2014; Kabakian‐Khasholian 2015; Qian 2001; Sapkota 2012; Shimpuku 2013).…”

“…Where they were included in antenatal preparation, they felt that they learned comfort and support measures to assist their partners, but that these measures were often challenging to implement throughout the duration of labour and birth.Abushaikha 2013; Bondas‐Salonen 1998; Chandler 1997; Ledenfors 2016; Sapkota 2012; Somers‐Smith 1999Low confidenceDue to minor concerns regarding coherence, moderate concerns regarding methodological limitations and relevance, and serious concerns regarding adequacy9In settings where lay companionship or doula care were available, providers were not well trained on how to integrate the companion as an active or important member of the woman’s support team.Bondas‐Salonen 1998; Brüggemann 2014; Kabakian‐Khasholian 2015; Kaye 2014; Lagendyk 2005; Torres 2013Moderate confidenceDue to minor concerns regarding methodological limitations, coherence and relevance, and moderate concerns regarding adequacy10Some doulas felt that they were not well integrated into decision‐making or care co‐ordination by the healthcare providers, and were sometimes ignored by healthcare providers.Berg 2006; McLeish 2018; Stevens 2011; Torres 2013Low confidenceDue to minor concerns regarding coherence, moderate concerns regarding methodological limitations, and serious concerns regarding relevance and adequacy11Most healthcare providers believed that having a lay companion support a woman throughout labour and childbirth was beneficial to the woman and worked well when companions were integrated into the model of care. However, when lay companions were not well engaged or integrated, conflict could arise as they may be perceived as an additional burden for healthcare providers to manage their presence, and provide ongoing direction and support.Brüggemann 2014; Harte 2016; Kabakian‐Khasholian 2015; Khresheh 2010; Maher 2004; Qian 2001Moderate confidenceDue to minor concerns regarding coherence, and moderate concerns regarding methodological limitations, relevance, and adequacy12Most midwives believed that doulas played a collaborative role in supporting women during childbirth, and were assets to the team who provided more woman‐centred, needs‐led support. However, some midwives found it difficult to engage as carers with women when doulas were present, as they felt that doulas encroached on their carer role.Akhavan 2012b; ...…”

Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery

“…Exceptions were the articles by Murray et al 42 and Harte et al ,44 which presented detailed descriptions of coding processes. In most articles, it was not clear if analysis was carried out using ‘traditional’ techniques or if rapid approaches were also used to analyse and interpret the data 2 49–51.…”