Opinion of Health Care Providers on Birth Companions in Obstetrics Department of a Tertiary Care Hospital in North India

Abstract

Background Despite impressive improvements in institutional births and a fall in maternal mortality, satisfaction of women with birthing experience in public health institutions is low (68%). Birth Companion is an important part of the Labour room Quality Improvement (LaQshya) programme introduced by the Government of India in 2017. Despite mandates, implementation of the concept has been unsatisfactory (9%), even though the importance of Birth Companion has increased due to enhanced risk posed by COVID-19. Little is known about awareness among health care providers on Birth Companions, perceived barriers or their suggestions. Methods We canvassed a 15-question instrument using ordinal scales on 151 health care providers comprising consultants, post graduates, residents, and nurses (response rate 69%) in the department of Obstetrics & Gynecology, Lok Nayak Hospital, Delhi, India to gauge their awareness and opinions about Birth Companions. Results Most health care providers across all categories were aware of the concept (93%), World Health Organization recommendation (83%) and Government instructions for its hospitals (68%) that every woman should be accompanied by a Birth Companion of her choice during labour. Birth Companions of choice suggested by them were the mother (70%), husband (69%). sister (46%) or nurse (43%). Most health care providers agreed that a Birth Companion should wear clean clothes (95%), be free from any communicable disease (91%), stay with the pregnant woman throughout the process of labour (74%) and should have herself gone though labour (42%). Almost all providers (95%) agreed that the presence of a Birth Companion during labour will be beneficial, as they would provide emotional support (99%), boost the confidence of the woman (98%), provide comfort measures like massage (95%), early initiation of breastfeeding (93%), reduce post-partum depression (91%), humanize labour (83%), reduce need for analgesia (70%) and increase spontaneous vaginal births (69%). Yet support for its introduction in their hospital was low (59%). Staff nurses had reservations (62%) with only 40% of those who believed Birth Companion to be beneficial approving of its introduction in their hospital. Over-crowding in labour room and privacy concerns for other women were identified as key barriers. Conclusion Even though most health care providers were aware of and convinced of multiple benefits of Birth Companion during labour, lack of adequate infrastructure in the labour room prevented them from supporting its introduction. Government should provide adequate funding to upgrade labour rooms in a way that provides privacy to the delivering women and frame guidelines and train Birth Companions to perform their role appropriately. Keywords: Birth Companion, Delivery, Respectful Maternity Care, Privacy, Health Care Providers, COVID-19

Desire for Birth Companionship Among Pregnant Women Attending Antenatal Care in Debremarkos City, Northwest Ethiopia: Magnitude and Associated Factors

“…The additional laboring mothers often felt helpless during labor and delivery and they were considered as providers who were not with them all the time ( 20 , 23 ). In other cases, health care providers are usually too much busy with additional things and ensure that when a laboring woman need help, there is someone readily available to help them, like to call the provider if they developed a problem, need to go to the bathroom, and when she went into the second stage of labor ( 24 , 25 ).…”