Saudi women’s acceptance and attitudes towards companion support during labor: Should we implement an antenatal awareness program?

Abstract

BACKGROUND AND OBJECTIVESDespite the known benefits of support during chilbirth, most hospitals in Saudi Arabia do not allow a companion during labor. This can be due to cultural beliefs among pregnant Saudi women. The aims of this study are to describe Saudi women’s preferences towards supportive companions during labor and to explore their attitudes and knowledge about the importance of support during childbirth.DESIGN AND SETTINGProspective cohort study conducted in three governmental tertiary hospitals within Riyadh.SUBJECTS AND METHODSWomen who consented were interviewed during their postpartum hospital stay using a validated standardized Arabic questionnaire. Participants were asked about their preferences and attitudes towards companions during childbirth, as well as about their knowledge on the importance of such support.RESULTSOf 402 women who participated in the study, 182 women (45.3%) preferred the presence of a companion during childbirth and only 57 of all interviewed women (14.2%) had ever had a supportive companion during any of their previous childbirths. The mother (58%) or husband (51%) was the most preferred person as a childbirth companion. Age, level of educational, or antenatal, intrapartum or postpartum status had no impact on their decision. However, women who had some sort of antenatal educational classes and/or read educational material about childbirth were more likely to prefer support during labor. More than one-third of participants (35.9%) thought that having a companion as support during labor would not help, but the most common reason for not preferring to have a companion was their fear of being exposed most of the time to their companion (64.1%).CONCLUSIONSA significant percentage of surveyed Saudi women preferred not to have a supportive companion during childbirth. The reason might be a lack of understanding of the positive role of a companion during childbirth or because of cultural beliefs. Education of women during their antenatal care about the importance and the implementation of such a practice are warranted.

A Study on the Attitude and Preference of Antenatal Clinic Attendees to Companionship during Labour and Delivery in Alex Ekwueme Federal University Teaching Hospital, Abakaliki

“…A study done at university college teaching hospital, Ibadan, Nigeria reported that 75% of the respondents desired companionship in labour [12]. Another study in Saudi Arabia found that 59% of women had support during labour [18]. In index study, most women preferred their husband as labour companion (47.25%); this however contrasts with study by Bakhata et al [12] where 68% of women declined to have male partners present during labour.…”

“…Evidence indicates that continuous support during labour has a number of measurable positive impacts on key birth outcomes [12]- [19]. It has been found to significantly reduce the number of caesarean sections and operative vaginal deliveries, an increase in the number of normal births, a reduction in the use of analgesia and a reduction in labour duration [18] [19].…”

“…Companionship, by a family member or a doula (a trained labour support person) can include emotional support (continuous presence, reassurance and praise), information about progress in labour, advice regarding coping techniques, comfort measures (such as touch, massage, warm baths/showers, promoting adequate fluid intake and output) and advocacy (helping the woman to articulate her wish and need) [1]- [18].…”

“…Women's birth experiences have widespread and long-term implications for women and their families [13] [16]. Poor experience may contribute significantly to perinatal mental health problems including post-traumatic stress disorder and postnatal depression undermine the development of a positive mother-baby attachment and influence women's decisions about future childbearing [18].…”

“…In actual clinical practice, there are a wide range of cultural and societal differences in childbirth support system [5] [17]. In developed countries, the main social supporters are usually the partners or close relatives [5] [18]. In contrast, in many developing countries like South America and Africa, companionship during labour is not routine [16] [19].…”