Two are better than one? The impact of lay birth companions on childbirth experiences and PTSD

Abstract

Although continuous support during childbirth is recommended by the World Health Organization (WHO) and has wellestablished benefits, the practice is still not routinely implemented in all maternity settings. We studied the possible effect of an additional lay companion (other than the partner) on childbirth experience and postpartum post-traumatic stress disorder (PTSD). Two hundred and forty-six women, who gave birth in maternity wards of a large tertiary health center in Israel, responded to questionnaires in person at 1-4 days (Demographic questions and the childbirth experience questionnaire) and on-line at 8-10 weeks postpartum (City Birth Trauma Scale). Obstetric data were taken from the medical files. Women who were accompanied by their partners and an additional companion were lower in birth-related PTSD symptoms (M = 1.17, SD = 2.61) than women accompanied by only their partner (M = 1.53, SD = 2.79) (F(2, 240) = 4.0, p < 0.05). Women who had a single companion (M = 1.44, SD = 2.61) showed more birth-related PTSD symptoms than women who had two or more companions (M = 1.17, SD = 2.52) (F(1, 241) = 6.4, p < 0.05). In addition, women who had a single companion were higher in general PTSD symptoms (M = 3.91, SD = 4.73) than women who had two or more companions (M = 2.31, SD = 4.29) (F(1, 241) = 4.2, p < 0.05). No differences were found in childbirth experiences of women with single or multiple companions. Allowing more than one lay companion (other than the partner) may be a simple cost-effective way of providing beneficial support in all birth settings, promoting respectful maternity care and reducing childbirth-related PTSD levels and by that future psychopathology sequela.

Past Traumatic Life Events, Postpartum PTSD, and the Role of Labor Support

“…Furthermore, we show that both PP-PTSD symptoms and subjective rates of traumatic birth experience were lowest among women who had both their partner and a doula or private midwife present at birth, which is supported by a previous study where authors show similar results as our findings, with higher PP-PTSD symptoms among women with a single companion compared to those with two or more companions [46]. Thus, allowing more than one person to accompany women during childbirth may be a simple and cost-effective approach for providing support in all birth settings and minimizing the incidence of PP-PTSD.…”

“…According to a Greek study, women with insufficient perinatal support from their partners were more likely to suffer from PTSD or PTSD symptoms after a cesarean birth than women who received adequate support from their spouses [45]. Furthermore, Handelzalts et al [46] found that participants who were supported by their partners and a second companion had fewer PP-PTSD symptoms than women who were accompanied only by their partners. Accordingly, several Russian studies showed that although there were no significant direct associations between support during labor and PP-PTSD, support from a partner, doula, or private midwife during childbirth was associated with lower rates of obstetric violence, fewer medical interventions, and higher birth satisfaction, which may indirectly mitigate the risk of PP-PTSD [20,24,47].…”

Experiences of birth companions as they provide support to labouring women at Queen Elizabeth Central Hospital in Blantyre, Southern Malawi

“…Several studies have investigated the expectations of birth companions. Studies have shown a variation in the expectations of birth companions [22,23]. The present study showed that birth companions expected their clients to respect cultural beliefs.…”

The Social Context of Pregnancy, Respectful Maternity Care, Biomarkers of Weathering, and Postpartum Mental Health Inequities: A Scoping Review

“…Handelzalts (2022) [75] Israel PL BC PTSD Women who were accompanied by their partners and an additional companion were lower in birth-related PTSD symptoms than women accompanied by only their partner (p < 0.05). Jones (2018) [82] 295 USA R SES PPD Residential stability was found to be statistically significantly associated with PPD symptom severity based on the 3-month EPDS total score (p = 0.01).…”