Association of Untrained Labor Companion with Operative Delivery Rate: Retrospective Study of 2247 Women

Supporting birth companions for women in labor, the views and experiences of birth companions, women and midwives: A mixed methods systematic review

BACKGROUND

Birth companions can have a positive effect on women's experiences in labor. However, companions can feel unprepared and need professional guidance to help them feel involved and provide effective support.

METHODS

A convergent segregated mixed-methods systematic review was conducted to explore women's, companions', and midwives' experiences of birth companion support and identify ways to improve the experience for women and companions. A thematic synthesis of qualitative data and a narrative summary of quantitative data were conducted followed by integration of the findings.

RESULTS

Companions who cope well in labor reported feeling involved, able to preserve women's internal focus and have a defined role, providing physical or emotional support. LBGTQ+ partners faced barriers to inclusion due to "forefronting" of their sexuality by staff and a lack of recognition in the language and processes used. The experience of birth companions can be enhanced by promoting their role as co-parent, guardian, and coach, provision of timely information and developing a trusting relationship with care providers. Only two papers reported midwives' views on birth companions in labor.

CONCLUSIONS

Women's and companions' satisfaction with birth is increased when companions can support the mother, feel supported themselves, and valued as a co-parent. The midwives' role in information provision and guidance can maximize birth companions' experience and ability to provide positive support. LBGTQ+ families need more support to feel included and recognized.

From global recommendations to (in)action: A scoping review of the coverage of companion of choice for women during labour and birth

Women greatly value and benefit from the presence of someone they trust to support them throughout labour and childbirth ('labour companion of choice'). Labour companionship improves maternal and perinatal outcomes, including enhancing physiological labour and birth experiences. Despite clear benefits, implementation is slow. We conducted a scoping review to assess coverage and models of labour companionship, including quantitative studies reporting coverage of labour companionship in any level health facility globally. We searched MEDLINE, CINAHL, and Global Health from 1 January 2010-14 December 2021. We extracted data on study design, labour companionship coverage, timing and type of companions allowed, and recoded data into categories for comparison across studies. We included data from a maternal health sentinel network of hospitals in Latin America, using descriptive statistics to assess coverage among 120,581 women giving birth in these sites from April 2018-April 2022. In the scoping review, we included 77 studies from 27 countries. There was wide variation in the coverage of labour companionship: almost one-third of studies reported coverage less than 40%, and one-third of studies reported coverage between 40-80%. Husbands or partners were the most frequent companion (37.7%, 29/77), followed by family member or friend (gender not specified) (32.5%, 25/77), family member or friend (female-only) (13.0%, 10/77). Across nine sentinel hospitals in five Latin American countries, there was variation in coverage, with no companion at any time ranging from 14.9%-93.8%. Despite the well-known benefits and factors affecting implementation of labour companionship, more work is needed to improve equitable coverage. Concerted efforts are needed to engage with communities, health workers, health managers, and policy-makers to establish policies, address implementation barriers, and integrate data on coverage into perinatal records and quality processes to ensure that all women have access. Harmonized reporting of labour companionship would greatly enhance understanding at global level.

Fathers' presence in the birth room - implications for professional practice in the Caribbean

Aims or Objectives: This study explored the perspectives of Obstetricians and Registered Nurses/Midwives on the presence of expectant fathers in the birth room.

METHODS

A qualitative research design was used to explore perceptions and attitudes of Obstetricians and Registered Nurses/Midwives. Data were collected using five focus group and five key informant interviews and analysed using van Manen's [2007. Phenomenology of practice. Phenomenology & Practice, 1(1), 11-30] interpretative phenomenological approach.

RESULTS

Four themes emerged (i) perception of the Obstetrician/Registered Nurse/Midwife, (ii) demands on the practitioner, (iii) support for staff and (iv) potential challenges for practice. While participants held positive views, the nature of the birth experience could have negative implications for themselves and expectant fathers. Poor communication could exacerbate negative perceptions in emergency settings.

CONCLUSIONS

The presence of expectant fathers in the delivery room could have a positive impact on the birth experience for mothers, fathers and health professionals in the Caribbean. However, it could be challenging in emergencies.