Experiences and perceptions of postnatal mothers on birth companion during childbirth at Nguruka Health Centre in Uvinza District, Kigoma Region, Tanzania

Abstract

ABSTRACT Background Childbirth is an important event in the life of a woman and her family. A labouring woman develops a feeling of security when is supported by a birth companion of her own choice who is continuously encouraging and appreciating her efforts. The World Health Organization (WHO) recommends birth companion as a key aspect for respective maternity care and every woman is offered the option to experience labour and childbirth with a companion of her choice. The quality of support a woman receives during childbirth is an important determinant of the use of maternal health care services, and may directly or indirectly influence maternal and neonatal mortality and morbidity. Women who receive continuous care and support during labour and delivery are more likely to give birth without using analgesia, less likely to have a caesarean delivery or instrumental vaginal birth and less likely to report dissatisfaction with her childbirth experience. Despite the known benefits of continuous support during childbirth, the practice is still not routinely implemented in most maternity settings. In Tanzania, Thamini Uhai in collaboration with the Regional Health Management Team (RHMT) is implementing the birth companion project in nine (9) health facilities offering birth companionship during labour and delivery. The project offers pregnant women the option to have a birth companion with them into the health facility to provide continuous support throughout labour and delivery. The project aims were to identify postnatal mothers and factors associated with companionship during childbirth where a woman chose to be supported either by desired birth companion from home or by a trained birth companion stationed at the facility (on-call birth companion). Despite its practices and efforts to scale-up, women‟s views and experiences on companionship during childbirth have not been adequately explored and need to be addressed. Broad objective To explore the experiences and perceptions with birth companion during childbirth among postnatal mothers at Nguruka Health Centre in Uvinza District, Kigoma region. Material and Methods The descriptive qualitative research design was used to explore views and experiences from postnatal mothers on birth companion during childbirth. The study was conducted at Nguruka health centre in Uvinza district, Kigoma region. Twelve (12) postnatal mothers who were conveniently recruited in the study provided written informed consent to participate in the study. In-depth interviews were conducted between April and May 2019 and analysis was guided by a thematic analytical framework. Results Major themes were; the experiences of care and support received from the birth companion, choosing the desired birth companion and perceived roles of the birth companion. The majority of women reported reduced fear of being alone in the labour room and received prompt care and support from their companions when the midwife was not around or was attending another woman. Despite that the facility has trained birth companions who are paid by the project and were available at the labour ward, most women preferred mothers-in-law and mothers as their companion of choice to facility based birth companions. Women‟s perceptions about continuous support during childbirth were influenced by affirmed attributes of the supportive person as well as the types of supportive care rendered. Conclusion and Recommendations Continuous support during labour and childbirth was valued by most women and their perceptions were influenced by the type and attributes of a supportive person. Most women preferred birth companion from home to facility-based birth companions. Allowing every woman to experience labour and childbirth with a companion of her choice and provision of continuous labour support during labour and delivery would enhance institutional delivery and reduce the number of home deliveries, early neonatal loss and maternal deaths through clean and safe delivery offered by skilled birth attendants. Therefore, provision of routine antenatal education and advocacy to pregnant mothers on the availability of trained birth companion stationed at the facility would increase the number of postnatal mothers supported by on-call birth companion during labour and delivery. Keywords: Birth companion, childbirth experiences, continuous labour support