A survey of pregnant and postnatal women, clinic attendees and maternity staff regarding the presence of birth companions during labour and delivery

Introduction: Continuous one-to-one support for women in childbirth has been demonstrated through a meta-analysis and several studies to improve maternal and infant outcomes and yet is not implemented in most public sector health facilities. The purpose of this qualitative study was to explore the opinions of women, community members and health professionals in an urban Zimbabwe setting, towards the notion of lay birth companions present during labour and delivery. Methods: Brief interviews were conducted with key informants and service-users selected using convenience sampling at an urban polyclinic. The opinions of obstetricians were obtained through consultations held at a central government hospital. Responses were recorded, analysed and grouped under themes that focused on the desirability of the intervention, opinions on who would be suitable candidates for such roles as well as the opinions of the relevant health professionals. Results: Overall 73.3% of all respondents supported the idea of birth companions and 43.6% of respondents opted for the husband as the best person to assume the role. About 80% of health professionals support the concept but cited logistical and cultural issues as barriers. Those against the idea felt it was unnecessary, the support from nurses was sufficient, and the presence of husbands in the delivery room would be culturally inappropriate. Conclusion: The involvement of birth companions supporting women during childbirth could be promoted as a low cost preventive intervention to improve maternal and perinatal outcomes, though cultural and structural barriers still remain to be overcome. Women relatives or trained lay supporters may be more acceptable as birth companions than male partners for privacy reasons.