4.2 Interpretation
Despite being recommended by the World Health Organization as one of the components of respectful maternity care, there is a dearth of studies on companionship in labour in our setting. Therefore, this study aimed to determine the awareness of companionship and desirability of pregnant women attending the antenatal clinic in UITH for companionship during labour. Exploring the desire of pregnant women for birth companionship for their future labour and delivery is very important to make the health facility ready to accommodate those companions, and it is essential to create a positive impression on health care providers about those companions.19
Although the benefits and promotion of support during labour and delivery have been in the past, most developing nations, such as Nigeria, still practice it below expectation.13 Lack of companionship in labour deprives women of cost-effective care.2,20 That might be because of the cultural background and poor architectural design of labour rooms in this environment, which discourages companionship during labour and delivery.
This study found the awareness of companionship in labour among antenatal clinic attendees in UITH to be relatively high (57.2%). However, only 18% of those aware of it had some form of companionship in their previous childbirth. The result is similar to the case in an Ethiopia study, which showed that only 13.8% of mothers utilized companionship during labour and delivery.21The result from the index study, as regards utilization of companionship during labour, is low when compared with a study done in Saudi Arabia, which found that 59% of women in labour had support during labour11 and the one conducted in Denmark, where 95% of women in labour had companions.10That could be due to socio-cultural differences and better-planned healthcare facilities to accommodate companions during labour, unlike in our environment where women labour primarily in open spaces without required privacy.
This study also found a high desire for companionship among the respondents (88.7%), similar to the finding from Abakaliki, where 92% of the respondents desired companionship in labour22. Similarly, another study at the University College Hospital, Ibadan, Nigeria, reported that 75% of the respondents desired companionship in labour.13 That showed that Nigerian women desire companionship in labour. However, its utilisation is low, and efforts must be made to prevent them from being deprived of this important supportive care as recommended by the WHO.
In this study, most women 64.4% preferred their husbands/partners as labour companions. The finding is similar to the findings from Abakaliki, which reported that 67.25% of the respondents preferred their husbands as companion in labour22. However, the finding in this study is in contrast to reported study from Russia where 68% of the women declined to have male partners present during labour.7 This difference may be due to individual, socio-cultural, or societal perceptions of the role of male partners.16 It could also be due to differences in family structures, relationships, and ties.
This study also found that the majority of the respondents (92%) expressed a desire to deliver their babies in a hospital with provision for companionship in labour. Most of these women would prefer to experience this, even at an additional cost. That agrees with a study conducted in Abakaliki.22
This study also revealed that most respondents (72.9%) had a tertiary (post-secondary) level of education. Most of these women opted for companionship in labour. However, it is unsurprising that those more educated women opted for companionship in labour. Enhanced efforts should also be made to propagate the role and value of companionship to less educated people. It agrees with another study, which demonstrated that the educational level of women was an important determinant.13There was a statistically significant relationship in relating educational level of the respondents to the desire for companionship in labour in this study, This is comparable to the findings by Mulualem where there was a lower desire for companionship in labour in those with secondary educational status whereas in a study done by Moharson Bello et al, women with post-secondary education were more likely to want their husbands as companion during labour.13,23There was a statistically significant relationship between ethnicity and desire for companionship in labour. Moharson Bello et al showed that ethnicity influences the desire for companionship in labour with non-Yoruba women more likely to want a companion in labour13. Similarly in a study done at Abakaliki Nigeria, most antenatal clinic antendees who were predominantly Igbo preferred their husband as companions during labour.22 Also, in a study done by Essex, mothers of certain ethnicities particularly black or Pakistan were at higher risk of being unaccompanied during childbirth which is associated with adverse maternal and infant outcomes.24Therefore ethnicity plays a significant role in desiring for companionship in labour.
The association between parity and desire for companionship in labour was statistically significant in this study, more women carrying first and second babies were more likely to desire for companionship in labour. Similarly in a study done by Mulualem, there was an association between the numer of pregnancies and desire for labour.23 Similarly in a study done by Beyenne, more primiparous women were more likely to utilize companion in labour21. In contrast to the findings in this study, Moharson Bello showed that nulliparous women had greater desire for companionship in labour.13