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