ASSESSING THE EFFECT OF COMPANIONSHIP DURING LABOUR ON LABOUR AND DELIVERY OUTCOMES AT MILE FOUR HOSPITAL, ISHIEKE ABAKALIKI, EBONYI STATE

  • UDOCHUKWU DANIEL AGHOR National Postgrduate Medical College of Nigeria (NPMCN)

Abstract

There are few human experiences as profound as the physical, psychological, and social
intensity of labour and childbirth. Beyond the physiological aspects, childbirth is a socially
and historically shaped event, with wide cultural and geographical variability. Historical
evidence showed that women have been attended to by other women during labour, mostly
relatives and in some societies, traditional birth attendants.
Although, the adoption of modern obstetric practices has resulted in decrease in the incidence
of maternal morbidity and mortality, obstetric interventions have continued to increase.
Women give birth in hospitals where they are often left to labour alone as the midwives often
have too many women they care for at the same time. Health care providers tend to
underestimate the importance of the experience of childbirth and focus more on the outcomes,
such as morbidity and mortality. Though, some women reported the experience of labour and
childbirth to be empowering, ecstatic or even orgasmic event, most others report it as being
stressful and painful.
In the early twentieth century, with the emergence of evidence-based healthcare, a worldwide
movement started to document the emotional, health benefits and maternal satisfaction
associated with companionship and support during labour.
Aim: This study was undertaken to compare the birthing experiences and labour outcome
among parturients with and without companionship in labour at Mile 4 Hospital Ishieke
Abakaliki with a view to enhancing positive maternal experience and better foetal outcome.
Materials and methods: This was a hospital-based prospective cohort study involving 587
pregnant women recruited using systematic random sampling method and randomly allocated
into intervention and control groups. The study lasted for four months. Relevant data onĀ 
demographic features were obtained using a pre-tested interviewer-administered
questionnaire. Data was analysed using Statistical Package for Social Sciences version 20.
Main outcome measures: The main outcome measures in this study were pain perception
and anxiety among parturients and Apgar score of the babies at 1 and 5-minutes.
Results: More women in the control group had severe pain compared to the intervention
group (x2-51.201; p<0.001). Also majority of the parturients with companions had low
anxiety levels (56.8%); 39.0% had moderate anxiety and only about 4.1% had high anxiety
levels. But among the women without companions, the majority of them (56.3%) had high
anxiety levels; in 38.0% of the women, their anxiety level was moderate while only a small
proportion of them (5.8%) had low anxiety(x2-254.162; p<0.001).
There was no significant difference in the Apgar score at 1 and 5 minutes between the two
groups.
Conclusion: Companionship during childbirth is a safe and effective intervention in
improving maternal labour experience with regard to psychosocial variables and does not
worsen foetal outcome. However, there is need for clear guidelines to govern the practice for
health care professionals and labour support persons to avoid potential harm to the parturient.

Published
2019-04-20
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