Healthcare providers perceptions regarding the presence of Birth Companion during childbirth at a tertiary care hospital in India.

backgroundDespite an increase in institutional births and a fall in maternal mortality, the satisfaction of women with their birthing experience in public health institutions is low. Birth Companion (BC) is an important part of the Labour Room Quality Improvement Initiative introduced by the Government of India in 2017. Despite mandates, its implementation has been unsatisfactory. Little is known about the perception of healthcare providers about BC.

methodsWe conducted a facility-based, cross-sectional quantitative study with doctors and nurses in a tertiary care hospital in Delhi, India to gauge their awareness, perception and knowledge about BC. Following universal total population sampling, the participants were administered a questionnaire, which was completed by 96 of 115 serving doctors (response rate of 83%), and 55 of 105 serving nurses (response rate of 52%).

resultsMost (93%) healthcare providers were aware of the concept of BC, WHO's recommendation (83%) and Government's instructions (68%) on BC during labour. A woman's mother was the BC of choice (70%) closely followed by her husband (69%). Ninety-five percent of providers agreed that the presence of a BC during labour will be beneficial, in providing emotional support, boosting the woman's confidence, providing comfort measures, helping in the early initiation of breastfeeding, reducing post-partum depression, humanizing labour, reducing the need for analgesia and increasing chances of spontaneous vaginal births. Yet, support for the introduction of BC in their hospital was low due to institutional barriers like overcrowding, lack of privacy, hospital policy, risk of infection; privacy issues and costs.

conclusionsWidespread adoption of the concept of BC would require, besides directives, a buy-in by the providers, and action on their suggestions. These include greater funding for hospitals, creating physical partitions to ensure privacy, sensitization and training of health providers and BC, incentivizing hospitals and birthing women, formulation of guidelines on BC, standards setting and a change in institutional culture.