The impact of birth companion on respectful maternity care and labor outcomes among primigravida in a rural tertiary care centre: a quasi-experimental study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20262112Keywords:
Birth companion, Respectful maternity care, Primigravida, Childbirth experience, Labor outcomes, Quasi-experimental studyAbstract
Background: Respectful maternity care (RMC) and continuous labor support are essential components of quality intrapartum care. Although the World Health Organization recommends allowing a companion of choice during childbirth, this practice remains underutilized in many resource-limited settings. This study evaluated the impact of a birth companion on RMC perceptions and labor outcomes among primigravida women in a rural tertiary care centre.
Methods: A quasi-experimental study was conducted in the Department of Obstetrics and Gynaecology, RL Jalappa Hospital, Kolar, during January 2026 – March 2026. Ninety-six primigravida women were enrolled and allocated into a study group (n=48), who received continuous support from a female birth companion, and a control group (n=48), who received standard intrapartum care. Data were collected using validated RMC, childbirth experience questionnaire (CEQ), and maternal satisfaction scales. Statistical analysis was performed using statistical package for the social sciences (SPSS) version 25.0, with p<0.05 considered significant.
Results: The study group demonstrated significantly higher RMC scores (42.56±4.12 versus 34.23±5.87), CEQ scores (3.74±0.42 versus 2.89±0.51), and maternal satisfaction scores (41.62±3.84 versus 32.48±5.36) (all p<0.001). Normal vaginal delivery was more frequent in the study group (81.25% versus 62.50%; p=0.042), while cesarean section rates were lower (12.50% versus 29.17%; p=0.049). Active labor duration was significantly shorter (5.82±1.34 versus 7.46±1.72 hours; p<0.001). Neonatal outcomes were similar between groups.
Conclusion: Birth companion support significantly improved RMC perceptions, childbirth experience, maternal satisfaction, and labor outcomes. Integrating birth companion programs into rural tertiary care settings may be a cost-effective strategy to enhance the quality of maternal care.
References
World Health Organization. WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience. Geneva: World Health Organization. 2018. Available at: https://www.who. int/publications/i/item/9789241550215. Accessed on 12 March 2026.
Tunçalp Ö, Were WM, MacLennan C, Oladapo OT, Gülmezoglu AM, Bahl R, et al. Quality of care for pregnant women and newborns—the WHO vision. BJOG. 2015;122(8):1045-9.
Soubeiga D, Gauvin L, Hatem MA, Johri M. Birth preparedness and complication readiness (BPCR) interventions to reduce maternal and neonatal mortality in developing countries: systematic review and meta-analysis. BMC Pregnancy Childbirth. 2014;14:129.
Bowser D, Hill K. Exploring Evidence for Disrespect and Abuse in Facility-Based Childbirth: Report of a Landscape Analysis. Bethesda, MD: USAID-TRAction Project. 2010. Available at: https:// coregroup.org/wp-content/uploads/media-backup/documents/elluminates/Respectful_Care_at_Birth_9-20-101_Final.pdf. Accessed on 12 March 2026.
Freedman LP, Ramsey K, Abuya T, Bellows B, Ndwiga C, Warren CE, et al. Defining disrespect and abuse of women in childbirth: a research, policy and rights agenda. Bull World Health Organ. 2014;92(12):915-7.
Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;7(7):CD003766.
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2013;(7):CD003766.
International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-5), 2019–21: India Report. Mumbai: IIPS. 2021. Available at: https://dhsprogram.com/pubs/pdf/ FR375/FR375.pdf. Accessed on 12 March 2026.
Fenwick J, Gamble J, Nathan E, Bayes S, Hauck Y. Pre- and postpartum levels of childbirth fear and the relationship to birth outcomes in a cohort of Australian women. J Clin Nurs. 2009;18(5):667-77.
Sapkota S, Kobayashi T, Takase M. Impact on perceived postnatal support and birth experience of a midwife-led community-based program in Nepal. Midwifery. 2013;29(12):1346-52.
Seth I, Singhal S, Seth A, Garg AM. The impact of birth companion on respectful maternity care and labor outcomes among Indian women: a prospective comparative study. Int J Reprod Contracept Obstet Gynecol. 2023;12:3508-14.
Afulani PA, Diamond-Smith N, Golber B, Prber M, Sudhinaraset M. Person-centered maternity care in low-income and middle-income countries: analysis of data from Kenya, Ghana, and India. Lancet Glob Health. 2017;5(9):e929-36.
Hodnett ED, Lowe NK, Hannah ME, Willan AR, Stevens B, Weston JA, et al. Effectiveness of nurses as providers of birth labor support in North American hospitals: a randomized controlled trial. JAMA. 2002;288(11):1373-81.
Kabakian-Khasholian T, Portela A. Companion of choice at birth: factors affecting implementation. BMC Pregnancy Childbirth. 2017;17(1):265.
Bohren MA, Berger BO, Munthe-Kaas H, Tunçalp Ö. Perceptions and experiences of labour companionship: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2019;3(3):CD012449.
Kumari R, Menon S, Kushtagi P. Continuous support during labor: a randomized controlled trial from India. Int J Gynaecol Obstet. 2020;151(2):264-69.
Yuenyong S, O’Brien B, Jirapeet V. Effects of labor support from close female relative on labor and maternal satisfaction in a Thai setting. J Obstet Gynecol Neonatal Nurs. 2012;41(1):45-56.
McGrath SK, Kennell JH. A randomized controlled trial of continuous labor support for middle-class couples: effect on cesarean delivery rates. Birth. 2008;35(2):92-7.
Patel R, Sharma M, Khatri N. Effect of birth companion on labor outcomes: a hospital-based study from Western India. J Obstet Gynaecol India. 2021;71(4):382-88.
Sharma B, Giri G, Christensson K, Ramani KV, De Costa A. The transition of childbirth practices among tribal women in Gujarat, India—a grounded theory approach. BMC Int Health Hum Rights. 2013;13:41.
Downloads
Published
How to Cite
Issue
Section
