Midwives' views regarding birth companionship during childbirth in designated primary healthcare facilities in Limpopo Province

Abstract

Introduction and background: The birth companionship programme was introduced as part of the Respectful Maternity Care (RMC) in Limpopo Province in 2017. The RMC initiative aims to improve the quality of care for pregnant women and encompasses transforming maternity units and providing physical and emotional support for women during pregnancy, labour, birth, and postnatal period. The term 'Birth or labour companion' refers to the support that pregnant women receive during labour or childbirth. This can be provided by a partner, family member, friend, doula, or a healthcare professional. The presence of a birth companion affords pregnant women emotional support, information as well as coping techniques. As a result, midwives are expected to offer pregnant women the option of having a birth companion during labour and birth. However, most primary health care facilities in the province have not yet embraced the birth companionship programme. As expected, the birth companionship was not practiced by midwives at the health care facilities where this research was conducted.

Objectives: To explore and describe the midwives’ views regarding birth companionship during childbirth in designated Primary Health Care Facilities in Limpopo.

Methodology: A qualitative research method was used to explore and describe the views of midwives on birth companionship in the Sekhukhune District of the Limpopo Province. The population is comprised of trained and practicing midwives in the 10 designated Primary Health Care Facilities. Purposive sampling was used to select midwives who were more knowledgeable about the problem under investigation. A total number of 30 midwives were interviewed. In-depth interviews were conducted with the midwives until saturation was reached. The interviews were conducted using a semi-structured interview guide. Tesch's open coding data analysis approach was used and applied when analysing the data. Ethical considerations and trustworthiness were maintained throughout the data collection, analysis and presentation of research findings.

Findings: Three main themes and sub-themes related to midwives’ views on birth companionship emerged. The themes are midwives’ knowledge and training on birth companionship; The role of birth companion during labour and the barriers affecting implementation of birth companionship. These themes further guided recommendations for birth companionship and the implementation thereof in midwifery practice, education and research.

Conclusions: Birth companionship is not widely practiced at the designated primary health care facilities where this study was conducted. Midwives, even though they understood the concept of birth companionship, had limited knowledge. Factors such as culture, poor infrastructure and human resources at primary health care facilities are amongst barriers to the successful implementation of birth companionship. Clear guidelines and training are necessary for midwives to implement and/or improve birth companionship practise at healthcare facilities. Lastly, midwives who receive training should train others within their facilities to ensure that birth companionship, as an option, is offered to women seeking antenatal care.

Key words: birth companionship, birth companion, childbirth, midwives, labour support