Client and provider factors associated with companionship during labor and birth in Kigoma Region, Tanzania.
Michelle M Dynes, Susanna Binzen, Evelyn Twentyman and 5 others
PMID 30453122WHAT IT FOUND
Only 12% of women had a companion at birth.
Provider workload and job satisfaction drove this: those working over 55 hours weekly or feeling very satisfied were significantly more likely to allow a companion in labor.
Key findings
01Companionship was rare, with less than half of women having a companion in labor and only about one in ten having one at birth.
02Clients had higher odds of having a labor companion if their provider worked more than 55 hours per week or reported very high job satisfaction.
03Providers who reported having an on-site supervisor were significantly less likely to allow a labor companion.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used a cross-sectional design and convenience sampling, so it cannot prove that provider factors caused the companionship outcomes. Data relied on self-reports from providers, which may be influenced by social desirability bias or fear of negative consequences. The study did not collect information on specific facility policies, so it is unclear if variations in companionship were due to formal rules or individual provider discretion. The analysis could not distinguish between women who had a companion of their choice versus one imposed or accepted by default.
Declared interests
Funded by Bloomberg Philanthropies and the H&B Agerup Fondation. No conflicts of interest declared.
The easy way to misread this
Do not assume that increasing supervision will lead to more respectful care through companionship. In this study, providers with on-site supervisors were less likely to allow labor companions, suggesting supervision may enforce restrictive no-companion policies.