Utilisation of and factors associated with birth companionship at Kawempe National Referral Hospital

Abstract

Background: The World Health Organization recommends birth companionship for all mothers as a way of improving labour outcomes as well as increasing satisfaction with care during childbirth by the mothers. In low and middle income countries, birth companionship remains an exception rather than the norm. There is limited information about the extent to which birth companionship is practiced and the factors associated with its implementation. This study therefore sought to address this knowledge gap, and provide the information needed by the policy makers to implement this important intervention. Methods: This was a cross sectional study, carried out at Kawempe National Referral Hospital in September 2022. 380 postnatal mothers aged between 15-50 years, who delivered during the study period were selected by systematic sampling from the postnatal ward. They were interviewed using provider-administered pre-tested structured questionnaires. The data was checked for completeness daily and then entered into Epi Data software, version 4.4 and exported to Statistical Package for Social Sciences SPSS version 24.0 for analysis. Having continuous support from a birth companion during labor was considered as birth companionship. Chi Square test was used to assess for the association between utilization of birth companionship and independent factors. Bivariate and multivariate logistic regressions were used to analyze the factors associated with having a birth companion during the entire labor process. Results: Of the 380 mothers interviewed, 39.5% utilized birth companionship. The factors associated with birth companionship were; residence outside Kampala [aOR=2.76, 95% CI: 1.41-12.76, P=0.004], family income of >1,000,000 UgShs [aOR=2.86, 95% CI: 1.61-12.21, P=0.011], history of complications during previous deliveries [aOR=2.88, 95% CI: 1.43-9.97, P=0.015], desire for birth companionship [aOR=4.17, 95% CI: 2.64-17.85, P=0.0017], belief that the health facility allowed birth companionship [aOR=3.43, 95% CI: 1.97-13.21, P=0.0026], and belief that the health workers were comfortable with birth companionship [aOR=2.87, 95% CI: 1.63-9.73, P=0.0042]. Conclusions: There is a low level of utilization of birth companionship at Kawempe National Referral. More effort has to be put into implementing birth companionship utilisation.