Exploring women’s preferences for birth companionship in Kenya
The World Health Organization recommends that every woman be offered the option to experience labor and delivery with the companion of her choice. A new study from the Bixby Center, UCSF Institute for Global Health Studies and the Kenya Medical Research Institute is the first study to explore how companionship during birth is practiced in Kenya and how patients and providers perceive it.
Researchers found that most women wanted to have a companion with them during labor, but fewer wanted someone there during delivery. Women who were allowed a companion during a previous birth were more likely to want one in the future. The most common reasons women cited for wanting a companion were to have someone to attend to their needs and help them make decisions. Women who didn’t want a companion there cited embarrassment, fear that the person would gossip about them, and fear that they might abuse the person or vice-versa. Many preferred a female companion to their male partner because of fears that seeing the delivery would affect the partner’s sexual desire or due to cultural beliefs that the presence of the man would prolong the birth.
Most providers reported that women were usually allowed a companion during labor, while fewer were allowed during delivery. They generally had the same reasons for allowing companions as the women mentioned, though they also noted that birthing companions could be helpful to providers in understaffed facilities.
Not all women were allowed a companion in labor or delivery. Younger, wealthier, employed, college-educated and literate women were more likely to be allowed continuous support. Women were less likely to be allowed a companion if they had a birthing complication or if 2 or more skilled providers were present.
The research suggests that there are different needs for different phases of delivery, and also for different types of birthing companions. It’s essential to understand and respect women’s varied preferences and desires while considering interventions with women, companions, and providers, as well as structural and health system interventions, to promote continuous support during labor and delivery.