Companionship utilization and its associated factors during childbirth among mothers who delivered at public hospitals in Shashemene town, Southern Ethiopia: A mixed-method study.

BACKGROUND

Childbirth companionship has multiple benefits and is associated with improved maternal and neonatal outcomes. However, childbirth companionship is an important component of respectful maternity care that is still underutilized in the clinical setting. Therefore, this study assessed factors associated with childbirth companionship utilization among mothers who delivered at a public hospital in Shashemene town, southern Ethiopia.

METHODS

A facility-based mixed methods study was performed among 411 mothers who delivered at Public Hospitals in Shashemene town from August 20 to September 20, 2021. We entered the collected data into Epidata version 3.1 and exported it to SPSS software version 23 for analysis. A binary logistic regression model was employed to assess the relationship between independent variables and childbirth companionship utilization. A p < 0.05, with an Adjusted Odds Ratio (AOR) and 95% confidence interval (CI) were employed to declare the association. For an in-depth interview, the interview guide was utilized to collect data. We used Open Code software 4.03 for verbatim transcription, translation, and thematic analysis of the data.

RESULTS

The magnitude of childbirth companionship utilization was 14.4% (95% CI: 11.2-17.6). Having complications during pregnancy and labor [AOR = 3.25, (95% CI: 1.74, 6.05)], having a future desire to have companions [AOR = 4.02, (95% CI: 1.72: 1.66, 9.41)], primiparous [AOR = 2.54, (95% CI: 1.25, 5.28)], and good knowledge of companionship [AOR = 3.00, (95% CI: 1.53, 5.91)] were significantly associated with childbirth companionship utilization. Qualitative findings also revealed that healthcare providers' denial, overcrowding of the delivery room, and mothers' fear of exposing partner/family members to stress were barriers to utilizing childbirth companionship.

CONCLUSION

In this study, the magnitude of childbirth companionship utilization was low and below the WHO recommendation. Therefore, the study highlights the significance of acting on the health system, client, and provider-side factors, which are important to improve the implementation of respectful maternity care components at the facility level. In addition, the integration of respectful maternity care counseling into routine prenatal care, regardless of mothers' pregnancy risk status, could enhance utilization. Moreover, addressing barriers to companionship utilization through healthcare provider training, developing clear facility-based guidelines, and improving health facilities' infrastructure is crucial to enhance childbirth companionship and improve maternal health outcomes.