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SOCIAL SUPPORT DURING DELIVERY IN RURAL CENTRAL GHANA: A MIXED METHODS STUDY OF WOMEN'S PREFERENCES FOR AND AGAINST INCLUSION OF A LAY COMPANION IN THE DELIVERY ROOM

Published online by Cambridge University Press:  21 August 2013

AMIR ALEXANDER ,
AESHA MUSTAFA ,
SARAH A. V. EMIL ,
EBENEZER AMEKAH ,
CYRIL ENGMANN ,
RICHARD ADANU  and
CHERYL A. MOYER
AMIR ALEXANDER
Affiliation:
Minority and Health Disparities International Research Training Program, University of Michigan, Ann Arbor, MI, USA Global REACH, University of Michigan Medical School, Ann Arbor, MI, USA
AESHA MUSTAFA
Affiliation:
Minority and Health Disparities International Research Training Program, University of Michigan, Ann Arbor, MI, USA Global REACH, University of Michigan Medical School, Ann Arbor, MI, USA
SARAH A. V. EMIL
Affiliation:
St Luke's Hospital, Apam, Ghana
EBENEZER AMEKAH
Affiliation:
St Luke's Hospital, Apam, Ghana
CYRIL ENGMANN
Affiliation:
Departments of Pediatrics & Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
RICHARD ADANU
Affiliation:
School of Public Health, University of Ghana, Accra, Ghana
CHERYL A. MOYER*
Affiliation:
Minority and Health Disparities International Research Training Program, University of Michigan, Ann Arbor, MI, USA Global REACH, University of Michigan Medical School, Ann Arbor, MI, USA Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA
*
1Corresponding author. Email: camoyer@med.umich.edu
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Summary

This study aimed to explore pregnant women's attitudes towards the inclusion of a lay companion as a source of social support during labour and delivery in rural central Ghana. Quantitative demographic and pregnancy-related data were collected from 50 pregnant women presenting for antenatal care at a rural district hospital and analysed using STATA/IC 11.1. Qualitative attitudinal questions were collected from the same women through semi-structured interviews; data were analysed using NVivo 9.0. Twenty-nine out of 50 women (58%) preferred to have a lay companion during facility-based labour and delivery, whereas 21 (42%) preferred to deliver alone with the nurses in a facility. Women desiring a companion were younger, had more antenatal care visits, had greater educational attainment and were likely to be experiencing their first delivery. Women varied in the type of companion they prefer (male partner vs female relative). What was expected in terms of social support differed based upon the type of companion. Male companions were expected to provide emotional support and to ‘witness her pain’. Female companions were expected to provide emotional support as well as instrumental, informational and appraisal support. Three qualitative themes were identified that run counter to the inclusion of a lay helper: fear of an evil-spirited companion, a companion not being necessary or helpful, and being ‘too shy’ of a companion. This research challenges the assumption of a unilateral desire for social support during labour and delivery, and suggests that women differ in the type of companion and type of support they prefer during facility deliveries. Future research is needed to determine the direction of the relationship – whether women desire certain types of support and thus choose companions they believe can meet those needs, or whether women desire a certain companion and adjust their expectations accordingly.

Type
Articles
Information
Journal of Biosocial Science , Volume 46 , Issue 5 , September 2014 , pp. 669 - 685
Copyright
Copyright © Cambridge University Press 2013 

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References

Bakhta, Y. & Lee, R. H. (2010) A survey of Russian women regarding the presence of a companion during labor. International Journal of Gynecology and Obstetrics 109(3), 201–203.Google Scholar
Bazzano, A. N., Kirkwood, B., Tawiah-Agyemang, C., Owusu-Agyei, S. & Adongo, P. (2008) Social costs of skilled attendance at birth in rural Ghana. International Journal of Gynecology and Obstetrics 102, 91–94.CrossRefGoogle ScholarPubMed
Campero, L., Garcia, C., Diaz, C., Ortiz, O., Reynoso, S. & Langer, A. (1998) “Alone, I wouldn't have known what to do”: a qualitative study on social support during labor and delivery in Mexico. Social Science & Medicine 47(3), 395–403.Google Scholar
D'Ambruoso, L., Abbey, M. & Hussein, J. (2005) Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana. BMC Public Health 5, 140. URL: http://www.biomedcentral.com/1471-2458/5/140Google Scholar
De Allegri, M., Ridde, V., Louis, V. R., Sarker, M., Tiendrebéogo, J., Yé, M.et al. (2011) Determinants of utilization of maternal care services after the reduction of user fees: a case study from rural Burkina Faso. Health Policy 99, 210–218.Google Scholar
Ejembi, C. L., Alti-Muazu, M., Chirdan, O., Ezeh, H. O. & Sheidu, S. (2004) Utilization of maternal health services by rural Hausa women in Zaria environs, northern Nigeria: has primary health care made a difference? Journal of Community Medicine and Primary Health Care 16(2), 47–54.Google Scholar
Faye, A., Mariama, N. & Ibrahim, B. (2011) Home birth in women who have given birth at least once in a health facility: contributory factors in a developing country. Acta Obstetricia et Gynecologica Scandinavica 90(11), 1239–1243.Google Scholar
Gabrysch, S., Cousens, S., Cox, J. & Campbell, O. M. R. (2011) The influence of distance and level of care on delivery place in rural Zambia: a study of linked national data in a geographic information system. PLoS Med 8(1), e1000394.CrossRefGoogle Scholar
Hodnett, E. D., Gates, S., Hofmeyr, J. & Sakala, C. (2007) Continuous support for women during childbirth. Cochrane Database of Systematic Reviews. Issue 3, Art. No. CD003766 doi: 10.1002/14651858.DC003766.pub2.Google Scholar
Hofmeyr, G. J., Nikodem, V. C., Wolman, W. L., Chalmers, B. E. & Kramer, T. (1991) Companionship to modify the clinical birth environment: effects on progress and perceptions of labor, and breastfeeding. British Journal of Obstetrics and Gynecology 98, 756–764.Google Scholar
House, J. S. (1981) Work Stress and Social Support. Addison-Wesley, Reading, MA.Google Scholar
Lori, J. R. & Boyle, J. S. (2011) Cultural childbirth practices, beliefs and traditions in post conflict Liberia. Health Care for Women International 32(6), 454–473.Google Scholar
Maimbolwa, M. C., Sikazwe, N., Yamba, B., Diwan, V. & Ransjö-Arvidson, A-B. (2001) Views on involving a social support person during labour in Zambian maternities. Journal of Midwifery and Women's Health 46, 226–234.Google Scholar
Mills, S. & Bertrand, J. T. (2005) Use of health professionals for obstetric care in northern Ghana. Studies in Family Planning 36(1), 45–56.Google Scholar
Mills, S.Williams, J. E., Adjuik, M. & Hodgson, A. (2008) Use of health professionals for delivery following the availability of free obstetric care in Northern Ghana. Maternal and Child Health Journal 12, 509–518.Google Scholar
Morhason-Bello, I. O., Olayemi, O., Ojengbede, O. A., Adedokun, B. O., Okuyemi, O. O. & Orji, B. (2008) Attitude and preferences of Nigerian antenatal women to social support during labour. Journal of Biosocial Science 40(4), 553–562.Google Scholar
Nikodem, V. C., Nolte, A. G., Wolman, W., Glumezoglu, A. M. & Hofmeyr, G. J. (1998) Companionship by a lay labor supporter to modify the clinical birth environment: long-term effects on mother and child. Curationis 21(1), 8–12.CrossRefGoogle ScholarPubMed
Oboro, V., Oyeniran, A., Akinola, S. & Isawumi, A. I. (2011) Attitudes of Nigerian women toward the presence of their husband or partner as a support person during labor. International Journal of Gynecology and Obstetrics 112(1), 56–58.CrossRefGoogle ScholarPubMed
Spangler, S. A. & Bloom, S. S. (2010) Use of biomedical obstetric care in rural Tanzania: the role of social and material inequalities. Social Science & Medicine 71, 760–768.Google Scholar
Story, W. T., Burgard, S. A., Lori, J. R., Taleb, F., Ali, N. A. & Hoque, D. M. E. (2012) Husbands' involvement in delivery care utilization in rural Bangladesh: a qualitative study. BMC Pregnancy and Childbirth 12, 28.CrossRefGoogle ScholarPubMed
Thwala, S. B. P., Jones, L. K. & Holroyd, E. (2011) Swaziland rural maternal care: ethnography of the interface of custom and biomedicine. International Journal of Nursing Practice 17, 93–101.Google Scholar
Wheaton, B. (1985) Models for the stress buffering functions of coping resources. Journal of Health & Social Behavior 26(4), 352–364.Google Scholar
Wolman, W. L., Chalmers, B., Hoffmeyr, J. & Nikodem, V. C. (1993) Postpartum depression and companionship in the clinical birth environment: a randomized controlled study. American Journal of Obstetrics and Gynecology 168, 1388–1393.Google Scholar
World Health Organization (2004) Making Pregnancy Safer: The Importance of the Skilled Birth Attendant. A joint statement by WHO, ACM and FIGO. WHO, Geneva. URL: http://whqlibdoc.who.int/publications/2004/9241591692.pdfGoogle Scholar
Yeunyong, S., Jirapaet, V. & O'Brien, B. A. (2008) Support from a close female relative in labour: the ideal maternity nursing intervention in Thailand. Journal of the Medical Association of Thailand 91(2), 253–260.Google Scholar