Attending to Labour & Childbirth

A childbirth companion (or social support during birth) has been found to improve the whole birth experience. Research shows that women who receive good social support during labour and childbirth tend on average to have shorter labours, to control their pain better and to have less need for medical intervention. This session focuses on the emotional support, reassurance and respect that you can give to a woman during the birth experience, and how you can encourage a childbirth companion to take on some of these roles.

Labour can be a very frightening experience for women, especially first births. In addition, women will experience physical sensations ranging from discomfort to severe pain. Helping the woman to be as relaxed as possible and aware of her situation can help minimize the physical pain and emotional distress of labour and birth. Women can be helped with this by receiving adequate care, timely information, comfort, support and reassurance during labour and birth. It is also important to maintain respect and courtesy whenever possible by explaining what you are going to do and why, and by being courteous to her and her family. It is equally important to maintain respect for privacy throughout the birth, by keeping the woman covered as much as possible for all procedures, or by providing curtains.

It is important to be familiar with the birth and emergency plan and to know if the woman and family have any preferences regarding labour and birth. If a skilled attendant respects the woman's and family's preferences regarding labour and birth they are more likely to have a better birthing experience.

In the birth and emergency plan, a woman will have also indicated a companion to support her during birth, and this childbirth companion can take on a central supporting role.

Women should be encouraged to have a companion of her choice present during labour and birth. Some women like to have their husband or partner; others prefer a close family relative, friend, or a traditional birth attendant (TBA). Experiences from different settings have shown that the best person to have as a childbirth companion is often an older woman from the community, someone who has had children herself. However, encouraging the husband/partner to be more involved with the birth, where it is acceptable, may also be beneficial for the whole family. Birth is a very emotional experience and for some people (especially the husband/partner) having more active involvement can make the whole process particularly special.

It can be useful to talk to the childbirth companion during pregnancy or at the onset of labour to find out how much he/she already know about labour and birth, and to discuss with him/her what they might expect to see and what he/she is expected to do. You should encourage the companion to give support using local practices which do not disturb your work (and the rest of the health team) during labour or birth. The companion can also help and encourage the woman to move around freely as she wishes and to adopt the birthing position of her choice.

Discuss with the woman in advance any situations when the birthing companion may not be allowed to remain in the room. If the health facility currently does not allow birthing partners to remain with women who are giving birth, consider opening this topic up for discussion with your colleagues. Even if you decide that companions cannot be there for the actual birth, you might consider encouraging them to be there to support the woman during labour or to assist with breastfeeding and postnatal care. Sometimes if there is little privacy in the birthing room it can be easier if the companion is another woman instead of a man. Suggesting that women be encouraged to bring a female childbirth companion can often overcome issues related to lack of privacy in the birthing room.