Continuous Labor Support and Person-Centered Maternity Care: A Cross-Sectional Study with Women in Rural Kenya

Objective This study assessed whether having continuous support during labor is associated with better person-centered maternity care (PCMC) among women in rural Kenya. Methods Data are from a cross-sectional survey with women aged 15–49 years who delivered in the 9 weeks preceding survey completion (N = 865). PCMC was operationalized using a validated 13-item scale, with a summative score developed from responses that capture dignity and respect, communication and autonomy, and supportive care from providers (excluding support from a lay companion). Continuous support was operationalized as the continuous presence of a lay companion (friend or family) during labor. We carried out bivariate analyses using chi-squared and t-tests and ran multivariable linear regression models to examine the association between continuous labor support and PCMC. Results The average PCMC score was 24.2 (SD = 8.4) out of a total score of 39. About two-thirds (68%) of women had continuous support during labor. The average PCMC scores among women who had continuous support was 25.7 (SD = 8.4) compared to 21.0 (SD = 7.6) among those who did not have continuous support (p-value ≤ 0.001). After controlling for various confounders this association was still significant (coefficient = 4.0; 95% CI 2.9, 5.2; p-value ≤ 0.001). Conclusions Women who have continuous labor support during childbirth are more likely to have improved PCMC. Efforts to promote PCMC should thus include continuous labor support.

Translation and validation of the first time fathers questionnaire into Persian

Background/Aims The presence of fathers during labour and birth can have favourable outcomes for the health of the mother, father and infant. However, there are few studies on fathers' experiences while being present during labour and birth, which necessitates the development of a valid questionnaire for this purpose. The aim of this study was to translate and culturally adapt the first time fathers questionnaire into Persian. Methods A total of 220 first-time fathers at private midwifery counseling centers were given a translated questionnaire to complete. Forward-backward translation of the questionnaire was conducted and content, face and construct validity were examined. After extracting factors and item distribution, confirmatory factor analysis was performed. Cronbach's alpha was used for reliability. Results A valid 19-item questionnaire with four dimensions, ‘worry’, ‘acceptance and support during labor’, ‘support during and after birth’, and ‘preparedness’ was obtained. The Cronbach's alpha was 0.78. Conclusions The Persian questionnaire is valid and reliable for examining the experiences of first-time fathers. It can be employed to evaluate fathers' experiences during labour and birth in midwifery services planning to promote quality of care during childbirth.

The Role of Husbands in Giving Labor Support

In Indonesia, the maternal mortality rate reaches 830 per day due to several problems during pregnancy and childbirth. The causes of problems vary both physiological and psychological. Psychological affects the mother's mental anxiety. Here the husband's role is very important. The husband's role will have an effect on the wife's emotions, if the wife feels calm, the central nerve cells produce the hormone oxytocin properly. The purpose of the study was to determine the role of the husband in providing childbirth support to postpartum mothers at the Jabon Jombang Health Center.The design of this study uses Descriptive, with a population of 32 respondents taken by Total Sampling, namely all husbands who have postpartum mothers at Jabon Jombang Health Center on July 24-27 2017. In collecting research data using questionnaires, then processed with Editing, Coding, Scoring, Tabulating, and Percentage.The results of the study were obtained from 32 respondents, that almost all respondents played an active role of 12 respondents (37.5%), and respondents who played a passive role were 20 respondents (62.5%). Based on the results of the study it can be concluded that there are still many husbands who play a passive role in preparing for their wife's needs during childbirth at Jabon Jombang Health Center

Continuous Support Promotes Obstetric Labor Progress and Vaginal Delivery in Primiparous Women – A Randomized Controlled Study

Background: Obstetric labor and childbirth are mostly regarded as a physiological process, whereas social, cultural, psychological and transcendental aspects have received less attention. Labor support has been suggested to promote labor progress. The aim of this study was to investigate whether continuous labor support by a midwife promotes labor progress and vaginal delivery.Material and Methods: A randomized controlled study at a university hospital in Sweden in 2015–17. Primiparous women with singleton pregnancy and spontaneous labor onset were randomized to continuous support (n = 30) or standard care (n = 29) during delivery. The primary outcome was the duration of active labor. Secondary outcomes were delivery mode, women's need of labor analgesia and satisfaction with delivery, maternal cortisol levels, and neonatal morbidity.Results: Continuous support was followed by shorter active labor 11.0 ± 5.7 h compared to 13.7 ± 3.9 h with standard care (p = 0.001). Women in the continuous support group tended to have lower cortisol levels and low cortisol during the first (p = 0.02) and second (p = 0.04) stages of labor were correlated with shorter active labor. Continuous support was followed by spontaneous delivery in 73%, instrumental delivery in 24% and emergency cesarean section in 3% in contrast to standard care which was followed by spontaneous delivery in 62%, instrumental delivery in 24% and cesarean in 14% (p = 0.19). The continuous support group received combined analgesic methods more often (p = 0.04). Women's satisfaction with delivery and neonatal morbidity were comparable.Conclusion: Continuous labor support was followed by shorter active labor compared to standard care. Women with continuous support had a high rate of vaginal delivery and tended to have lower cortisol levels during all stages of active labor reflecting a lower stress level. Low cortisol was correlated to shorter active labor. Based on these results, we recommend continuous labor support for all primiparous women during active labor.