Association of Birth Companionship by Former Traditional Birth Attendants on Birthing Experiences of Parturient Women in Kakamega County, Kenya

Abstract

The current model of maternity care is institution-centred, rather than woman-centred. Women's experiences illuminate midwives' efforts to maintain power and control by situating birth as a medical event and to secure status by focusing on the technical elements of care, including controlling bodies and knowledge. A study conducted in Kenya, India and Ghana concluded that regardless of the setting, women are not getting adequate person-centred maternity care and that such care varied by socioeconomic status, type of provider and type of facility.Most women in Kakamega county labour alone. As a result, women in labour experience ‘emotional distress', ‘stressful circumstances', ‘lack of social support' and may not open up to service providers contributing to unfavourable birth outcomes. To investigate the association between supportive companionship provided by traditional birth attendants and birthing experiences of parturient women during labour and childbirth in Kakamega County, Kenya. A quasi-experimental cross-sectional mixed method design was adopted involving 2367 parturient women in Kakamega county, Kenya. Former traditional birth attendants were trained and deployed as birth companions providing emotional support in the form of encouragement, advice, information, comfort measures and physical support to women during labour and childbirth in intervention health facilities. Measurements were taken at baseline and after implementation of the birth companion intervention from control and intervention health facilities using a questionnaire capturing data on client satisfaction, anxiety and self-esteem. Data was summarized using frequency distributions and cross tabulations and presented in the form of tables and graphs. Associations were determined using Pearson's correlation and independent sample t-test. The study found traditional birth attendant as birth companions significantly improved birthing experiences of parturient women. Supported women as they had higher levels of satisfaction, lower anxiety and higher self-esteem than those who were not supported.