ArticleBMJ open2022
Factors influencing the implementation of labour companionship: formative qualitative research in Thailand.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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16 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Variation in caesarean section rates according to the Robson classification in four low- and middle-income countries: a meta-analysis of groups 1 to 4.BMC pregnancy and childbirth · 2025Pooled it
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- Between help and hindrance: a qualitative study on inclusion of birth companions in closed, invited and contested spaces within maternity care settings in Malawi.BMJ public health · 2026Article
- Obstetric Care Providers' Practices and Associated Factors Towards Birth Companionship in Public Hospitals of South Gondar zone, Northwest Ethiopia, 2025.SAGE open medicine · 2026Article
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- Planning for scale: analysis of adaptations and contextual factors influencing scale-up of the QUALI-DEC intervention to optimize caesarean section use.Implementation science communications · 2025Article
- Towards a universal implementation of labor companionship: a synthesis of the policy and facility environment of eight low-and-middle income countries.Frontiers in health services · 2025Article
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- Labour companionship and respectful treatment of women during childbirth: a cross-sectional study across 16 hospitals in Benin, Malawi, Tanzania and Uganda.BMJ public health · 2025Article
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- Exploring Healthcare Providers' and Women's Perspectives of Labor Companionship during Childbirth: An Interpretative Phenomenological Analysis Study.Healthcare (Basel, Switzerland) · 2024Article
- Utilization of birth companionship and its associated factors among laboring mothers during facilities birth in sub-Saharan Africa. Systematic review and meta-analysis.SAGE open medicine · 2024Review
- Implementing the QUALI-DEC project in Argentina, Burkina Faso, Thailand and Viet Nam: a process delineation and theory-driven process evaluation protocol.Global health action · 2023Article
- Women's and health providers' perceptions of companionship during labor and childbirth: a formative study for the implementation of WHO companionship model in Burkina Faso.Reproductive health · 2023Article
- From global recommendations to (in)action: A scoping review of the coverage of companion of choice for women during labour and birth.PLOS global public health · 2023Article
- Barriers and Facilitators of Continuous Labor Companion Support in Ethiopia: Qualitative Formative Study on Facility Readiness and Respectful Maternity Care.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
9 authors at 6 institutions in 6 countries.
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Abstract
introductionWHO recommends that all women have the option to have a companion of their choice throughout labour and childbirth. Despite clear benefits of labour companionship, including better birth experiences and reduced caesarean section, labour companionship is not universally implemented. In Thailand, there are no policies for public hospitals to support companionship. This study aims to understand factors affecting implementation of labour companionship in Thailand.
methodsThis is formative qualitative research to inform the 'Appropriate use of caesarean section through QUALIty DECision-making by women and providers' (QUALI-DEC) study, to design, adapt and implement a strategy to optimise use of caesarean section. We use in-depth interviews and readiness assessments to explore perceptions of healthcare providers, women and potential companions about labour companionship in eight Thai public hospitals. Qualitative data were analysed using thematic analysis, and narrative summaries of the readiness assessment were generated. Factors potentially affecting implementation were mapped to the Capability, Opportunity, and Motivation behaviour change model (COM-B).
results127 qualitative interviews and eight readiness assessments are included in this analysis. The qualitative findings were grouped in four themes: benefits of labour companions, roles of labour companions, training for labour companions and factors affecting implementation. The findings showed that healthcare providers, women and their relatives all had positive attitudes towards having labour companions. The readiness assessment highlighted implementation challenges related to training the companion, physical space constraints, overcrowding and facility policies, reiterated by the qualitative reports. DISCUSSION: If labour companions are well-trained on how to best support women, help them to manage pain and engage with healthcare teams, it may be a feasible intervention to implement in Thailand. However, key barriers to introducing labour companionship must be addressed to maximise the likelihood of success mainly related to training and space. These findings will be integrated into the QUALI-DEC implementation strategies.
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