ArticleBMC pregnancy and childbirth2025
"It shows that I belong": a qualitative study assessing birth companionship of choice in a maternity clinic in Freetown, Sierra Leone.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Article
- Midwives' experiences and perceptions on the use of the Labour Care Guide: A qualitative study.Curationis · 2026Article
- Integrated Determinants of Maternal Healthcare Decisions: A Cross-Sectional Analysis of Predisposing, Enabling, and Illness-Level Factors in Bo District, Sierra Leone.Annals of global health · 2026Article
- 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
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Authors and funding
5 authors.
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Abstract
backgroundDespite existing evidence supporting birth companionship of choice as a simple, low-cost measure to improve quality of care in childbirth, it is inconsistently practiced in many regions. In Sierra Leone, one of the least safe countries for women to deliver a baby, Princess Christian Maternity Hospital (PCMH) began encouraging companionship of choice for women during childbirth in March 2022. However, little is known about the perspectives of healthcare workers or the perinatal experiences of women and their companions. Our objective was to describe the experiences and perceptions surrounding birth companionship of choice among healthcare workers, women, and their companions.
methodsWe conducted a qualitative assessment at PCMH in August 2022 through eleven focus group discussions and thirteen in-depth interviews with healthcare workers, women, and their companions. Discussions and interviews were recorded, transcribed, and thematically coded for analysis.
resultsWomen described various means of support from their birth companion and cited trust and the ability to provide expertise as key criteria when choosing a companion. Healthcare workers emphasized that, despite initial hesitation, companionship has been advantageous. However, there were still many challenges for healthcare workers when companions were present in the labor ward, such as maintaining patient privacy. Companions revealed that they were learning about facility-based delivery through companionship and sharing their positive experiences with their community. With a few exceptions, both companions and women reported overall satisfaction with their treatment in the labor ward.
conclusionFindings suggest that birth companionship of choice is a key component of a positive birth experience, improving perceived quality of care and potentially increasing the number of women giving birth in facilities. It also presents many advantages and challenges for healthcare workers. The presence of a birth companion inside the labor ward increases appreciation for facility-based care and potentially alleviates mistrust between the healthcare system and the community.
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