Saturday, 27 February 2016

Birth companions allowed during delivery in public health facilities

Birth companions allowed during delivery in public health facilities 
Dr SS Agarwal, Dr KK Aggarwal

IMA has welcomed the innovative move by the Ministry of Health and Family Welfare aimed at reducing the maternal mortality ratio and infant mortality rate in the country.

Birth companions will now be allowed during delivery in public health facilities. This step signifies India’s commitment under SDGs to further accelerate initiatives with specific focus on quality parameters of the interventions. 
Birth companions are women who have experienced the process of labor and provide continuous one-to-one support to other women experiencing labor and child birth. The presence of a female relative during labor is a low-cost intervention, which has proved to be beneficial to the women in labor. These women provide emotional support (continuous reassurance), information about labor progress and advice regarding coping techniques, comfort measures (comforting touch, massages, promoting adequate fluid intake and output) and advocacy (helping the woman articulate her wishes to the other). 
Pre-requisites for a birth companion
The birth companion has to be a female relative, preferably one who has undergone the process of labor. 
  • In facilities where privacy protocols are followed in the labor room, the husband of the pregnant woman can be allowed as a birth companion. 
  • She should not suffer from any communicable diseases. 
  • She should wear clean clothes. 
  • She should be willing to stay with the pregnant woman throughout the process of labor. 
  • She should not interfere in the work of hospital staff and the treatment procedures. 
  • She should not attend to other women in the labor room. 
The World Health Organization promotes labor companionship as a core element of care for improving maternal and infant health (WHO 2002). The regional plan of action for maternal and neonatal health care includes the monitoring of maternal and fetal well-being, and encourages the presence of a companion to provide support during labor and delivery as one of the interventions to improve neonatal health. A trained birth companion contributes to reduced tension and shortened labor, increased mother's feelings of control, decreased interventions and cesareans. It also enhances the partner's participation, improves outcome for the newborn, facilitates parent/infant bonding and decreases postpartum depression while increasing positive feelings about the birth experience. 

Robert Bradley in 1947 gave the woman's partner an active, major role (i.e., husband-coached childbirth) and emphasized an extremely natural approach, with few or no drugs and little medical intervention during labor and delivery. The Bradley Method emphasizes that birth is a natural process; mothers are encouraged to trust their body and focus on diet and exercise throughout pregnancy; and it teaches couples to manage labor through deep breathing and the support of a partner or labor coach.

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