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Effect of Birth Companion Support on Women's Satisfaction with Childbirth Experience in Nigerian Hospitals

Abstract

Childbirth is a significant experience in women's reproductive lives and the quality of care received during labour and delivery can influence maternal satisfaction, emotional wellbeing, confidence, and perceptions of healthcare services. In Nigerian hospitals, some women may experience anxiety, fear, pain, inadequate communication, limited emotional support, unfamiliar clinical environments, and restricted involvement in decisions during childbirth. Birth companion support provides women with continuous emotional, informational, physical, and practical support from a person of their choice during labour and childbirth. Such support may help women cope with labour, communicate their needs, feel more secure, and participate more actively in decisions concerning their care. However, hospital policies, staffing limitations, privacy concerns, inadequate infrastructure, cultural practices, and inconsistent implementation of birth companion programmes may limit women's access to continuous companionship. Against this background, this study investigates the effect of birth companion support on women's satisfaction with childbirth experience in Nigerian hospitals. The study will be anchored on the Social Support Theory, Health Belief Model, and Patient-Centred Care Theory. Social Support Theory explains how emotional, informational, instrumental, and appraisal support provided by birth companions may influence women's psychological wellbeing and perceptions of childbirth. The Health Belief Model provides insight into how women's perceptions of childbirth-related risks, perceived benefits of companionship, perceived barriers, and cues to action may influence their acceptance and utilization of birth companion support. Patient-Centred Care Theory emphasizes respect for women's preferences, communication, dignity, participation in decision-making, emotional support, and individualized care as important components of a positive healthcare experience. Collectively, these theoretical perspectives provide a suitable framework for explaining how birth companion support may influence women's satisfaction with childbirth experience. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise women who have delivered in selected Nigerian hospitals. A multistage sampling technique will be used to select states, local government areas, hospitals, maternity units, and eligible postpartum women. Birth companion support will be assessed using indicators such as availability of companion support, presence of a chosen companion during labour and delivery, duration of companionship, emotional support, physical comfort measures, informational support, communication assistance, advocacy, involvement in decision-making, and support from healthcare professionals for companion participation. Women's satisfaction with childbirth experience will be assessed using indicators such as satisfaction with communication, respect and dignity, emotional support, involvement in decisions, pain management, privacy, responsiveness of healthcare providers, perceived quality of care, overall childbirth experience, and willingness to use or recommend the facility for future childbirth. Where appropriate, validated childbirth satisfaction and experience assessment instruments will be used. Data will be collected using structured questionnaires, validated satisfaction assessment tools, maternity records, hospital delivery registers, and relevant maternity care programme documents. Descriptive statistics will be used to summarize participants' characteristics, birth companion support, and levels of childbirth satisfaction. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of birth companion support on women's satisfaction with childbirth experience. Where a quasi-experimental design is adopted, childbirth satisfaction scores among women receiving structured birth companion support may be compared with those receiving standard maternity care, while relevant demographic, obstetric, and healthcare-related factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that birth companion support has a significant positive effect on women's satisfaction with childbirth experience in Nigerian hospitals. Women who receive continuous support from a chosen birth companion are expected to report higher levels of satisfaction than women who experience childbirth without continuous companionship. Emotional reassurance, encouragement, physical comfort, communication assistance, and advocacy may help women cope with labour and feel respected, supported, and involved in their care. Birth companions may also help women communicate their preferences and concerns to healthcare providers, thereby improving their perception of responsiveness and quality of care. However, restrictive hospital policies, limited space in maternity units, privacy concerns, inadequate staff understanding of companionship, cultural expectations, and inconsistent implementation of birth companion programmes may reduce their effectiveness. The study therefore expects respectful, safe, culturally appropriate, and well-coordinated birth companion support to contribute significantly to improved satisfaction with childbirth experience among women in Nigerian hospitals. The study is expected to contribute to the literature on birth companion support, childbirth satisfaction, positive childbirth experience, respectful maternity care, patient-centred maternity care, maternal wellbeing, labour support, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, maternity units, obstetricians, midwives, nurses, maternal health programmes, women's health organizations, development partners, and policymakers regarding strategies for improving women's experiences of childbirth. The study will also provide evidence-based recommendations for developing and implementing birth companion policies, training healthcare workers on supportive companionship, improving maternity-unit infrastructure and privacy, involving women in decisions about their birth companions, strengthening respectful maternity care, and integrating safe birth companion support into maternity services across Nigerian hospitals.

Keywords: Birth companion support, childbirth satisfaction, childbirth experience, women, labour support, respectful maternity care, patient-centred care, maternal health, maternity services, Nigerian hospitals, public health.