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SOCIAL SUPPORT DURING DELIVERY IN RURAL CENTRAL GHANA: A MIXED METHODS STUDY OF WOMEN'S PREFERENCES FOR AND AGAINST INCLUSION OF A LAY COMPANION IN THE DELIVERY ROOM

Published online by Cambridge University Press:  21 August 2013

AMIR ALEXANDER
Affiliation:
Minority and Health Disparities International Research Training Program, University of Michigan, Ann Arbor, MI, USA Global REACH, University of Michigan Medical School, Ann Arbor, MI, USA
AESHA MUSTAFA
Affiliation:
Minority and Health Disparities International Research Training Program, University of Michigan, Ann Arbor, MI, USA Global REACH, University of Michigan Medical School, Ann Arbor, MI, USA
SARAH A. V. EMIL
Affiliation:
St Luke's Hospital, Apam, Ghana
EBENEZER AMEKAH
Affiliation:
St Luke's Hospital, Apam, Ghana
CYRIL ENGMANN
Affiliation:
Departments of Pediatrics & Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
RICHARD ADANU
Affiliation:
School of Public Health, University of Ghana, Accra, Ghana
CHERYL A. MOYER*
Affiliation:
Minority and Health Disparities International Research Training Program, University of Michigan, Ann Arbor, MI, USA Global REACH, University of Michigan Medical School, Ann Arbor, MI, USA Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA
*
1Corresponding author. Email: camoyer@med.umich.edu

Summary

This study aimed to explore pregnant women's attitudes towards the inclusion of a lay companion as a source of social support during labour and delivery in rural central Ghana. Quantitative demographic and pregnancy-related data were collected from 50 pregnant women presenting for antenatal care at a rural district hospital and analysed using STATA/IC 11.1. Qualitative attitudinal questions were collected from the same women through semi-structured interviews; data were analysed using NVivo 9.0. Twenty-nine out of 50 women (58%) preferred to have a lay companion during facility-based labour and delivery, whereas 21 (42%) preferred to deliver alone with the nurses in a facility. Women desiring a companion were younger, had more antenatal care visits, had greater educational attainment and were likely to be experiencing their first delivery. Women varied in the type of companion they prefer (male partner vs female relative). What was expected in terms of social support differed based upon the type of companion. Male companions were expected to provide emotional support and to ‘witness her pain’. Female companions were expected to provide emotional support as well as instrumental, informational and appraisal support. Three qualitative themes were identified that run counter to the inclusion of a lay helper: fear of an evil-spirited companion, a companion not being necessary or helpful, and being ‘too shy’ of a companion. This research challenges the assumption of a unilateral desire for social support during labour and delivery, and suggests that women differ in the type of companion and type of support they prefer during facility deliveries. Future research is needed to determine the direction of the relationship – whether women desire certain types of support and thus choose companions they believe can meet those needs, or whether women desire a certain companion and adjust their expectations accordingly.

Type
Articles
Copyright
Copyright © Cambridge University Press 2013 

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