Continuous support for women during childbirth
RHL practical aspects by Martis R
FIRST CONTACT (PRIMARY CARE) LEVEL
All primary care facilities should provide continuous support for women during childbirth (1). This is regardless of the labour/birth room set-up. In some countries it might be appropriate to have a female relative and in other countries and settings, in particular where women come from rural areas without family support, hospital volunteer lay support persons may be the appropriate choice. Support people do not need any training with sophisticated skills or technology.
REFERRAL HOSPITAL (SECONDARY CARE) LEVEL
Continuous support during childbirth is highly recommended for secondary care level as these environments can be a source of increased level of anxiety for the labouring women. She is placed in an unknown environment and in pain. Continuous social support can assist with reducing this anxiety.
There are often a number of barriers to overcome the implementation of these research results and in particular secondary hospitals need to assess these carefully, as it will assist with successful implementation of a clinical practice guideline on continuous support for labouring women. (See also commentary update under 2.3. Implementation of the intervention).
AT HOME OR IN THE COMMUNITY
In many low income countries a considerable number of births still take place in the community, either at the pregnant woman’s house or at the traditional birth attendant’s house. In these cases, continuous social support is usually given as a normal part of the labour and birth process. However, in some community settings women are only attended by birth attendant’s without other support. In all settings labouring women should have continuous social support and hence even if the woman gives birth in the community setting the results of this up-dated review need to be incorporated. Village and community elders or the appropriate governing infra structure need to address on how this can be implemented effectively.
- Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub2.
This document should be cited as: Martis R. Continuous support for women during childbirth : RHL practical aspects (last revised: 8 September 2007). The WHO Reproductive Health Library; Geneva: World Health Organization.