Medical and Administrative Barriers to the Implementation and Sustenance of a Labor Companionship Program: A Cross-sectional Study in a Teaching Hospital in Sri Lanka

Abstract

Aim: The aim of the study was to describe how medical and administrative barriers in implementing a labor companionship program were overcome and to identify similar barriers adversely affecting the sustenance of the program. Materials and methods: Medical and administrative barriers encountered when implementing a labor companionship program at the Academic Unit (AU) of Teaching Hospital, Mahamodara, Galle (THMG), in 2012 and how these barriers were overcome are described. From March to April 2016, a cross-sectional study was carried out using an interviewer-facilitated self-administered questionnaire, on specialist obstetricians and gynecologists, house officers, staff nurses, and midwives of AU of THMG, to identify possible reasons for the failure to sustain the labor companionship program. Data regarding demographic characteristics, knowledge and attitudes regarding women having a labor companion (LC), and counseling pregnant women to have an LC were collected. Results: Four out of five specialists, all 13 house officers, 23 out of 30 staff nurses, and 12 out of 16 midwives participated in the study. All the specialists and nurses, 85% of house officers, and 58% of midwives were aware that the presence of an LC was beneficial for women in labor. However, only 24% of doctors and 17% of staff nurses and midwives had counseled pregnant women routinely regarding an LC and only 53% of doctors and 20% of nurses and midwives had counseled more than 10 pregnant women regarding LC, during the week immediately preceding the data collection. Conclusion: Medical and administrative barriers are encountered when establishing a labor companionship program, but they can be overcome. Midwives must be educated regarding the beneficial effects of an LC. Doctors and nurses must be motivated to increase counseling of women and their partners regarding the beneficial effects of an LC in order to sustain a labor companionship program.