Effect of Midwife-Provided Orientation of Birth Companions on Maternal Anxiety and Coping during Labor: A Stepped Wedge Cluster Randomized Control Trial in Eastern Uganda

Eva Wodeya Wanyenze (), Gorrette K. Nalwadda, Josaphat K. Byamugisha, Patience A. Muwanguzi and Nazarius Mbona Tumwesigye
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Eva Wodeya Wanyenze: Department of Nursing, Mbarara University of Science and Technology, Mbarara 403, Uganda
Gorrette K. Nalwadda: Department of Nursing, College of Health Sciences, Makerere University, Kampala 101, Uganda
Josaphat K. Byamugisha: Department of Obstetrics and Gynecology, College of Health Sciences, Makerere University, Kampala 101, Uganda
Patience A. Muwanguzi: Department of Nursing, College of Health Sciences, Makerere University, Kampala 101, Uganda
Nazarius Mbona Tumwesigye: Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala 101, Uganda

IJERPH, 2023, vol. 20, issue 2, 1-14

Abstract: The study aimed to assess the effect of midwife-provided orientation of birth companions on maternal anxiety and coping during labor. A stepped wedge cluster randomized trial design was conducted among 475 participants (control n = 240), intervention n = 235) from four clusters. Midwives in the intervention period provided an orientation session for the birth companions on supportive labor techniques. Coping was assessed throughout labor and anxiety scores were measured after birth. Independent t-test and Chi-Square tests were used to assess the differences by study period. Anxiety scores were reduced among women in the intervention period ( p = 0.001). The proportion of women able to cope during early active labor was higher during the intervention period ( p = 0.031). Women in the intervention period had 80% higher odds of coping ( p = 0.032) compared to those in the control period. Notable differences in anxiety and coping with labor were observed among first-time mothers, younger women, and when siblings provided support. Midwife-provided orientation of birth companions on labor support lowers maternal anxiety and improves coping during labor. Findings could inform the planning and development of policies for the implementation of the presence of birth companions in similar low-resource settings.

Keywords: continuous support; outcomes; birth companion; low-resource setting; Uganda (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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