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, Nazarius Mbona Tumwesigye, Eva Wodeya Wanyenze, Gorrette K Nalwadda, Josaphat K Byamugisha, Patience A Muwanguzi, Nazarius Mbona Tumwesigye

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: Uganda; birth companion; continuous support; low-resource setting; outcomes.

Conflict of interest statement

All authors report no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Trial design.
Figure 2
Figure 2
Trial duration and dates of study periods.
Figure 3
Figure 3
Trial flow chart.
Figure 4
Figure 4
Anxiety score by study period.

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