Introducing Birth Companion in Labour: A Quality Improvement Initiative

Tamkin Khan; Ayesha Ahmad; Bushra Fatima; Saman Furqan; Enas Mushtaq; Tabassum Nawab; Aparna Sharma

doi:10.1007/s13224-023-01780-w

Introducing Birth Companion in Labour: A Quality Improvement Initiative

J Obstet Gynaecol India. 2023 Oct;73(Suppl 1):1-10. doi: 10.1007/s13224-023-01780-w. Epub 2023 Jun 22.

Authors

Tamkin Khan¹, Ayesha Ahmad², Bushra Fatima¹, Saman Furqan³, Enas Mushtaq⁴, Tabassum Nawab⁵, Aparna Sharma⁶

Affiliations

¹ Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh 202002 India.
² Department of Obstetrics and Gynaecology, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh 226003 India.
³ Department of Obstetrics and Gynaecology, Rohilkhand Medical College, Bareilly, 243006 India.
⁴ Department of Obstetrics and Gynaecology, Himalayan Institute, Jolly Grant, Dehradun, India.
⁵ Department of Community Medicine, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh 202002 India.
⁶ Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India.

PMID: 37916015
PMCID: PMC10616060 (available on 2024-10-01)
DOI: 10.1007/s13224-023-01780-w

Abstract

Background: Birth companion (BC) has been globally recognised as an essential component of childbirth care. As our institution did not allow BC in labour, this study was planned as a quality improvement (QI) project to introduce the concept. We aimed to achieve birth companionship from existing 0 to 100% over a period of six months.

Intervention: QI team was constituted, and an initial brainstorming session conducted. A fishbone diagram was drawn to analyse issues that need addressal before implementation of the initiative. The framework was defined, and team members assigned their roles and responsibilities. A series of five successive Plan-Do-Study-Act (PDSA) cycles were carried out over a period of six months, which included introduction of the concept, dissemination of information, infrastructural changes in labour room and introducing column for documentation in birth register. To achieve sustainability, comprehensive group counselling sessions were started for women during antenatal period, and sensitisation classes were regularly conducted for newly inducted trainees and faculty.

Result: Birth companionship was achieved in 98% of cases.

Conclusion: The QI tools helped in preparation and planning of changes by breaking down a large problem into smaller sections and covering all aspects of challenges in a systematic manner using team-based approach. National directives and recommendations, sensitisation of leadership and training of stakeholders were found to be important facilitators. Robust systems of monitoring and successive PDSA cycles were needed for continuous improvement and sustainability of the idea.

Keywords: Birth companion; Continuous support during childbirth; Labour companionship; PDSA cycles; Quality improvement; Respectful Maternity Care.

© Federation of Obstetric & Gynecological Societies of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.