Bohren Meghan A, Hazfiarini Alya, Vazquez Corona Martha, Colomar Mercedes, De Mucio Bremen, Tunçalp Özge, Portela Anayda
Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia.
The Latin American Center for Perinatology/Women´s and Reproductive Health Unit, Pan American Health Organization, Montevideo, Uruguay.
PLOS Glob Public Health. 2023 Feb 1;3(2):e0001476. doi: 10.1371/journal.pgph.0001476. eCollection 2023.
Women greatly value and benefit from the presence of someone they trust to support them throughout labour and childbirth ('labour companion of choice'). Labour companionship improves maternal and perinatal outcomes, including enhancing physiological labour and birth experiences. Despite clear benefits, implementation is slow. We conducted a scoping review to assess coverage and models of labour companionship, including quantitative studies reporting coverage of labour companionship in any level health facility globally. We searched MEDLINE, CINAHL, and Global Health from 1 January 2010-14 December 2021. We extracted data on study design, labour companionship coverage, timing and type of companions allowed, and recoded data into categories for comparison across studies. We included data from a maternal health sentinel network of hospitals in Latin America, using descriptive statistics to assess coverage among 120,581 women giving birth in these sites from April 2018-April 2022. In the scoping review, we included 77 studies from 27 countries. There was wide variation in the coverage of labour companionship: almost one-third of studies reported coverage less than 40%, and one-third of studies reported coverage between 40-80%. Husbands or partners were the most frequent companion (37.7%, 29/77), followed by family member or friend (gender not specified) (32.5%, 25/77), family member or friend (female-only) (13.0%, 10/77). Across nine sentinel hospitals in five Latin American countries, there was variation in coverage, with no companion at any time ranging from 14.9%-93.8%. Despite the well-known benefits and factors affecting implementation of labour companionship, more work is needed to improve equitable coverage. Concerted efforts are needed to engage with communities, health workers, health managers, and policy-makers to establish policies, address implementation barriers, and integrate data on coverage into perinatal records and quality processes to ensure that all women have access. Harmonized reporting of labour companionship would greatly enhance understanding at global level.
女性非常重视有她们信任的人在整个分娩过程中给予支持（“首选分娩陪伴者”），并从中受益。分娩陪伴可改善孕产妇和围产期结局，包括提升生理分娩体验。尽管有明显益处，但实施进展缓慢。我们进行了一项范围综述，以评估分娩陪伴的覆盖范围和模式，包括报告全球各级卫生机构分娩陪伴覆盖情况的定量研究。我们检索了2010年1月1日至2021年12月14日期间的MEDLINE、CINAHL和Global Health数据库。我们提取了关于研究设计、分娩陪伴覆盖范围、允许陪伴的时间和类型的数据，并将数据重新编码为类别以便进行跨研究比较。我们纳入了拉丁美洲一个孕产妇健康定点医院网络的数据，使用描述性统计来评估2018年4月至2022年4月在这些地点分娩的120,581名妇女中的覆盖情况。在范围综述中，我们纳入了来自27个国家的77项研究。分娩陪伴的覆盖范围差异很大：近三分之一的研究报告覆盖范围不到40%，三分之一的研究报告覆盖范围在40%至80%之间。丈夫或伴侣是最常见的陪伴者（37.7%，29/77），其次是家庭成员或朋友（未指明性别）（32.5%，25/77），家庭成员或朋友（仅限女性）（13.0%，10/77）。在五个拉丁美洲国家的九家定点医院中，覆盖范围存在差异，任何时候都没有陪伴者的比例在14.9%至93.8%之间。尽管分娩陪伴的益处众所周知且影响其实施的因素也已明确，但仍需要开展更多工作来改善公平覆盖。需要共同努力，与社区、卫生工作者、卫生管理人员和政策制定者合作，制定政策，解决实施障碍，并将覆盖数据纳入围产期记录和质量流程，以确保所有妇女都能获得服务。统一报告分娩陪伴情况将极大地增进全球层面的了解。
