Assessment of the Effectiveness of Continuous Labour Support by a Trained Companion of Choice on Events of Labor and Maternal Satisfaction in the Bugisu Sub Region, Uganda
Study Details
Study Description
Brief Summary
A randomized control trial employing a cross sectional stepped wedge design. Women with anticipated vaginal delivery, receiving usual care for the control group while women receiving usual care plus support from a trained companion will constitute the experimental group. Events and outcomes will then be assessed during and after birth.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
The order of introduction of the intervention will be determined randomly. Control data will be obtained from the first health facility until the sample size for the control for that facility is achieved. Following collection of control data for the first facility, the intervention will be introduced to the same facility to a new group of participants. Simultaneously control data from the other facilities will be collected and this will be done until all the facilities are covered in a step wedge manner.
The intervention will consist of a session of training on admission in labor. The training will focus on emotional and physical support; emotional support including being Present, demonstrating a caring and positive attitude, saying calming verbal expressions, using humor, praise, encouraging and acknowledging efforts during the process of pushing the baby. Physical support including supporting her to change position favoring upright positions, walking with her, giving her drinks and food, massage, reminding her to go and pass urine, helping her find a comfortable position for pushing, wipe her face with cool cloth and help her breast feed.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Other: Arm 1 Women are normally escorted to the health facilities by one or more family members and or friends. Women usually labor in an open first stage room where more than one woman is admitted sometimes with curtains to separate the beds with one person allowed besides her to provide support. The support persons do not have designated roles to play during this process. Routine analgesia is not given neither is continuous fetal monitoring. Midwives, |
Behavioral: Support from a trained companion
Birth companions trained on how to effectively support women during labor
|
| Experimental: Arm 2 One session of training on admission in labor. The training will focus on emotional and physical support; emotional support including being Present, demonstrating a caring and positive attitude, saying calming verbal expressions, using humor, praise, encouraging and acknowledging efforts during the process of pushing the baby. Physical support including supporting her to change position favoring upright positions, walking with her, giving her drinks and food, massage, reminding her to go and pass urine, helping her find a comfortable position for pushing, wipe her face with cool cloth and help her breast feed |
Behavioral: Support from a trained companion
Birth companions trained on how to effectively support women during labor
|
Outcome Measures
Primary Outcome Measures
- Incidence of a Spontaneous Vaginal delivery [labour duration]
delivery of the baby naturally without use of oxytocin, vacuum extraction, or a cesarean section
Secondary Outcome Measures
- coping and anxiety [labour duration]
Women's self-reported anxiety on admission and after birth will be measured using the 10 cm Visual Analogue Scales Coping with labour will be assessed using the Roberts coping with labour algorithm the midwife looks out for cues for coping and not coping
- Length of labour [labour duration]
From time of admission (4-6cm) to birth
- Apgar score [At 1 and 5 minutes]
Apgar score of baby at birth
- use of oxytocin to augment labor [labor duration]
Use of oxytocin to augment labor
- Maternal satisfaction questionnaire [Labour duration]
Level of satisfaction on support, information, pain control, humaneness and general satisfaction with birthing experience
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Women with a singleton fetus and a supposed cephalic presentation.
-
Women with a female friend or relative willing to stay with them through the process of labor and birth.
Exclusion Criteria:
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Women with a multiple pregnancy.
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Women with a previous cesarean section
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Women who are mentally incapacitated or deaf and dumb
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Mbale Regional Referral Hospital | Mbale | Uganda | +256 |
Sponsors and Collaborators
- Makerere University
- Swedish International Development Cooperation Agency (SIDA)
Investigators
- Study Chair: Gorrette Nalwadda, PhD, Makerere University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2017-54