Is the policy of allowing a female labor companion feasible in developing countries? Results from a cross sectional study among Sri Lankan practitioners

BACKGROUND: Companionship during labor is known to have both physical and psychosocial benefits to mother and baby. Sri Lanka made a policy decision to allow a labour companion in 2011. However, implementation has been unsatisfactory. Given the leading role Obstetricians play in the implementation of policy, a study was undertaken to assess the knowledge, attitudes and practices among them. METHOD: A descriptive cross sectional study was conducted among consultant obstetricians working in the state hospitals using the platform ‘Survey Monkey’. RESULTS: Out of the 140 consultant obstetricians invited, 68(48.5%) participated. Among the study participants, 40 (58.8%) did not allow labour companions in their wards. Lack of space (n = 32; 80%) and the volume of work in the labor wards (n = 22; 55%) were the commonest reasons for not allowing a companion. Only 16.7% (n = 5) of the obstetricians handling more than 300 deliveries per month allowed a companion (p = 0.001). Less than 50% of the obstetricians were aware of the advantages associated with the practice such as shorter labor, lesser analgesic requirement, higher chances of a normal birth, improved neonatal outcome and reduced requirements for labor augmentation for slow progress of labor. Knowledge on advantages on breast feeding and reduced need of instrumental delivery also remained low. CONCLUSION: In an individual unit, the consultant often decides policy. The study points out the need to improve awareness among the practitioners.