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Effect of Birth Companion Programmes on Maternal Satisfaction with Maternity Care in Nigerian Hospitals

Abstract

Maternal satisfaction with maternity care is an important indicator of the quality, acceptability, and responsiveness of maternal health services. Positive experiences during childbirth may influence women's willingness to use healthcare facilities for future pregnancies and recommend maternity services to other women. However, some women in Nigerian hospitals may experience childbirth in environments characterized by inadequate emotional support, limited communication, long waiting times, lack of privacy, restricted involvement in decision-making, and insufficient attention to their psychological and social needs. Birth companion programmes provide women with the opportunity to have a chosen companion, such as a partner, relative, friend, or trained support person, present during labour and childbirth to provide emotional, informational, and practical support. Such programmes may improve women's childbirth experiences by reducing anxiety, strengthening communication, increasing perceived support, and promoting respectful maternity care. Maternal satisfaction with maternity care refers to women's assessment of the quality, responsiveness, comfort, communication, respect, support, and overall experience of care received during pregnancy, labour, childbirth, and the immediate postpartum period. Against this background, this study investigates the effect of birth companion programmes on maternal satisfaction with maternity care in Nigerian hospitals. The study will be anchored on the Patient-Centred Care Theory, the Donabedian Model of Healthcare Quality, and the Health Belief Model. Patient-Centred Care Theory emphasizes respect for patients' preferences, values, needs, communication, participation, and emotional support in healthcare delivery. The Donabedian Model evaluates healthcare quality through structure, process, and outcome and provides a framework for examining how the organization and delivery of maternity services influence maternal experiences and satisfaction. The Health Belief Model provides a framework for understanding women's perceptions of healthcare services and factors influencing their acceptance and utilization of supportive maternity interventions. Collectively, these theoretical perspectives provide a suitable framework for explaining how birth companion programmes may influence maternal satisfaction with maternity care in Nigerian hospitals. The study will adopt a quantitative cross-sectional or quasi-experimental research design, depending on the availability of hospitals implementing birth companion programmes and suitable comparison facilities. The study population will comprise women who receive maternity services and give birth in selected Nigerian hospitals. A multistage sampling technique will be used to select states, hospitals, maternity units, and eligible participants. Birth companion programmes will be assessed using indicators such as availability of a formal companion policy, eligibility of companions, proportion of women permitted to have companions, duration of companion presence, type of companion, staff support for the programme, privacy arrangements, orientation provided to companions, and implementation consistency. Maternal satisfaction with maternity care will be assessed using indicators such as satisfaction with communication, respect and dignity, emotional support, involvement in decision-making, privacy, responsiveness of healthcare providers, waiting time, physical comfort, cleanliness, pain management, information provided, and overall satisfaction with maternity services. Data will be collected using structured questionnaires, maternal satisfaction scales, maternity records, facility assessment tools, and relevant hospital programme documents. Descriptive statistics will be used to summarize participants' characteristics, birth companion programme implementation, and maternal satisfaction levels. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple regression analysis, will be used to determine the effect of birth companion programmes on maternal satisfaction with maternity care. Where appropriate, satisfaction levels among women exposed to birth companion programmes will be compared with those receiving conventional maternity care. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that birth companion programmes have a significant positive effect on maternal satisfaction with maternity care in Nigerian hospitals. Women who have access to a supportive birth companion are expected to report higher levels of satisfaction with communication, emotional support, respect, involvement in decision-making, and their overall childbirth experience than women who give birth without a companion. The presence of a trusted companion may help women feel less anxious and isolated during labour while providing emotional reassurance and practical assistance. Birth companions may also facilitate communication between women and healthcare providers and help women better understand information provided during maternity care. Effective implementation of birth companion programmes may therefore contribute to a more respectful, supportive, and woman-centred maternity care environment. Conversely, restrictions on companion presence, inadequate privacy, overcrowded maternity wards, negative staff attitudes, limited facility infrastructure, and unclear programme guidelines may reduce the potential benefits of birth companion programmes. The effectiveness of the programme may also depend on the willingness and capacity of healthcare providers to support companion participation within maternity settings. The study is expected to contribute to the literature on birth companion programmes, maternal satisfaction, respectful maternity care, patient-centred care, childbirth experiences, maternal health, midwifery, reproductive health, and health-service quality in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospital administrators, obstetricians, midwives, nurses, maternal health programme managers, women's health organizations, development partners, and policymakers regarding strategies for improving women's experiences of maternity care. The study will also provide evidence-based recommendations for establishing and strengthening birth companion programmes, developing clear hospital policies, training healthcare workers on companion-supported maternity care, improving privacy and communication, promoting respectful maternity care, involving women in decisions concerning childbirth, and creating maternity environments that support women's emotional and social needs across Nigerian hospitals.

Keywords: Birth companion programmes, maternal satisfaction, maternity care, Nigerian hospitals, respectful maternity care, patient-centred care, childbirth experience, maternal health, midwifery, reproductive health, healthcare quality, public health.