Women\u27s perceptions of spousal relevance in childbirth pain relief in four Nigerian hospitals.

With a diverse and multiethnic population of about 180 million, Nigeria is the most populous nation in Africa, and women constitute 49.4% of its population [1]. The estimated rate is six births per woman, with the mean age of 20.3 at first birth [1]. Nigeria is a patriarchal society where socio-cultural systems promote male dominance in several, if not all, spheres of life [2]. Societally or culturally bestowed authority on males mandates them to be the sole decision makers on most family issues, including permission for women to use maternity healthcare services [3]. Of births in Nigeria, 63% occur at home with traditional birth attendants, while only 36% are delivered in healthcare facilities [1]. In deliveries at healthcare facilities, varieties of pharmacological pain relief methods are available to women; examples are analgesics such as the opioids, pentazocine and pethidine [4]. These pharmacological pain-relief methods are seldom accessed by women due to poor utilization, poor provider attitudes, and lack of clearly stated pain management guidelines [3–5]. Regardless of whether a woman delivers at home with traditional birth attendants or in health care facilities, pain relief is essential. The challenges relating to the use of pharmacological pain relief methods in healthcare facilities in Nigeria make it pertinent to explore the comfort that spousal presence may provide to women in labor as part of pain relief during childbirth [6]. Such spousal presence may be viewed from multiple perspectives. Considering that, the focus of care and pain relief during childbirth is on women and that very little is known in Nigeria about spousal involvement in childbirth pain relief, this study looks at the issue from the point of view of women’s perceptions. Understanding their perceptions on the subject is paramount in enhancing maternity care, satisfaction and experience. Previous studies on women’s perceptions of spousal presence in childbirth in Nigeria are scarce and exclude pain or pain relief. These studies revealed that spousal support is necessary and that spouses are preferred labor companions for women in labor [7–9]. They also showed that spousal presence made delivery less stressful and improved emotional security for women. It was also important to women that their spouses appreciated them more after sharing their birth experience [9]. A randomized study conducted in Northern Nigeria revealed that even women who for cultural and religious reasons were strongly opposed to the physical presence of their spouses in the labor room agreed that spouses should accompany their partners for ante-natal care, delivery, and postnatal care [10]. On the other hand, another randomized study of Nigerian women showed no particular preference for their partner/husband attendance of labor and delivery; women skeptically viewed husband/partner companionship during labor [11]. This study aimed to explore the perspectives of women regarding the impact of spousal presence on women’s experience of childbirth pain