Obstacles to labour companionship at Bamalete Lutheran hospital Ramotswa : Botswana

M.Cur.Obstacles to labour companionship at Bamalete Lutheran Hospital (BLH) in Botswana are discussed. There is an underutilization of labour companionship in the BLH maternity ward despite several efforts that have been made to introduce labour companionship. Labour companionship is a rare exception in the BLH labour ward. Why is labour companionship underutilized at Bamalete Lutheran Hospital and what could be done to promote labour companions? An explorative, descriptive, qualitative, contextual, multiple case study was conducted to explore and describe obstacles to, and the need for, the utilisation of labour companionship, and to develop and recommend strategies to overcome the identified obstacles to labour companionship at BLH. Five unaccompanied primigravidae were selected from mothers who had delivered at BLH. Their ideal labour companions and the attending midwives were also selected for the study. A semi-structured interview with open-ended questions and an audiotape were used to collect data from the primigravidae and their ideal companions. Naive sketches were used to collect data from the attending midwives. Morse and Field cognitive processes were used to analyse the data (1996: 103). This study identified four major obstacles to labour companionship as the lack of knowledge about the concept of labour companionship and the availability of the service by the primigravidae; the lack of knowledge on how labour companionship should be practised in a hospital setting by the ideal companions; the lack of privacy of the labour ward unit; and the reluctance of the midwives to implement labour companionship. The Botswana Sexual Reproductive Health information, education and communication (IEC) approach was utilized as a guide in developing the promotion strategies for labour companionship at BL