DOI: 10.5061/dryad.wpzgmsbzv
title: Birth companionship and mistreatment

description: Birth companionship during facility-based childbirth has been recommended
 by the World Health Organization to improve maternal and newborn outcomes.
 However, limited evidence exists on how companionship affects women's
 experiences of mistreatment during childbirth and their mental health. To
 assess the characteristics of birth companionship during intrapartum care
 and examine its associations with women's experiences of mistreatment
 and postpartum anxiety and depression. We analysed cross-sectional data on
 314 women who gave birth in six public health facilities in rural Sindh,
 Pakistan. Women were interviewed 42 days postpartum about their childbirth
 experiences and postpartum anxiety and depression. Multivariable
 regression models were used to examine associations between birth
 companionship, mistreatment, and postpartum anxiety/depression. Path
 analysis explored whether mistreatment mediated the relationship between
 companionship and postpartum anxiety and depression. Most women (83.1%)
 had a full-time companion in the labor room, with in-laws (44.6%) being
 the most common, followed by family members (26.1%) and friends (15.0%).
 Higher levels of companion support were associated with lower levels of
 mistreatment, particularly regarding non-confidential care, lack of
 supportive care, and ineffective communication. Women receiving low
 companion support were 2.86 times more likely to experience postpartum
 anxiety and depression compared to those receiving high support.
 Informational support emerged as the strongest protective factor against
 both mistreatment and postpartum anxiety/depression. Path analysis
 revealed that the effect of companion support on postpartum mental health
 was mediated by experiences of mistreatment during childbirth. Birth
 companionship, especially informational support, plays a crucial role in
 reducing mistreatment during childbirth and improving maternal mental
 health outcomes. These findings underscore the need for supportive
 policies and health system interventions that actively encourage the
 engagement of companions from a woman's personal network during labor
 and childbirth. Future research should explore strategies to optimize the
 role of birth companions in promoting respectful maternity care and
 maternal well-being.
description: Data Collection: In-person interviews were conducted by trained
 data collectors in privacy using structured questionnaires. Women were
 recruited at health facilities at the time of discharge, and information
 on their sociodemographic characteristics was collected. Their experiences
 of childbirth and mental health were collected at 42 days postpartum at
 their homes. Data were collected electronically using tablets. Data were
 analysed in Stata version 16.0
description: # Birth companionship and mistreatment
 [https://doi.org/10.5061/dryad.wpzgmsbzv](https://doi.org/10.5061/dryad.wpzgmsbzv) ## Description of the data and file structure Data Structure: The dataset comprised of 314 women who were interviewed in-person after childbirth. Each record in the data file represents a woman. Metadata: * Data were collected electronically in face-to-face interviews * Province, Country: Sindh, Pakistan * Data collection period: November - December 2021 * Author details: Waqas Hameed ([waqas.hameed1@gmail.com](mailto:waqas.hameed1@gmail.com)) * Research instruments: Mistreatment tool, Patient Health questionnaire-4, and newly developed items to gather data on type of birth companion support. | facilityid | Facility Code | Codes | | :--------- | :---------------------------------------------------------------------- | :------------------------------------------------------------------------------------------------ | | pid | Participant ID | Numeric | | agecat | Women's age | 0. 15 - 24 years; 1. 25 - 34 years; 2. 35 - 46 years | | mtongue | Mother tongue | 0. Sindhi; 1. Urdu, Punjabi, Balochi, Pushto, Siraki | | wedu | Womens Education | 0. None/illiterate; 1. Attended any formal education | | poverty | Household Economic Status | Range: 0-100 (higher score indicates household is more affluent | | bsex | Sex of baby | 1. Boy; 2. Girl | | anc | Received antenatal care for index childbirth  | 1. Yes; 2. No | | mdel | Mode of birth for current pregnancy  | "1. Yes; 2. No" | | callow | Was your companion allowed to stay in labour room with you | "1. Yes, allow full time; 4. No, not allow any time" | | chospital | Women had birth companion at any point during her stay in the hospital  | "1. Yes; 2. No" | | emp | Women involvement in household decision making | Numeric value | | disability | Status of women's any disability | "0. None or no disability; 1. Any disability" | | primi | Primigravida status | "0. No; 1. Yes" | | pabuse | Physical Abuse | Numeric value - higher values indicates higher cumulative level of physical abuse | | vabuse | Verbal Abuse | Numeric value - higher values indicates higher cumulative level of verbal abuse | | stidis | Stigma & Discrimination | Numeric value - higher values indicates higher cumulative level of stigma and discrimination | | confiden | Non-Confidential Care | Numeric value - higher values indicates higher cumulative level of non-confidential care | | icomm | Ineffective Communication  | Numeric value - higher values indicates higher cumulative level of Ineffective communication | | lsupport | Lack of supportive care | Numeric value - higher values indicates higher cumulative level of Lack of supportive care | | pstand | Lack of Professional Standards | Numeric value - higher values indicates higher cumulative level of lack of professional standards | | hcondi | Health facility culture and constraints | Numeric value - higher values indicates higher cumulative level of constraints | | mistreat | Overall Cummulative Level of Mistreatment | Numeric value - higher values indicates higher cumulative level of overall mistreatment | | linclus | Lack of Inclusive Care | Numeric value - higher values indicates higher cumulative level of mistreatment | | sbaby | Sex of baby | "0. Boy; 1. Girl" | | words | Console touch and reassuring words | 1. Yes; 0. No | | distract | Distract by talking about any subject to ease anxiety or pain | 1. Yes; 0. No | | adopt | Help her adopt alternate position to ease pain | 1. Yes; 0. No | | breathing | Encourage and/or remind women of the breathing exercise | 1. Yes; 0. No | | update | Update women about current condition | 1. Yes; 0. No | | privacy | Main privacy | 1. Yes; 0. No | | medintake | Support regarding nutritional and medicine intake | 1. Yes; 0. No | | hurt | Avoid doing or saying anything that may hurt women | 1. Yes; 0. No | | ambulate | Assist to ambulate during labour | 1. Yes; 0. No | | anxdep | Symptoms of anxiety and depression | 1. Yes; 0. No | | comp | Companion during hospital stay  | 0. None; 1. In-laws; 2. Family; 3. Mix -fam and in-law; 4. Misc (friend/with or without relativ | | labor | Presence of companion during labour | 1. Yes; 0. No | | cbirth | Presence of companion during childbirth | 1. Yes; 0. No | | aftrbirth | Presence of companion during after childbirth | 1. Yes; 0. No | | csuport | Level of companion support on discrete scale | Numeric value - (higher values indicates higher support) | | csuport3 | Level of companion support on ordinal scale | 0. Low (Score: 0-5); 1. Moderate (Score: 6-7); 2. High (Score: 8-9) | | emosprtbin | Any emotional support | 1. Yes; 0. No | | inssprtbin | Any instrumental support | 1. Yes; 0. No | | infsprtbin | Any informational support | 1. Yes; 0. No | | csuportr | Level of companion support on discrete scale - reversed coding | Numeric value - reversed coding (higher values low support) | | emosprtr | Any emotional support - reversed codin | Numeric value - reversed coding (higher values low support) | | infsprtr | Any informational support - reversed codin | Numeric value - reversed coding (higher values low support) | ## Code/software ### Recommended Software for Data Analysis: Stata, Statistical package for social scientists, SAS, R or any other statistical sofware