Analysis of factors affecting companions’ level of adherence to support roles during labor and childbirth: a mixed-methods study

Background: Labor companions often lack clarity about their support roles during childbirth. Therefore, this study aims to analyze factors influencing companions’ adherence to support roles during labor and childbirth. Methods: A convergent parallel mixed-methods design was used to examine factors influencing companions’ adherence to support roles from May to June 2024. Systematic random sampling selected 320 participants from the maternity ward. Data were collected via face-to-face exit interviews. Purposive sampling chose 24 labor companions for in-depth interviews. Adherence to support roles was measured using a four-point Likert scale, ranging from “not at all” to “all of the time.” Ethical approval was obtained from the IRB at Jimma University, and support letters were secured for each study facility. Written consent was obtained from all participants. Results: Companions’ adherence to support roles during childbirth had an overall mean score of 1.39 (95% CI: 1.29–1.49) on the four-point Likert scale. Specifically, 27.5% of companions reported not at all, and 35.63% reported only a little support, while 17.19% reported providing support all of the time. Awareness among companions was associated with increased adherence to support roles ( B = 0.238, p = 0.029). Nevertheless, companions with less prior experience (first time: B = −0.377, p = 0.001; second time: B = −0.280, p = 0.031) showed significantly lower adherence to support roles. The qualitative data also explored that, unclear role definition, unwelcoming approach of healthcare providers, and social-cultural factors were associated with minimal adherence to support roles. Conclusion: A structured orientation session for companions is a vital recommendation to address hindering factors to their support roles. Such a session might equip them with techniques how to provide.