In this article:
Understanding the Role of a Birth Companion
A birth companion does not replace professional medical care. Instead, they add to it by giving ongoing emotional and physical support.The companion may be:
- A spouse or partner
- A parent or sibling
- A close friend or relative
- A trained doula or community health worker
- Providing reassurance and comfort through touch, words, or presence
- Supporting breathing and relaxation techniques
- Advocating for the birthing individual’s needs respectfully
- Offering practical help such as hydration or positioning support
Why Birth Companionship Matters in India
India sees over 2 crore births each year. The government has made many efforts to improve hospital deliveries, but the emotional and psychological sides of childbirth are often overlooked.Research shows:
- Continuous support during labour reduces the likelihood of caesarean births by 25–30%.
- People with companions report higher satisfaction with their birth experiences.
- Companionship contributes to respectful maternity care, aligning with India’s LaQshya programme under the National Health Mission.
Barriers in Indian Settings
Even with its benefits, allowing companions during labour is still difficult in many Indian facilities. These barriers are complex and include cultural, institutional, and infrastructural issues.1. Cultural and Social Barriers
- Many families perceive childbirth as a private or “female-only” event.
- Some believe it is inappropriate for spouses to be present during labour.
- Hesitation arises from fear of embarrassment or exposure in shared labour wards.
2. Facility and Infrastructure Barriers
- Overcrowded labour rooms make privacy difficult.
- Limited space restricts the entry of non-medical individuals.
- Some hospitals lack curtains or partitions for maintaining dignity.
3. Institutional Barriers
- Policies are often unclear or inconsistently implemented.
- Health staff may feel companions interfere with their work.
- There is concern about infection control or safety.
4. Awareness and Training Gaps
- Many pregnant individuals are unaware of their right to have a companion.
- Health workers may not be trained to integrate companions smoothly into the care process.
Government and Policy Support
Recognising these challenges, the Indian government has taken progressive steps to institutionalise birth companionship.Key initiatives include:
- The Ministry of Health and Family Welfare (2019) directed that one birth companion be allowed during labour and delivery in all public health facilities.
- The LaQshya programme promotes respectful and dignified maternity care, with companionship as a core element.
- National Quality Assurance Standards (NQAS) encourage hospitals to ensure the presence of birth companions wherever feasible.
Overcoming the Barriers
To make companionship effective and inclusive, both mindset and management must evolve.1. Strengthening Infrastructure
Modify labour rooms to ensure privacy with partitions or curtains.Create clearly marked areas for companions to sit or stand safely.
Maintain hygiene and provide appropriate protective gear if required.
2. Building Awareness
- Include information about the right to a birth companion in antenatal counselling.
- Conduct awareness campaigns within communities and maternity clinics to promote awareness and education.
- Display posters and pamphlets in waiting areas to normalise the idea.
3. Training Healthcare Providers
- Orient staff to understand the benefits and protocols of companionship.
- Develop simple checklists for managing companions during labour.
- Recognise the role of emotional support as part of quality maternity care.
4. Engaging Communities
- Encourage local self-help groups, ASHAs, and midwives to spread awareness.
- Include discussions on birth companionship in maternal health education programs.
- Involve community leaders to publicly endorse the practice.
5. Respecting Personal Choice
- Ensure that having a companion is a choice, not an obligation.
- Respect the privacy and personal boundaries of the birthing individual.
- Maintain flexibility—each birth experience is unique.
The presence of a birth companion in the labour room is not a privilege—it is a fundamental aspect of compassionate maternity care. Overcoming the barriers in Indian settings requires collaboration between communities, hospitals, and policymakers.
When emotional comfort meets medical safety, childbirth becomes not only a clinical success but a profoundly human experience. Allowing companionship in labour is a small step towards a bigger goal—respectful, empowered, and joyful birthing for every individual in India.
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FAQs on Breaking Barriers: Making Birth Companions a Reality in Indian Labour Rooms
- Can a birth companion be anyone, or are there restrictions in hospitals?
Most hospitals in India allow one birth companion of the birthing individual’s choice, such as a spouse, parent, or friend. However, each facility may have its own rules depending on space, infection control, and staffing. It’s always advisable to discuss this early during antenatal visits. In some public hospitals, companions may need to follow hygiene protocols like wearing clean clothing or protective gear before entering the labour room. - How can rural or small facilities manage birth companionship despite limited resources?
Even with limited resources, small facilities can make a real difference. Simple steps like using curtains for privacy, training staff to work with companions, and raising community awareness can help a lot. Empowering ASHAs and midwives to teach families about companionship is also useful. Rural facilities can focus on low-cost changes and respectful care, showing that compassion does not always need a big budget.