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Background: South Africa has included birth companions in its national guidelines for maternity care and the revised Maternity Case Record, in and effort to improve the quality and experience of care. However, reservations amongst healthcare providers remain about the acceptability of birth companions in the labour ward.Objectives: To document the experiences and perceptions of birth companions who supported women in labour in a rural hospital in Limpopo Province where a Respectful Maternity Care (RMC) project was piloted.Method: An institution-based cross-sectional study design was employed. Purposive sampling was employed where all birth companions who supported a woman during labour and birth were included in the study. The experiences and perceptions of birth companions were captured using a birth companion feedback book during the period of 1st April to 30th August 2019. Thematic analysis was used to analyse the data.Results: Seventy-one (71) of the 73 birth companions only had positive responses about the birthing experience and how both the birth companion and woman in labour were treated. Two birth companions were dissatisfied with the treatment provided by the midwife that supported the birth.Conclusion: It is important for healthcare providers to understand the far reaching emotional and psychological impact of their attitudes and behaviour on, not only women in labour but also on others who witness their (healthcare providers) behaviour. Mechanisms to obtain feedback from birth companions should be integrated into strategies to improve the quality and experience of care for women during childbirth.

Background: Advancements in medical interventions have contributed to the prevention of innumerable deaths of women and newborns globally, leading to the medicalization of childbirth, which may have inadvertently contributed to a dehumanization of the birthing experience by denying women the social and emotional support that they enjoyed when giving birth in the home environment. The WHO places equal importance on the quality of clinical care and the quality of experience of care. Emotional support, provided by a birth companion of choice, is critical for enhancing the experience of care during labour and birth. This study explores advocacy for women to have a birth companion, as well as perceptions of women about having a birth companion during labour and birth in a rural sub-district of Limpopo Province in South Africa. Methods: A cross-sectional study based on a continuous electronic RMC client satisfaction survey, on an on-line platform, which was completed by 506 women in a postnatal ward of a rural district hospital. Observations of interactions between midwives, women in labour and their birth companions during labour and birth were conducted in the same hospital. The survey data was analysed using descriptive statistics in Excel, and comprises both univariate and bi-variate analyses. The qualitative data from the observations was analysed using thematic analysis techniques. Results: Over 80% of women who completed the survey reported that they were informed about what a birth companion is and encouraged to register a birth companion at the health facility where they were attending antenatal care. Almost half of the women (49%) who were encouraged to bring a birth companion, had a birth companion during labour, whereas 15% of those not encouraged to bring a birth companion, had a birth companion during labour. The respondents who were feeling neutral, happy and very happy about having a birth companion were most likely to recommend having a birth companion to their family member or friends. Conclusion: The findings show that encouraging and supporting the presence of a woman’s companion of choice during labour and childbirth is an effective intervention that is respectful of women’s autonomy and agency and which is crucial for improving quality of clinical care and the experience of care during labour and birth