Supporting birth companions for women in labor, the views and experiences of birth companions, women and midwives: A mixed methods systematic review

Background Birth companions can have a positive effect on women's experiences in labor. However, companions can feel unprepared and need professional guidance to help them feel involved and provide effective support. Methods A convergent segregated mixed‐methods systematic review was conducted to explore women's, companions’, and midwives’ experiences of birth companion support and identify ways to improve the experience for women and companions. A thematic synthesis of qualitative data and a narrative summary of quantitative data were conducted followed by integration of the findings. Results Companions who cope well in labor reported feeling involved, able to preserve women's internal focus and have a defined role, providing physical or emotional support. LBGTQ+ partners faced barriers to inclusion due to “forefronting” of their sexuality by staff and a lack of recognition in the language and processes used. The experience of birth companions can be enhanced by promoting their role as co‐parent, guardian, and coach, provision of timely information and developing a trusting relationship with care providers. Only two papers reported midwives’ views on birth companions in labor. Conclusions Women's and companions’ satisfaction with birth is increased when companions can support the mother, feel supported themselves, and valued as a co‐parent. The midwives’ role in information provision and guidance can maximize birth companions’ experience and ability to provide positive support. LBGTQ+ families need more support to feel included and recognized. Qualitative data from 32 studieswere analysed into six overarchingthemes: feeling connected; feeling overwhelmed; feeling supported; feeling ‘inthe way’; midwives’ perspectives and the specific experiences of lesbianpartners.