Mothers without companionship during childbirth: an analysis within the Millennium Cohort Study.
BACKGROUND
Studies have highlighted the benefits of social support during labor but no studies focused on women who choose to be unaccompanied or who have no companion available at birth. Our goals were, first, to identify characteristics of women who are unaccompanied at birth and compare these to those who had support and, second, to establish whether or not being unaccompanied at birth is a risk marker for adverse maternal and infant health outcomes.


METHODS
The sample comprised 16,610 natural mother-infant pairs, excluding women with planned cesarean sections in the Millennium Cohort Study. Multivariable regression models were used to examine, first, sociodemographic, cultural, socioeconomic, and pregnancy characteristics in relation to being unaccompanied and, second, being unaccompanied at birth in relation to labor and delivery outcomes, maternal health and health-related behaviors, parenting, and infant health and development.


RESULTS
Mothers who were single (vs not single), multiparous (vs primiparous), of black or Pakistani ethnicity (vs white), from poor households (vs nonpoor), with low levels of education (vs high levels), and who did not attend antenatal classes (vs attenders) were at significantly higher risk of being unaccompanied at birth. Mothers unaccompanied at birth were more likely to have a preterm birth (vs term), an emergency cesarean section (vs spontaneous vaginal delivery) and spinal pain relief or a general anesthetic (vs no pain relief), a shorter labor, and lower satisfaction with life (vs high satisfaction) at 9 months postpartum. Their infants had significantly lower birthweight and were at higher risk of delayed gross motor development (vs normal development).


CONCLUSIONS
Being unaccompanied at birth may be a useful marker of high-risk mothers and infants in need of additional support in the postpartum period and beyond.
Essex
Holly N
HN
Department of Health Sciences, University of York, United Kingdom.
Pickett
Kate E
KE
D000328:Adult; D002657:Child Development; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000523:psychology*; D016015:Logistic Models; D008429:Maternal Welfare; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D036801:Parturition / Q000523:psychology*; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome; D012306:Risk; D012944:Social Support; D012959:Socioeconomic Factors; D006113:United Kingdom