title: Birthing support and breastfeeding initiation in Somaliland: experiences at the Edna Adan Maternity Hospital in Hargeisa, Somaliland.
abstract: BACKGROUND
  Research has identified a relationship between birthing practices and breastfeeding initiation Continuous support during labor and delivery is a key component to increasing breastfeeding initiation.
  
  
  OBJECTIVE
  The purpose of this project was to assess the impact of labor support on breastfeeding initiation in a setting in which women receive traditional birthing support from female family members.
  
  
  METHODS
  Research was conducted at the Edna Adan Maternity Hospital in Hargeisa, Somaliland using the grounded theory method of qualitative research. Semi-structured interviews, direct observations and participant observations were conducted. A purposeful, non-statistical sample was chosen: ten women, five family members, six health care providers and five birth observations were included. The CDC EZ-Text, a software program developed by the Center for Disease Control and Prevention for use in qualitative research, was used in managing and analyzing the data. Data analysis and interpretation was conducted using micro-analysis, open, axial and selective coding procedures.
  
  
  RESULTS
  The results indicated that due to cultural influences, contradictory beliefs and practices, lack of critical thinking and lack of long term planning, traditional birthing support was not always indicative of immediate breastfeeding initiation.
  
  
  CONCLUSIONS
  The presence of a labor companion is a low-cost, preventative intervention that is consistent with the cultural practices of Somaliland. Breastfeeding education and support should, therefore, include a tertiary approach which includes pregnant and birthing women, labor support persons or family members and health care providers.
authors: Virginia College of Osteopathic Medicine, Blacksburg, VA, USA. kholder@vcom.vt.edu
authors: Kelly
authors: K
authors: Holder
mesh_terms: D016550:Birthing Centers / Q000458:organization & administration; D001942:Breast Feeding / Q000523:psychology; D003469:Culture; D003696:Delivery Rooms / Q000458:organization & administration; D036861:Delivery, Obstetric; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007743:Labor, Obstetric; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D036301:Qualitative Research; D012944:Social Support