{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:45:05Z","timestamp":1782949505879,"version":"3.54.5"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Childbirth companionship has multiple benefits and is associated with improved maternal and neonatal outcomes. However, childbirth companionship is an important component of respectful maternity care that is still underutilized in the clinical setting. Therefore, this study assessed factors associated with childbirth companionship utilization among mothers who delivered at a public hospital in Shashemene town, southern Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A facility-based mixed methods study was performed among 411 mothers who delivered at Public Hospitals in Shashemene town from August 20 to September 20, 2021. We entered the collected data into Epidata version 3.1 and exported it to SPSS software version 23 for analysis. A binary logistic regression model was employed to assess the relationship between independent variables and childbirth companionship utilization. A p\u2009&lt;\u20090.05, with an Adjusted Odds Ratio (AOR) and 95% confidence interval (CI) were employed to declare the association. For an in-depth interview, the interview guide was utilized to collect data. We used Open Code software 4.03 for verbatim transcription, translation, and thematic analysis of the data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The magnitude of childbirth companionship utilization was 14.4% (95% CI: 11.2\u201317.6). Having complications during pregnancy and labor [AOR\u2009=\u20093.25, (95% CI: 1.74, 6.05)], having a future desire to have companions [AOR\u2009=\u20094.02, (95% CI: 1.72: 1.66, 9.41)], primiparous [AOR\u2009=\u20092.54, (95% CI: 1.25, 5.28)], and good knowledge of companionship [AOR\u2009=\u20093.00, (95% CI: 1.53, 5.91)] were significantly associated with childbirth companionship utilization. Qualitative findings also revealed that healthcare providers\u2019 denial, overcrowding of the delivery room, and mothers\u2019 fear of exposing partner\/family members to stress were barriers to utilizing childbirth companionship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, the magnitude of childbirth companionship utilization was low and below the WHO recommendation. Therefore, the study highlights the significance of acting on the health system, client, and provider-side factors, which are important to improve the implementation of respectful maternity care components at the facility level. In addition, the integration of respectful maternity care counseling into routine prenatal care, regardless of mothers\u2019 pregnancy risk status, could enhance utilization. Moreover, addressing barriers to companionship utilization through healthcare provider training, developing clear facility-based guidelines, and improving health facilities\u2019 infrastructure is crucial to enhance childbirth companionship and improve maternal health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0347161","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:45:42Z","timestamp":1777398342000},"page":"e0347161","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Companionship utilization and its associated factors during childbirth among mothers who delivered at public hospitals in Shashemene town, Southern Ethiopia: A mixed-method study"],"prefix":"10.1371","volume":"21","author":[{"given":"Dedefo Gemeda","family":"Anbesa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8168-3656","authenticated-orcid":true,"given":"Abdene Weya","family":"Kaso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gebi","family":"Agero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girma","family":"Bacha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayanos","family":"Taye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"pone.0347161.ref001","first-page":"325","article-title":"Childbirth and Stress","author":"A Horsch","year":"2016","journal-title":"Stress: Concepts, Cognition, Emotion, and Behavior"},{"issue":"1","key":"pone.0347161.ref002","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1002\/ijgo.12841","article-title":"An overview of advances in global maternal health: From broad to specific improvements","volume":"146","author":"N Khorrami","year":"2019","journal-title":"Int J Gynaecol Obstet"},{"issue":"1","key":"pone.0347161.ref003","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12992-018-0338-9","article-title":"Approaches towards improving the quality of maternal and newborn health services in South Asia: challenges and opportunities for healthcare systems","volume":"14","author":"NU Mian","year":"2018","journal-title":"Global Health"},{"key":"pone.0347161.ref004","article-title":"Companion of choice during labour and childbirth for improved quality of care: evidence-to-action brief","author":"WH Organization","year":"2020"},{"issue":"3","key":"pone.0347161.ref005","article-title":"Perceptions and experiences of labour companionship: a qualitative evidence synthesis","volume":"3","author":"MA Bohren","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0347161.ref006","first-page":"14","article-title":"The respectful maternity care charter-the universal rights of childbearing women","volume":"16","author":"E O\u2019Keefe","year":"2016","journal-title":"Australian Midwifery News"},{"key":"pone.0347161.ref007","article-title":"Companionship during labour promotes vaginal delivery and enhances maternal satisfaction","volume":"17","author":"VW Chung","year":"2017","journal-title":"Hong Kong Journal of Gynaecology, Obstetrics and Midwifery"},{"issue":"3","key":"pone.0347161.ref008","doi-asserted-by":"crossref","first-page":"218","DOI":"10.21608\/pssjn.2020.48535.1059","article-title":"Supportive care provided by companion during childbirth and it\u2019s effect on labor progress and maternal satisfaction","volume":"7","author":"R Younes","year":"2020","journal-title":"Port Said Scientific Journal of Nursing"},{"key":"pone.0347161.ref009","first-page":"1","article-title":"The experience and role of the companion during normal labor and childbirth: a systematic review of qualitative evidence","volume":"9","author":"LAK Hoga","year":"2011","journal-title":"JBI Libr Syst Rev"},{"issue":"12","key":"pone.0347161.ref010","doi-asserted-by":"crossref","first-page":"351","DOI":"10.3390\/soc15120351","article-title":"Barriers and Beliefs: A Qualitative Study of Jordanian Women\u2019s Perceptions on Allowing Companions in the Labour Room","volume":"15","author":"RS Maabreh","year":"2025","journal-title":"Societies"},{"issue":"4","key":"pone.0347161.ref011","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1007\/s00737-022-01243-7","article-title":"Two are better than one? 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