{
  "abstract": "Background: The WHO and the Government of India recommend allowing a chosen birth companion during labour and delivery. However, implementation across public facilities remains poor. This study aimed to introduce and sustain the presence of birth companions for at least 50% of labouring women within 5 months at a tertiary-care hospital in eastern India using quality-improvement (QI) methods.\n\nMethods: The Model for Improvement (MFI) with sequential Plan–Do–Study–Act (PDSA) cycles was applied from May to September 2022. Barriers were analysed through a fishbone diagram. Interventions included staff sensitisation, protocol development and workflow redesign. Staff attitude and respectful maternity care perception were assessed using short Likert-scale feedback forms after each cycle.\n\nResults: At baseline, no women were accompanied by a birth companion. After five PDSA cycles, 75% of labouring women had one. Staff-perception scores for respectful care improved by 38%, and resistance to the practice declined. No breach of privacy or infection-control incidents were reported.\n\nConclusions: Iterative QI cycles successfully introduced the birth-companion concept in a busy public-sector hospital. Context-specific administrative and behavioural interventions enhanced acceptance among staff and patients, improving respectful-maternity-care delivery. Sustained policy support and periodic staff motivation will be essential for scale-up.",
  "abstract_shown": true,
  "affiliations": [
    "Obstetrics and Gynecology, All India Institute of Medical Sciences Patna, Patna, Bihar, India",
    "Emergency Medicine, All India Institute of Medical Sciences Patna, Patna, Bihar, India",
    "Community Medicine, Madhubani Medical College & Hospital, Madhubani, Bihar, India",
    "Hospital Administration, All India Institute of Medical Sciences Patna, Patna, Bihar, India",
    "Community and Family Medicine, All India Institute of Medical Sciences Patna, Patna, Bihar, India",
    "Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mukta Agarwal",
      "orcid": "0000-0002-0141-5756"
    },
    {
      "affs": [
        0
      ],
      "name": "Simran Simran",
      "orcid": "0000-0001-7128-474X"
    },
    {
      "affs": [
        1
      ],
      "name": "Divendu Bhushan"
    },
    {
      "affs": [
        2
      ],
      "name": "Pallavi Lohani",
      "orcid": "0000-0002-2105-6674"
    },
    {
      "affs": [
        3
      ],
      "name": "Sujit Kumar Sinha"
    },
    {
      "affs": [
        0
      ],
      "name": "Hemali H Sinha"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Chandramani Singh"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9f74h152ya2h3.bib",
  "cited_by": 0,
  "doi": "10.1136/bmjoq-2025-003638",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711549/",
  "id": "9f74h152ya2h3",
  "issns": [
    "2399-6641"
  ],
  "landing_url": "https://doi.org/10.1136/bmjoq-2025-003638",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "1506"
    ],
    [
      "heading",
      "Quality Improvement Report"
    ],
    [
      "openalex",
      "2729|Maternal and Perinatal Health Interventions"
    ]
  ],
  "openalex": "W7223369084",
  "pdf_url": null,
  "pmcid": "PMC13711549",
  "pmid": "42919570",
  "published": "2026-10-23",
  "publisher": "BMJ Publishing Group",
  "ris": "https://research.draconitic.com/paper/9f74h152ya2h3.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:22:18Z",
      "native_id": "PMC13711549",
      "source": "pmc",
      "url": "https://doi.org/10.1136/bmjoq-2025-003638"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2729|Maternal and Perinatal Health Interventions",
      "subfield": "reproductive-child"
    }
  ],
  "title": "From policy to practice: establishing birth companion presence in labour rooms via quality improvement methods",
  "title_text": "From policy to practice: establishing birth companion presence in labour rooms via quality improvement methods",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:18Z",
  "url": "https://research.draconitic.com/paper/9f74h152ya2h3",
  "venue": "BMJ Open Quality",
  "versions": []
}