Maternity restrictions still in place despite agreement they should end

‘Distressing’ rules see partners unable to attend labour for full duration

May 11th: Campaigners protest against restrictions at maternity units. File photograph: Tom Honan

May 11th: Campaigners protest against restrictions at maternity units. File photograph: Tom Honan

 

Restrictions within maternity care are still in place in some hospitals, despite the Taoiseach, the Minister for Health and the chief medical officer all agreeing they should end.

According to maternity care campaigners, some hospitals are still not allowing partners to stay with expectant mothers for the full duration of labour.

Instead, partners are permitted only when the woman is in “active labour”, dilated a certain number of centimetres, or has their own room.

Other hospitals are not facilitating partner visits after the birth.

Guidance from the Health Protection Surveillance Centre in relation to maternity units was updated on Friday, June 11th.

“An accompanying person [partner] should generally be facilitated in accompanying a woman throughout the process of labour and childbirth during the time the woman is in the labour ward,” it said.

“Before moving to the labour ward, in particular when the woman is in a multibed area, access for an accompanying person may be limited by the requirement to respect the needs of other patients for rest and privacy.”

This addition is new, with the previous version only stating that a partner should be able to accompany a woman “throughout the process” of labour and childbirth, whether spontaneous or induced.

This guidance also stated that maternity services should allow a minimum 30-minute daily visit from partners, and partners should also be allowed to attend the 20-week scan and visit their baby in the neonatal intensive care unit (ICU).

The guidance added that any restrictions on the above should be based on a documented risk assessment that is reviewed regularly.

‘Passing the buck’

Krysia Lynch, chair of the Association for Improvements in the Maternity Services in Ireland, said it appears that most hospitals are allowing partners to attend the neonatal ICU and 20-week anatomy scans.

However, she said the updated guidance published on Friday is “passing the buck” with regards to allowing partners to be present in early labour.

“It says partner access may be limited by the ‘requirement to respect the needs of other patients for rest and privacy’. Who decides that one person gets to override everyone else’s needs and wishes?”

She added that it is “curious” that the guidance says partner access can be limited by other people on the ward, as opposed to Covid-19 infection control measures. “This line focuses on privacy and respect, not Covid.”

Up to 200 women who gave birth in the past three weeks have contacted the association, Ms Lynch said. “Their experience has been the same as the people who gave birth in the three weeks before that. People are so angry.”

She maintained that women should have a partner to accompany them in the early stages of labour: “They are entering the hospitals in labour on their own, and their partners are called up when the hospital sees fit. They could be on their own for hours.”

Ms Lynch said it is critical for women to have support in early labour, as they often don’t have access to pain relief or a one-on-one midwife.

She said gyms, cinemas, restaurants and pubs are now open, but partners are still restricted when trying to support their pregnant loved one. “There are people who are delaying going to hospital so they can be with their partner for as much of labour as possible.”

Maternity rights campaigner Linda Kelly from Cork, who gave birth during the first wave of the pandemic, said she can’t understand why the restrictions are still in place when the majority of healthcare staff are vaccinated, as are a growing number of pregnant people and their partners.

“Women have contacted hospitals saying their partner is fully vaccinated, but they still can’t attend all of their appointments, there’s no rationale for this.

“It’s been very distressing for people. They thought restrictions would be lifted in their totality.”

‘Infrastructural challenges’

East hospitals

In a statement, the Ireland East Hospital Group said with the exception of the National Maternity Hospital on Holles Street, their three regional maternity units are part of a general hospital campus.

“These hospitals have specific infrastructural challenges where social distancing cannot be sufficiently met within the Covid guidelines while facilitating partners to attend with the maternity patients.”

In Mullingar, Wexford and St Luke’s in Kilkenny, partners can attend “active labour” and theatre for scheduled caesarean sections.

Wexford General Hospital and St Luke’s General Hospital are not allowing partners to visit after the birth.

Holles Street and Regional Hospital Mullingar are allowing pre- and post-birth visits.

South/Southwest hospitals

A representative for South/Southwest Hospital Group said that once a woman is transferred to a single space for induction or dilation, their partner is welcome to accompany them.

“Induction can take up to 2-3 days, normally in shared spaces, ie in four-bedded wards, so it was never the practice in our maternity hospital that a partner would stay for the entirety of this process.

“Partners ordinarily would be asked to leave at 10pm to allow for sleep and rest for the patients.”

Unlike Cork University Maternity Hospital (CUMH), the representative said, hospitals in Waterford, Kerry and Tipperary have to navigate “many factors” when it comes to visiting restrictions as they are general hospitals.

CUMH is allowing visits to inpatients.

On the Health Service Executive’s website, it does not say whether post-birth visits are being facilitated at the three general hospitals.

Portlaoise hospital

In the Midland Regional Hospital Portlaoise partners can attend the birth, once the woman is in labour and admitted to the delivery suite. This includes when the woman is induced in the delivery suite.

Partners can also be present in theatre at caesarean sections and at the booking scan.

“The hospital has reintroduced scheduled visiting to the maternity ward for antenatal and postnatal women, which is arranged by appointment [and usually lasts an hour],” a representative said.

Coombe hospital

Meanwhile, in the Coombe, partners can attend the labour ward when the woman is in established labour (1cm dilated), and they can attend the theatre for a caesarean section.

Partners can also attend early pregnancy assessment unit appointments, as well as dating and anatomy scans.

Designated partners may also visit the wards daily during certain times.

UL hospitals

University of Limerick Hospitals Group said that nominated partners get 45-minute visiting slots on the hospital’s postnatal wards, between the hours of 6pm and 8pm daily.

“Birthing partners will also continue to be supported in attending the labour ward and theatre.”

RCSI hospitals

When the Royal College of Surgeons (RCSI) hospital group (which includes Our Lady of Lourdes in Drogheda, Cavan General Hospital and the Rotunda) was asked what restrictions were in place at their maternity units and hospitals, it said: “National guidance is being adhered to by all maternity sites in the RCSI Hospital Group.”

According to the Rotunda’s website, if the woman is induced, partners will be able to join them only when active labour is established and she has been moved to a single-occupancy room.

Visits are being facilitated in all of these hospitals.

Saolta hospitals (west)

Saolta University healthcare group, which comprises University Hospital Galway, along with maternity units in the Sligo, Letterkenny, Mayo and Portiuncula hospitals, said their maternity units are facilitating access for birthing partners in line with recent national guidance on visiting restrictions, published on June 11th.

According to the HSE website, partners of women attending University Hospital Galway may attend for the birth once the woman is admitted into a single room on the labour ward, and partners can attend a caesarean section.

In Mayo, partners are allowed to attend with mothers in labour, but they must leave the maternity department when the mother is transferred to the maternity ward.

In the other hospitals in this region, partners can accompany the pregnant person while in labour, but the HSE website doesn’t give specific details.

Inpatient visits are being facilitated in all of these hospitals.