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Why are restrictions still in place for partners at maternity units and when are they likely to change?

Partners should be able to attend maternity appointments now – due to a fall in cases and the vaccination of healthcare staff.

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MOTHERS AND WOMENS’ advocacy groups have been calling for partners to be allowed to attend pre-natal appointments, the delivery suite and post-natal wards now that Covid-19 cases have stabalised at a lower level and the country is reopening.

But the guidance from the HSE to 19 maternity hospitals and units around the country has remained the same: assess whether you can allow partners to attend based on your clinical situation.

“You can get your haircut, play sport with an entire team of people, visit a museum, but you can’t have your partner with you during one of the most momentous and sometimes traumatic experiences you could possibly face,” mother Linda Kelly asked, who is one of 58,000 signatories to a petition calling on the Irish Government to allow partners to attend maternity appointments.

In recent days, the HSE and the Taoiseach signalled that partners should be able to attend maternity appointments at hospitals safely now – due to the fall in cases and the vaccination of healthcare workers.

Some local variations to restrictions may still be in effect, however – here’s why that is, and the reasons for the restrictions being implemented in the first place.

The medical rationale for the restrictions

Politicians, healthcare workers, and hospitals have commented in recent weeks on the reasons for the restrictions in partners and visitors being limited in attending maternity appointments over the past few weeks.

Among the reasons is that one of the strategies hospitals have to limit the risk of Covid-19 outbreaks is to ensure the minimum number of unvaccinated and untested people enter the hospital as is possible. 

Though acknowledging the stress that this can cause to all new mothers and their partners, Covid risk assessments in hospitals by infection prevention and control teams have concluded that some hospitals cannot facilitate partners attending scans or births without jeopardising the safety of all mothers, partners and their babies in wards.

The risk factors of additional people attending hospitals include:

  • Some hospitals, particularly older hospitals, have smaller wards where social distancing is harder to maintain
  • Most women and their partners are in an age cohort where they won’t be vaccinated until May or June
  • The threat Covid-19 poses to pregnant women through Covid placentitis is a concern.

Although these tight restrictions may seem severe when compared to the reopening of hairdressers, the return of inter-county travel, and the return of hospitality next month, the aim behind the measures, according to health authorities, is to keep hospital services running by limiting the risk of Covid-19 outbreaks.

The argument against this is: a pregnant woman most likely lives with her partner, or is in very close contact with them – so the risk is the same regardless of whether one or both of them go in to the hospital. 

What was said at NPHET

On the NPHET briefing on Monday 19 April, Deputy Chief Medical Officer Dr Ronan Glynn said that any partner who has symptoms or who has been identified as a close contact should not be attending any pre-natal, post-natal appointments, or the delivery room.

The clinical director of the HSE’s Women’s and Infants’ Programme Dr Peter McKenna was asked a number of questions by Virgin Media News’ Zara King on this topic at the same NPHET briefing.

He acknowledged that it is difficult for partners not to be able to attend scans, and that the sacrifices made by families to keep hospitals safer were “considerable”.

Explaining the reasonings for the restrictions, McKenna said: “There was three things that hospitals had to bear in mind when they were drawing up their restrictions. The first was the background community rate [of Covid-19]. The second was the the number of staff and the possibility of key staff becoming unwell. And then the third was the infrastructure of the individual hospital.”

He said that two of these factors have changed – the low number of cases, and the vaccination of healthcare staff. 

He said that individual hospitals would know their situation best, but asked hospitals to “become more liberal” on their approach to partners attending scans and appointments.

I would be hopeful that they would consider themselves in a position to have a less restrictive policy in the coming weeks.

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What happened this week

In Leaders’ Questions this Wednesday, Labour leader Alan Kelly asked the Taoiseach Micheál Martin about the measures in maternity wards; the Taoiseach responded that he would be speaking to the HSE about recommendations for “uniformity” across the maternity healthcare system.

On Wednesday, RTÉ News reported that partners are to be allowed to attend maternity hospital appointments, under a “uniform approach” to be announced on Thursday.

At a HSE briefing yesterday Chief Clinical Officer Dr Colm Henry said that the HSE want to remove as much “distress as possible” for people as possible.

So our advice with maternity hospitals is there should be a partner present for the 20-week anomaly scan, during labour, and of course, the parent should be able to visit in circumstances where the newly born child is in a neonatal intensive care unit. Of course, parents should be able to visit.

He acknowledged that this advice was the same as a few weeks ago, but hasn’t been applied consistently across all units, possibly due to some outbreaks and Covid-19 cases in the community.

What has happened has been that during local outbreaks, local interpretation, local public-health assessment, there has been a halt, or lack of consistency, of that plan.
In some hospitals, for example, we had outbreaks that brought the hospital to the brink of closure. We know that in at least three or four hospitals in January. We had to introduce as much measures as we could to extinguish the outbreaks.

But he said the guideline to allow partners to attend maternity appointments should be implemented “more evenly” across all 19 maternity units and hospitals now due to a fall in cases and a low number of outbreaks in hospitals.

“What I would say is, there can’t be any that up on the infection prevention control measures, that’s really important. The threat remains. We can’t drop our guard on those important infection and prevention control measures.”

Speaking on RTÉ Morning Ireland today, Taoiseach Micheál Martin said that women should have their partners in hospital with them for pre-natal and post-natal appointments, and for the labour. 

“That should happen, we do need uniformity now,” he said. “We’re now in a much better place in terms of the virus – in fact Paul Reid in his presentation to us the other night said it was now non-Covid activities accelerating. So that should happen, and we were working to make sure that that happens.”

Despite these comments, it’s possible that restrictions at maternity hospitals and units may occur depending on outbreaks of Covid-19, and conditions at the hospital itself.

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