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Maternity Care

'Huge disappointment' about new draft maternity restriction guidance, advocates say

Campaigners have criticised differing guidance for private rooms and those with multiple beds.

LAST UPDATE | 1 Sep 2021

A MATERNITY CAMPAIGNER has said a draft version of new guidance on Covid-19 maternity restrictions will “continue to separate pregnant people from their partners”. 

The Journal last night reported details of the expected updated guidance on visitations to maternity units and hospitals. The guidance will be finalised and published later this week. 

The new guidelines are expected to tell hospitals that partners do not need to leave during labour and childbirth if a pregnant person has been taken directly to a single-occupancy room.

Senior health sources say that the guidance will outline that controls on access for partners should be the minimum needed to prevent Covid-19 transmission.

Partners should be facilitated to accompany the pregnant person during admission and their initial assessment until they have been settled in an assigned bed.

Linda Kelly, who is part of the #BetterMaternityCare campaign, said she was “really disappointed” with the draft guidance.

Kelly was among those meeting with officials in the HSE today to discuss the restrictions. 

“There was a very constructive engagement at our last meeting. We felt that they understood the issue, we felt there was a real willingness to find solutions – we don’t see any of that reflected in the document,” Kelly said. 

“The main aspect of concern for us is that there is a continued policy of separating pregnant people and their partners during labour.”

She said there is “no credibility to any guidelines that continue to separate pregnant people from their partners, that’s the nuts and bolts of this”. 

Dr Kyrsia Lynch, chair of the Association for Improvements in Maternity Services – Ireland (AIMS), said she felt “huge disappointment on several levels” about the draft guidance. 

She criticised that “effectively, the restrictions are not being lifted”. 

“The only slight change is that there is an emphasis on the partner going into maternity hospitals or units for initial assessment and potentially having to leave when they are moved,” Lynch told The Journal

“For us, we would always advocated, as the national maternity strategy advocates, that care in maternity services is woman-centred or family-centred, and what this has shown us is that the plan has been designed around bed allocations.

It’s almost as if the people experiencing maternity services and the people making policies and drawing up restrictions are speaking two completely different languages.

Following today’s meeting, the HSE said it will carefully consider feedback from all stakeholders and update the guidance shortly.

“We remain committed to facilitating the maximum possible access for nominated support partners at all stages of the pregnancy pathway, where possible in the context of ensuring the safety of women and infants given that there is a high prevalence of Covid-19 in the community,” the health service added. 

Lynch said the draft guidance drawn up before today’s consultation with advocates “indicates a system in which peoples’ experiences are not valued”. 

“One of the things that worries me is that there is such focus on single-bed occupancy,” she said. 

“This could create a situation where people availing of private care have a leg up on people not receiving private care.”

With private healthcare, pregnant women can usually stay in a single-occupancy room after their birth to recover if a room is available. This is generally not the case for public patients. 

“We would like to see measures that can be applied irrespective of what occupancy status people find themselves in,” she said. 

“We need solutions for multi-bed occupancy because that is what most people are going to be experiencing.

“We need solutions-focused responses that address everybody’s experience, not just people who find themselves in single-occupancy rooms.” 

Advocates have always pushed for partners not to be considered as non-essential visitors, and Lynch said officials should work to create “all measures around the two people instead of just the one person carrying the baby”. 

“There is still an opportunity to do that and we would urge the government to do that. Review these guidelines and see if something else can arise or if they can come up with something else.”

Draft guidance 

If the pregnant person is going directly to a single patient occupancy room, sources say there should be no requirement for the partner to leave during labour and childbirth.

Single occupancy rooms should be provided if it’s expected that a labour or induction will be long, complex, or high-risk.

However, in multi-bed areas, it will still be considered necessary to limit a pregnant person’s partner to two one-hour visits per day.

When someone in labour is preparing to be transferred to the labour ward, the partner should be facilitated to accompany them.

Linda Kelly said many maternity hospitals don’t have a high volume of single-occupancy rooms and before and after labour, many would be in multi-bed rooms where restrictions remain. 

“There’s nothing about single occupancy that will address anything to do with people being on their own in early labour, including induction,” Kelly said.

Social Democrats TD Holly Cairns has criticised having “no estimate for when restrictions at maternity hospitals are likely to be lifted” after a roadmap was outlined for the reopening of society.  

“Maternity care should not be an afterthought, but that has been the consistent approach by this government. At every step, and every stage, women and pregnant people have been ignored,” Cairns said in a statement. 

‘As open access as possible’

Last week, the Psychological Society of Ireland (PSI) expressed concern about the implications of continued maternity restrictions on parents and the wider family during the Covid-19 pandemic. 

There has been criticism in recent months of the different approaches taken by maternity hospitals, with some found not to be fully compliant with official guidance – having tighter restrictions on partner access during labour and at prenatal appointments.

Health Minister Stephen Donnelly said last night that the existing restrictions in maternity units and hospitals “really have very little to do with Covid”.

“What they have to do with is decades of under-investment in maternity care and women’s healthcare,” the minister said on Virgin Media Television’s The Tonight Show. 

“It’s around diagnostic suites that are too small, it’s around multi-occupancy wards which women shouldn’t be in in this day and age.

“So we are dealing with Covid, but actually this government is making women’s healthcare, and I am making women’s healthcare, one of the pillars for healthcare in this government. We need massive investment.”

Speaking at a media briefing yesterday following the announcement of a further easing of Covid-19 restrictions, the Taoiseach said the government’s commitment is “to have as open access as possible” at maternity hospitals and units following months of ongoing restrictions. 

“The HSE have developed new guidelines in respect of access for partners to maternity wards, and those will issue imminently from the Department of Health,” he said.

“Our intention is, and the commitment from the HSE, is to have as open access as possible.”

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