AIMS welcomes the BMJ article www.bmj.com/content/371/bmj.m3876.full highlighting recent research on inconsistencies in Trusts’ restrictions on partner attendance in maternity care. AIMS is concerned by the finding that 43% of Trusts had yet to reverse these restrictions, and 24% intended to reinstate them unchanged in the event of a local or national rise in infections www.bmj.com/content/370/bmj.m3483/rr-1. If you are affected by this, write to your Trust using our template letters www.aims.org.uk/information/item/template-letters.
AIMS has been working with the researchers to draw attention to their findings using a real case of parents who contacted our Helpline and agreed to be involved. We are pleased that our campaign and press release have so far led to stories featuring the research being published in the Evening Standard , Mail on Sunday and The Observer.
To help build further media interest we are seeking ‘case studies’. If you have been affected by the restrictions and would be happy to have the details of your experience shared publicly, please get in touch with campaigns@aims.org.uk . You would need to be willing to have your name, age, occupation and location published in the media, together with a photo.
This the text of the press release we sent out on Friday 9th October 2020
New research using a freedom of information requests reveals the full extent of maternity restrictions across England.
Pregnant women in England are still forced to receive much of their maternity care alone. All NHS trusts imposed some restrictions to partner attendance during the first peak of the COVID-19 pandemic. Almost half (43%) have so far failed to take any steps to lift these restrictive policies, despite NHS England guidance urging them to do so1. It is known that the absence of partners throughout maternity care increases the risk of negative health outcomes and mental ill health, and isolates women2,3,4.
Six in ten trusts are still restricting partner attendance at antenatal scans. In extreme cases, this means women hearing heart-breaking news about their babies alone. Jodie Ryan, an NHS nurse, told us:
“I had some bleeding and had to have an emergency scan. It was during this scan that I was told my baby had no heartbeat. I cannot express enough the devastation I felt …It affected my mental health dramatically and I had to then let my partner know this devastating news afterwards, which was horrendous.”
Her partner Dylan was equally impacted by Jodie receiving this tragic news alone:
“It made me feel 100% worse knowing my girlfriend had to take on the bad news all by herself. It’s hard enough me working away majority of the time but for both of us that news was the worst possible news we could have received, and she had to receive it all on her own, yet we can go and sit in the pub out of choice with a lot of random people. It’s a disgrace!”
Restrictions imposed by the majority of trusts (86%) have meant many women are alone in hospital during early labour which can last hours or even days. Although all trust policies allowed birth partners to attend once labour is established, the unpredictable nature of birth has meant that in some circumstances women have given birth alone. For others, partners usually have to leave within hours of the baby’s birth, with 99% of trusts imposing some form of restriction on partner attendance at postnatal services during the first peak. The research also found there has been immense variation in the restrictions and how they have been applied, leading to a ‘postcode lottery’, and confusion for women at a highly vulnerable time.
A senior midwife at an NHS birth centre shared that their team had worked hard to enable partners to safely be there from the time a woman arrived until the family leave with their baby:
“We have lived with this for enough for it to become a new normal, we all now know how to manage this safely.”
Another midwife working in a foetal medicine unit stated:
“We all know how important it is that birth is treated as a family event, not just seeing the woman alone, but that is what we are doing and women are going through this in isolation. Where is the compassion?”
Following the first wave, many NHS trusts have relaxed their restrictions, but 35 trusts (43%) have not, despite recommendations from NHS England, the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and Society of Radiographers1. Furthermore, 1 in 4 trusts explicitly reported plans to reinstate restrictions in the event of a significant second spike in hospital admissions.
Nadia Higson, Vice-Chair of AIMS (the Association for Improvements in the Maternity Services) commented:
“We have received many heart-rending calls from people affected by these restrictions, which reveal a lack of flexibility to respond to individual needs and a failure to consider the mental health impact of blanket restrictions. Yet we know some trusts have found ways to accommodate support for women, at least for mothers with specific needs such as severe anxiety, or if English isn’t their first language.”
AIMS is calling on all NHS trusts to learn from best practice and implement NHS guidance as a matter of urgency to protect the health and wellbeing of women. To find out more about its campaign including resources to support pregnant women and their partners visit www.aims.org.uk.
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For further information, please contact:
Dr Sebastian Walsh, Sebastian.walsh@nhs.net, 07936707415
Editor’s Notes:
The World Health Organisation recommends companions throughout the maternity pathway to improve maternal and newborn health outcomes, and to promote gender equality5. Partner support during birth is associated with shorter labours, less caesareans, reduced pain, improved condition of the baby at birth, reduced negative feelings about and less postnatal depression2,3,4.
The freedom of information request was sent to all 127 English NHS trusts 24/08/20. Results were analysed on the 23/09/20. Results were received by 81 trusts (64%) by that date. The FOI was requested, analysed and reported by three public health speciality registrars based in the East of England:
Dr Sebastian Walsh, Public Health Specialty Registrar, East of England
Fiona Simmons-Jones, Public Health Specialty Registrar, East of England
Rebecca Best*, Public Health Specialty Registrar, East of England
*Rebecca Best also worked as a ward manager of a birth centre during the first wave of the COVID-19 pandemic.
References:
1. NHS England and NHS Improvement. Framework to assist NHS trusts to reintroduce access for partners, visitors and other supporters of pregnant women in English maternity services. 2020
2. Bohren MA HGJSCFRK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev 2017;
3. Bohren MA BBOMH, Tunçalp Ö. Perceptions and experiences of labour companionship: a qualitative evidence synthesis. Cochrane Database Syst Rev 2019;
4. Morrell CJ, Sutcliffe P, Booth A et al. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technol Assess (Rockv) 2016; 20.
5. Organization WH. WHO recommendations on health promotion interventions for maternal and newborn health 2015. World Health Organization, 2015.
About AIMS:
AIMS was founded sixty years ago “to support women and families to achieve the birth that they wanted.” Since then we have campaigned tirelessly for improvements to the UK's maternity services, as well as supporting maternity service users, their families and other supporters. Our dual objectives are reflected in our mission statement:
We support all maternity service users to navigate the system as it exists, and campaign for a system which truly meets the needs of all.
We hope that this page is of interest, especially to our colleagues in the maternity services improvement community.
The AIMS Campaigns Team relies on Volunteers to carry out its work. If you would like to collaborate with us, are looking for further information about our work, or would like to join our team, please email campaigns@aims.org.uk.
Please consider supporting us by becoming an AIMS member or making a donation. We are a small charity that accepts no commercial sponsorship, in order to preserve our reputation for providing impartial, evidence-based information.
AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all.