Birth partners and visitors in maternity services in the time of COVID-19
During the early weeks and months of the COVID-19 pandemic, all visiting across all NHS services was suspended.
In order to be able to have good social distancing and reduce the risk of spreading the virus in hospital to other families and staff. partners were asked not to attend appointments, ultrasound scans or to visit on antenatal and postnatal wards from March – June 2020.
One key exception across UK NHS maternity services was that women were supported to have one, symptom free, birth partner with them in the labour room once they were in active labour until after the birth.
The RCM and RCOG supported and encouraged the presence of a birth partner, including this in the overall COVID and pregnancy guidance and publishing a rapid evidence review on the topic from the RCM’s Professorial Advisory group in April 2020. This review can be found here.
This review highlighted the strong evidence base for continuous one to one companionship throughout labour:
‘ There is professional agreement (RCOG, 2020; RCM 2020, WHO 2020, ICM, 2020) that women’s human rights and the evidence base should be upheld, including access to a companion of choice. Indeed, in times of heightened anxiety, uncertainty, and fear, and when midwifery support may be reduced, it is arguably even more important. The key recommendation from all current guidance, and from the current review, can be summarised as:
An individual, asymptomatic birth companion should be enabled to stay with the woman throughout labour, birth and immediate postnatal period (p2, Lavender, Downe et al, RCM, 2020)
As the first acute phase of the pandemic began to pass in the summer of 2020 and many of the strictest lockdown measures were eased, guidance was published to support maternity services in reinstating access to partners and visitors in a safe and manageable way.
- The Scottish Government published guidance on this in July 2020
- The RCM produced a briefing on re-introduction of visitors to Maternity units across the UK, including a risk assessment tool, in July 2020.
- NHS England produced a framework on this for services in early September
Continued review of services
With the virus spreading more quickly again in communities across the UK during September 2020 and a growing number of local lockdowns and the return of some national restrictions, services are needing to review again local guidelines for visiting and partner attendance.
In areas of high prevalence and where additional local measures or lockdowns are in place, it is likely that the relaxing of visitor restrictions we saw over the summer, may need to be paused.
All maternity services across the UK are doing everything they can to ensure maximum access to important appointments, including scans, for partners and key support people, while also balancing that with the need to keep all of the women and families and staff working in hospitals safe.
While the UK Government and devolved Governments and administrations have the responsibility to set out the framework for partner and visitor attendance in maternity units, it is for local Trusts and Boards to make local assessments of how fast and how far opening up of all areas can be implemented. Decisions about partner and visitor attendance will be based on the local maternity unit geography, including the space available in clinic and scan rooms and waiting areas, the size of corridors, the number of side rooms available on antenatal and postnatal wards and the size of ward bays. Local restrictions and viral prevalence in the community and local data about where transmission is taking place, will also shape decision making.
As the situation with COVID-19 evolves, maternity services will also review what is safe and possible and will once again open up visiting and appointments.
It is important that any visitors follow guidance in hospitals about wearing a face covering and handwashing and maintaining a safe social distance from others.
The RCM has published a downloadable poster for maternity services to use to inform visitors of their responsibilities.
Midwives and maternity teams might also find it helpful to read our webpage on partners and visitors for women and families, and to direct women using their services to this part of the RCM website.