MATERNITY CARE CAMPAIGNERS will raise ongoing concerns about partners’ access to hospitals during pregnancy with the HSE next week. 

As most public health restrictions around the country are being lifted, expectant parents are questioning why some limits are still being enforced on partners attending services. 

Pregnant women have described instances of partners not being permitted to come with them to the emergency department or complications with partners attending appointments, with guidance being implemented differently by individual hospitals.

Linda Kelly of Better Maternity Care told The Journal that it will raise the issues with the HSE at a meeting next Wednesday.

The HSE says it plans to restore access to pre-pandemic levels “as soon as is practical”, but that healthcare settings are different other environments and “we do need to move more cautiously”.

Under the current guidance for hospitals, there is a range of appointments and circumstances during which partners should be permitted to attend, though hospitals are allowed to exercise discretion in allowing access. 

Since last November, HSE guidance allowed for many of the strict rules limiting partners’ access during maternity care and labour in the pandemic to be lifted.

The guidance said that all maternity services could provide access for a nominated support partner to inpatient areas during normal visiting hours from 8am to 9pm.

A nominated support partner should have access to the labour ward and throughout delivery.

During pregnancy, partners should be able to attend the 12-week and 20-week scans.

Additionally, they should be allowed to attend at early pregnancy assessment units and any unscheduled events, including emergency services or other antenatal care that could be emotionally distressing.

But speaking to The Journal, Kelly said that although hospitals should enable access for partners, especially now as most Covid-19 restrictions are being lifted, this hasn’t always been the case.

“We’ve been engaging with the HSE since the end of last year and in the main it has been very positive. We’ve been making progress on lots of different issues, including the issue of emergency presentations like A&E,” Kelly said.

“All of the hospitals reported to the HSE that they were allowing partner access in A&E visits, particularly when someone was in the clinical area. Sometimes they aren’t allowed in the waiting room because the room is so small,” she said.

“So we took that as something that was already done and sorted and then we’ve been getting an increasing number of messages from people to say no actually they’re not allowing people in.”

If all the restrictions are lifted in society, it can’t be the case that hospitals are continuing with the hospital lockout. It’s not a credible position on any level that that’s how we would live as a society moving forward from Covid.”

Kelly said that not all hospitals are implementing guidance allowing partners access to antenatal appointments.

“Hospitals should start facilitating that. Letterkenny and Limerick have in certain instances, but there’s been very few announcements in the other hospitals,” she said.

“That’s something that we’re continuing to fight for.” 

‘Disappointment’

Other advocates say that access should be equal across the country, rather than being significantly different depending on the hospital where a patient is receiving care.

The Association for Improvements in Maternity Services (AIMS) Ireland has received reports from women who describe experiences where their partner wasn’t allowed to attend an appointment with them or was left waiting for hours after being informed they had miscarried before their partner could join them.

“These are things that are not supposed to be happening, and yet they are happening,” said Dr Krysia Lynch, chair of AIMS.

Speaking to The Journal, Dr Lynch said that there is “variance in the implementation of the guidelines” between hospitals.

“On the HSE website, it lists all the things that are supposed to happen. It’s got a list of all of the restrictions that are currently in place and all 19 maternity units signed up to all aspects of the guidance,” Dr Lynch outlined.

That’s what it says on the website. What’s coming out of women’s mouths is something completely different because people are contacting us all the time and telling us that they’re unable to have what it says on the website, that their partner wasn’t able to be with them, that they got bad news about a miscarriage and they were less five hours on their own before their partner was able to come and be with them.

Similarly, some partners are being allowed to stay for entire day after a baby is born, while others are only permitted during the minimum visiting hours.

“It’s always been down to the individual hospital manager on the day as to what they will and won’t allow. So the guidance is there, but it’s simply a guidance. If the hospital manager or the group manager decide no, we’re not going to do that, then people kind of don’t have any recourse,” Dr Lynch said.

“Local managers know their units best, and we understand that, but having said all of that, there really needs to be greater facilitation and understanding by the local managers, that they’re part of a national picture.

“People know what’s going on in other hospitals and it’s just not appropriate that there should be such a vast difference between what’s available in one place and another place.

“The concept of national governance of maternity services really needs to be seriously evaluated as a result of Covid-19 practices, because what we’ve seen is that governance is very variable locally and that’s not in women’s best interest.”

In a statement to The Journal, the HSE said that it “understands that many people may expect that changes in access to hospitals and other clinical areas should change in line with the general removal of social restrictions”.

“The HSE plans to restore access to pre-pandemic levels as soon as is practical. However, healthcare settings are different to most places where people come together for work and social activity and we do need to move more cautiously,” a spokesperson said.

The HSE understands the disappointment of people who have experienced difficulties with access for nominated support partners. 

The HSE said that it is working with hospitals to implement the guidance and that it encourages people who experience difficulty to raise the issue directly with the relevant hospital.

“If they can provide details of the date and time and the difficulty that they experienced this provides the hospital management with the specifics to look into the issue.”

Hospital visits

Chief Medical Officer Dr Tony Holohan advised the government earlier this year that there was no longer a public health justification to limit visiting in healthcare facilities.

The latest overall guidance on hospital visits, which came into effect on 21 February, removed the requirement for a Covid-19 vaccine pass.

It also clarified that it is not necessary to withdraw access from a nominated support person in the event of a Covid-19 outbreak.

The guidance says that hospitals “must strike a balance between the need to manage the risk of introduction of Covid-19 by people accessing the hospital while ensuring that patients who need the support of a partner, a member of their family or a friend has reasonable access to that person”. 

In a statement after NPHET advised the government that there was no longer a public health reason for visitor restrictions at hospitals, the Social Democrats called on the Minister for Health to direct that the restrictions should be lifted.

The party’s health spokesperson Róisín Shortall said that the pandemic had been “extremely difficult for patients and their families”. 

“In the wider community, people are now able to freely mix in pubs and nightclubs. There is no justification for very restrictive visiting rules to remain in place in hospitals and nursing homes. These must be lifted as a matter of urgency,” Shortall said.

“Health Minister Stephen Donnelly must give a very clear direction on this. We cannot have a repeat of what happened previously when restrictions in maternity hospitals were extended long beyond any public health rationale. The time to act is now, before any further hurt and pain is caused.”