Outrage over maternity restrictions must deliver lasting reforms

Krysia Lynch, chair of maternity advocacy group AIMS Ireland, said there is growing engagement online. File picture:Colin Keegan, Collins Dublin

Campaigners are hoping the outrage so widely expressed over maternity restrictions for partners might now translate to more fundamental reforms and supports for the National Maternity Strategy.

There was little doubt last March that visiting restrictions were a reaction to the risks and strangeness of the virus.

Indeed, the threat from the Delta variant has become clearer in recent weeks, with a British study showing a rise in Covid-19 hospital admissions among pregnant women.

But while jurisdictions like Northern Ireland now include hospital visiting in Government updates, things have been more ad-hoc in Ireland to the detriment of women and other patients generally.

The pushback has been driven by parents who want a shared birth experience; the old idea that men waited in the pub is long gone for the majority of new parents. 

But it seems many of those in authority could not read the room.

Many women have said they prefer these quieter wards without dozens of friends and family visiting, while being horrified at equating their partners or doulas with casual visitors.

Chair of maternity advocacy group AIMS Ireland, Krysia Lynch, said they and other advocacy groups have seen growing engagement online with hashtags like #BetterMaternityCare #Womenascend and #WhoseNeedsAreBeingMet.

“The restrictions have created such a sense of outrage and they have gone on for so long, that the outrage has now manifested in actions,” Ms Lynch said.

“There are people now who have been simmering in the background, with respect to the lack of implementation of the Maternity Strategy, with respect to the system of patriarchy that persists, and the power dynamic that persists in our maternity services. This has been the final straw that broke the camel’s back.” 

She said it is clear from the hundreds of messages they receive people are “angry” with the lack of shared control. They are frustrated with the slow access to vaccines, and unclear about their impact on the restrictions.

The lack of transparent guidelines and lack of transparent risk assessment is pushing people into feeling the restrictions don’t have their roots fully in infection control.

“They want that kind of attitude gone but we know cultural change and organisational change doesn’t happen with the snap of a finger.” 

General hospital wards have also been closed to visitors except for compassionate visiting and for parents of young children.

Contrast this with Northern Ireland where the picture has evolved throughout the pandemic despite infection rates remaining high. In the last week, 8,830 positive cases were identified compared to 12,199 here from a larger population.

Chief nursing officer for Northern Ireland, Professor Charlotte McArdle, told the BBC there is now a “standardised, regional risk assessment” protocol with local deviation allowed on application. 

A phased return to visiting is in place.

Visting guidelines published on the NI Direct government website say visiting means a “chosen birth partner” can attend “ any pregnancy-related appointments or ultrasound scans, for induction of labour, duration of labour and birth, for up to three hours after the birth”.

When women are inpatients, they can have one daily visit.

Ms Lynch said even when the vaccine campaign was just starting, there was a different attitude to hospital visiting across the UK.

“It was always a case of let’s find the best solution in the time available, and that is what we are not doing,” she said.

We are not finding a time-sensitive solution that puts women at the centre of the maternity services, and that is what we should be doing. 

Instead women have had to find solutions for themselves; some opting to bypass hospitals where safe to do so.

Last year, numbers accessing homebirths shot up by 33% according to the HSE.

Others opted for community care in parallel with hospital care in greater numbers than before.

In one example, extra pandemic funding is helping Waterford University Hospital expand its outreach clinics led by demand according to director of midwifery Paula Curtin.

Funding for staffing would also address a key worry for managers. They are aware that if in a team of midwives or in smaller hospitals, just one sonographer or obstetrician caught Covid-19, there would be no subs on the bench.

Consultants associations and midwifery representatives have long called for greater recruitment which the HSE says is now taking place.

It should not have taken a pandemic to put these options more squarely on the table.

Choice in pregnancy is a key plank of the National Maternity Strategy (2016 to 2026). A review of this was due last year; the HSE has said it is being finalised now.

This radical document has the potential to further switch the focus to community care especially for low-risk pregnancies. That is, if it is supported by the public and politicians as well as from within the health system.

The key question now is whether those parents who refused to stay silent about their personal challenges can maintain this public pressure for change when the trauma of the pandemic has passed.