The following are extracts from current discussions among midwives in Europe about birth companions and visitors.

The rights of women: ICM statement on coronavirus

“A single, asymptomatic birth partner should be permitted to stay with the woman, at a minimum, through pregnancy and birth. Continuous support by a birth partner increases spontaneous vaginal birth, shortens labour and decreases caesarean births and other medical interventions.”

Statement of the International Confederation of Midwives: Women’s Rights in Childbirth Must be Upheld During the Coronavirus Pandemic.

On-line campaigns to reverse hospital policies to exclude partners

In USA and Europe, campaigns to reverse hospital decisions to exclude birth partners have been launched. For example, 350,000 people in UK signed a petition, No woman should have to birth alone in UK.

“Due to exhaustion and the various pain medication, I was incoherent and became unable to make any decisions for myself. My heart rate became so accelerated due to the stress of the situation that hospital staff believed I was about to go into cardiac arrest and had a crash team rush into the room. Fortunately, they were not needed. Do you know why? Because my husband was able to speak to me in a way that only he knows, that calmed me and made sense to me, and we managed to agree to an epidural, which relaxed me and my labour was smooth sailing from there.”

A woman with a partner is exposed to less risk of infection from health staff

During labour

“There is debate about companionship in the light of covid-19 for some settings in Europe – but in others it is still absolutely seen as a right, and, indeed, as a way of minimising cross-infection for staff. If a woman has a birth companion she is better able to labour without the need for constant staff support, is less likely to need an epidural (so to need an anaesthetist) and is less likely to need a Caesarean section (and so, again, less likely to occupy a theatre and need theatre staff, and more likely to be able to leave hospital quicker).”

Professor Soo Downe OBE, University of Central Lancashire, UK

During postnatal care

“If a mother has had a Caesarean and cannot lift her baby out of the cot, or get out of bed unaided, she will have to call staff to help her. The staff will then move between patients and colleagues throughout the ward (and hospital) and have multiple (sometimes close and prolonged) contacts with people during their shift.

“A single visitor, if food is provided for them, only needs to leave the room or bedspace on arrival/departure and to go to the toilet. They are able to provide physical and emotional care, which otherwise will fall to staff to do.

“Every social contact potentially increases the spread of the virus, including each contact between patients and staff. Social distancing principles should be applied within the hospital environment wherever possible, as well as by the public. Stopping visitors will increase the opportunities for the spread of the virus by staff within the hospital or care facility, and increase the workload of staff.”

Gillian Meldrum, Midwife, Chelsea ad Westminster Hospital NHS Foundation Trust, UK

Lock partners in, not out

“On arrival at the health unit, mother and companion are together: either both are likely to be infected or neither. The companion is no significant additional risk to others. The risk occurs if they separate and subsequently come back together, bringing the virus in from others. So one solution is to ensure they are not separated. In short, the companion who arrives with the woman at the health facility must stay with her permanently, locked in, not out.”

Duncan Fisher OBE, Editor, FamilyIncluded.com

Visitors as “partners in care”

“Instead of regarding visitors as a problem (outsiders intruding on “our system”) we need to develop their role as “partners in care” with the staff. After a brief explanation of relevant infection control procedures, and their importance, they will be more vigilant than staff in the protection of their loved ones from infection. Staff  need to be considered as far more at risk of both spreading and being exposed to infection than a single visitor who remains in one area in contact with one patient.”

Gillian Meldrum

Header photo: Government of Alberta. Creative Commons.