For today’s dads, waiting in the pub while their partner attends maternity appointments probably wasn’t part of the plan.
While Don Draper and his ilk might have been content to sit out their offspring’s arrival, chewing on a cigar while awaiting news, modern expectations are, thankfully, very different. Nowadays, birth partners – whether dads, doulas or same-sex spouses – play a vital role in the pregnancy process. Modern birth is approached very much as a team effort and wards run on the assumption new mums will have bedside help.
At least, that is, until 2020, when lockdown saw a ban on hospital visitors extend so fully across the board that women were forced to attend scans, check-ups and even embark on labour alone. With birth partners allowed only in the ‘active’ stages of labour (an anachronism for any woman who has ever spent days in ‘early’ labour), tens of thousands of women have been forced to experience contractions, vital tests and even miscarriages alone. Astonishingly, for many dads today, the pub is still more permittable than the pregnancy clinic.
So dire is confusion across the sector that yesterday, the Royal College of Midwives (RCM) and Royal College of Obstetricians and Gynaecologists (RCOG) issued an urgent press statement, blasting continuing “completely unacceptable” inequity across the country when it comes to antenatal care. A month on from the creation of guidelines for the safe return of partnered appointments, and with the situation now back to some form of normal in Scotland, NHS England is yet to publish any change to change restrictions. Thousands of families remain in limbo.
It’s something that new mum, Radio 1 Newsbeat reporter Shiona McCallum, just can’t fathom. In June, she laboured for almost 60 hours, the majority before her husband Michael was allowed into the birthing suite. By that point, both she and baby were in distress.
“After pethidine, an epidural and eventually getting to 10cm dilated, we were told the baby’s head would need to be turned manually. Eventually, they used the ventouse cup and deep cavity forceps and by the end of it, I was completely exhausted.
“Shortly after delivery, our son, Ramsay, had to be taken to the neonatal unit for oxygen as he wasn’t breathing properly. While I was getting stitched up, Michael went with Ramsay and from that point onwards, we were separated and Michael was sent home. Due to various complications with both myself and Ramsay, we had to stay in the hospital for eight additional nights without seeing Michael. It was distressing, anxiety-inducing, isolating and totally sucked any joy out of having a newborn. I just needed my husband there.”
For Shiona, the additional demands on hospital staff as a result of coronavirus protocols only left her feeling more vulnerable and alone. “It was impossible to build rapport with the midwives because they were in full PPE. They did ward rounds to check on Ramsay, but didn’t have time in eight days to sit down with me one-to-one and demonstrate breastfeeding.
“Lots of women on the ward were stressed and, like me, found themselves sobbing at the whole situation. It felt like the rules were affecting the midwives too as they had to keep explaining to mums that they couldn’t change the situation. They kept saying how sorry they were.”
It’s a situation that newly-qualified midwife Claire* can easily sympathise with. She was working with a community midwifery team focussed on home care when lockdown hit, and says the whole experience has been difficult for mums and midwives alike.
“We had full PPE – mask, gloves and aprons – and were phoning each woman to ask infection screening questions before their antenatal appointments, whether at home or at GP surgeries. That put a lot of strain on our workload – additional time needed to phone everyone, to cleaning equipment such as BP cuffs, beds and changing our PPE between patients. But we learned to adapt and we extended our appointments.
“I tried not to see PPE as a barrier – you’d learn to smile with your eyes. I was never that concerned for my own health, but I was worried about going from house to house or clinic to house, and how we could be carriers.
“At times, I wanted to spend more time with women. Many had been quickly discharged and had more questions for me. There were first-time parents who didn’t have the usual support from their family and friends. First-time parents who had missed out on antenatal classes. And I felt so frustrated at the news that the pubs and restaurants would be opening but, at that time, women could not take their partner along to their scan. It seemed that women’s rights, the right to good antenatal and postnatal care, was being treated as an afterthought. In England, it seems, they still are.”
The pregnancy postcode lottery
Claire, who works In Fife, Scotland, says the situation there has largely returned to normal, albeit with the addition of COVID-screening. Partners are now allowed to attend labour at any stage. But she says the situation as it was in lockdown, and as it remains in England, has been upsetting for many couples.
“When partners were only allowed in active labour – the pushing stage – it was pretty devastating for women who were being induced, when it can take several days before getting to the active stage.
“In terms of appointments and scans, women were worried about being given bad news. I know that some women have had to find out they have had a miscarriage on their own and I can’t imagine how that must feel.
“The whole experience has further strengthened my belief in the need for holistic, woman-centred care. The role of the midwife is to be an advocate for women. But midwifery services were almost forgotten about. Babies are still being born, that didn’t stop during the pandemic, and every family has the right to good support, antenatal and postnatal care.”
For Shiona, who is now home and enjoying time with Michael and Ramsay as a family, Claire’s words ring true. “It felt like there was a complete disregard for women’s mental health – infection control was prioritised above all else. I think it’s appalling for these restrictions to go on longer.
“The rules really compromised family welfare and brought in extra angst at what is already a daunting time. We ended up using Zoom so that Michael could properly see Ramsay and chat to him – he had only seen him all wired up and on oxygen in the hospital straight after the birth. It was heartbreaking to be forced apart and so unnatural when you have been looking forward to becoming a family for nine months. The situation was so hideous that I started to have panic attacks and as a result ended up staying in longer. It was a vicious cycle.”
A joint framework created by RCM and RCOG was issued in early August, aimed at getting visitors back into the maternity care system. Today, it remains unpublished by NHS England, something the colleges brand “completely unacceptable”.
“Not only is this causing distress to pregnant women and their families, it is also impacting on our members, some of whom have faced abuse from visitors unable to attend appointments,” RCM CEO Gill Walton says. “We recognise that there is the need to vary local rules depending on circumstances, such as staffing levels and locally-imposed restrictions due to rising levels of COVID, but we urge NHS England to stop the delay and publish the guidance for all concerned.”
As the row continues, for Shiona, the changes will always be too late. “I wish the government would stop and think about what is right for mum and baby. If mum has been living with her partner, as we had been, why shouldn’t they be allowed into the ward or clinic? The restrictions are turning the start of what should be a blissfully happy time into something ugly and stressful. Sadly, for me, Ramsay’s start in life will always be tainted.”
Meanwhile, Claire says that, far from having deterred her from continuing with midwifery, her lockdown experiences have only served to convince her of the strength of women.
“Women continue to inspire and amaze me every day. I’ve seen some tremendously difficult situations but the women have been so resilient through these difficult times and shown just how strong they are.
“The woman we pass on the street, we don’t know her story. She may have had five previous miscarriages and is putting on a brave face to the rest of the world. She may have endometriosis and has to put up with people constantly asking her when she will have children. She may be seeking refuge in this country and doesn’t speak the language – she’s pregnant and frightened. She may have lost her own grandmother to COVID and is terrified of her baby getting sick. She may be fleeing domestic violence, living in emergency accommodation with no cot, buggy or clothes for her baby. She may be breastfeeding even though she has mastitis and feels that the world will judge her if she doesn’t feed her baby.
“I think there’s a reason why newborn babies have a higher chance of survival if they are female. I think we all come out fighting. I think we all have the capability to be stronger than we know.”
*Name changed to protect interviewee privacy