Our battle with Covid restrictions
Inevitably coronavirus restrictions have been challenging our hospital trust in the way we’d like to provide care for women and their families. But we had a strong focus: we were committed to ensure that mothers could bring a supporter with them when they gave birth in our unit during the lockdown phase of the pandemic, and further eased rules over the summer as the numbers of new cases fell. Here’s a little more on how things went down at the Royal Berkshire.
From the end of April, all women were invited to have a Covid test on admission for the birth of their baby, and although few have declined, most could see the benefit of being able to plan visits from their families once lockdown restrictions eased, as well as our community staff doing their postnatal checks.
Not birthing alone
We’re proud to say that at no time were women asked to give birth without being able to bring someone with them. This applied to those coming in while being in labour, and those who were having a planned Caesarean birth. Partners were able to go to the theatre with women having an emergency Caesarean as well, dressed in all the necessary scrubs and face masks.
“Partners were able to go to theatre with women, dressed in scrubs and face masks.”
One-on-one care
We were also able to continue with our home birth service throughout the pandemic, but we did close our co-located midwifery birthing centre to maximise our staff availability. We had to move a number of midwives to roles where they were not 'patient facing', such as those who needed to shield, or who were pregnant themselves, as per national advice. Our home birth service increased its capacity, and we did not see a rise in unattended home births in this time. We achieved one-on-one care in all labour settings (a KPI), as indeed we had sustained for more than the last eighteen months prior to the pandemic.
Challenging restrictions
Due to the location of our induction suite, we did have to pause partners being there during the assessment or start of induction during lockdown, but this was one of the first areas where we reopened the doors to supporters towards the end of June. Each mother was asked to identify one person who would be with them for their induction and this same person had to be their birth partner. The name was shared at staff handovers so everyone knew who was supporting any mother in the unit. We also asked that the birth partner was masked at all times on the hospital site.
“Longer visiting hours meant more flexibility for partners.”
When we reopened the postnatal visiting (also at the end of June), we limited the duration to two one hour blocks (see the charter here), and again only to the birth partner. We have now, following feedback we sought from new families, extended visiting from 11am to 7pm, but kept the same 'one person' requirement. This longer time has afforded more flexibility for fathers who are not working from home, and has helped with childcare and school pickups for those with older children.
The alternatives we offered
Partners were able to join video and telephone consultations from early in the pandemic, such as booking appointments with community midwives, women wanting to discuss birth after Caesarean, or specific issues with our consultant midwives and for the twenty week appointment with an obstetrician. For women who came alone to a hospital appointment, we were happy for them to dial their partners on their own phones and put a speaker on so a three-way conversation could take place. Partners were able to physically attend for routine scans rather later in the timeframe, and come into the clinic if there was a back-to-back appointment with an obstetrician.
Written by Jane, Obstetrician