Dear Sir,
We read with interest Kasaven et al., (1) who eloquently describe some
of the implications to the practice of obstetrics and gynaecology. They
correctly identify the heightened anxiety that patient’s face when
attending hospital during pregnancy. During this time the reduction in
patient attendance can be multifactorial. However, we feel one area
which has been neglected is partner support. There is evidence that
having a partner present during a birth can reduce a woman’s anxiety and
additionally be beneficial to the partner (2). Father’s also can
experience significant anxiety in the peri-natal period (2) and maternal
stress particularly with relationship strain can be harmful to the baby.
Parental presence during CPR for a child is beneficial for parents as
they can make sense of the situation. It logically would also be
beneficial to partners with maternal emergency caesarean sections and of
course postnatally to bond with the baby (3). Current policy dictates
that fathers can only be present during the birth, however in a
multiparous woman or a woman requiring a crash caesarean section the
timeframe allowing for partner’s attendance is not reasonable or
feasible. COVID-19 is clearly the reason for this policy, however,
examining the risk of a couple, who have both been screened as negative
on a COVID-19 test and live in the same household. If the male member of
the couple has COVID-19 the female is likely to have a high viral load
from the partner due to kissing or sexual intercourse (4), a common
practice in an attempt to induce labour. The early knowledge of
infection can allow for appropriate infection control measures to be put
in place. The rate of a false negative is 4-30% (4) but this is still a
risk with the mother. The risk to staff with correct personal protective
equipment and training is minimal (4). Additionally, women who do not
have continuous support are more likely to have an instrumental/surgical
delivery, use more pain medication, prolonged labours which may result
in complications such as postpartem haemorrhage (5), which ultimately
places hospitals and clinicians at greater risk of litigation. With risk
of domestic violence and risk of increased mental health issues as
highlighted by Kasaven et al., are we doing more harm than good and is
this an unintended consequence of COVID-19 that could be prevented? The
implication to patient care is huge for what appears to be little
benefit. Have we forgotten that we should be delivering patient centred
care? Perhaps it is time for change.
Herron JBT (1), Herron RL (2)
1. University of Sunderland, Faculty of health science and wellbeing,
Chester Road, Sunderland SR1 3SD.
2. Northumbria University, School of Nursing, Midwifery and Health, 2
Sandyford Rd, Newcastle upon Tyne NE1 8QH.