UK government criticised for 'inconsistent' restrictions on pregnant women’s check-ups

Maternal health advocates demand answers after pubs and shops reopen but some women in England’s least-hit areas are still required to attend vital scans alone. 

Nandini Archer
22 July 2020, 12.30pm
A woman walks past St Thomas' Hospital in London, UK May 2020
Isabel Infantes/EMPICS Entertainment

The UK government has been criticised for failing to address “inconsistent” restrictions on pregnant women’s check-ups that have remained in place at some hospitals even after pubs and ‘non-essential’ businesses have been allowed to reopen.

Scotland and Northern Ireland have guaranteed women the right to have their partner or another companion with them during antenatal appointments, where serious illnesses may be detected, following outcry over COVID-19 restrictions that forbade this. 

But nine NHS Trusts across London told openDemocracy that they still require women to attend their antenatal appointments alone – including the University College Hospital where Boris Johnson’s partner gave birth in April.

Trusts serving North East Lincolnshire, Cornwall and Devon – areas of England with some of the lowest COVID-19 infection rates, below 160 per 100,000 people as of 22 June – also say on their websites that companions are banned from most antenatal appointments.

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Three of the London trusts said their policies were “in line with NHS guidance” and “follow national guidelines” – despite the NHS lifting its national suspension of hospital visitors on 5 June, leaving it to “local discretion by trusts and other NHS bodies”.

The other London trusts gave no explanation for their enduring restrictions, or said that they were in place to limit COVID-19 exposure risks. The Department of Health and Social Care refused to provide a comment for this article, and NHS England did not respond. 

It’s “deeply concerning”, London MP Stella Creasy told openDemocracy, that the government has developed clear policies “about whether you can go fishing, horseracing or to the pub… but not when you receive important health news at a scan”.

Creasy said she has been “deluged with heartbreaking stories” of women affected by these restrictions, and called on the UK government to “put in place clear guidelines to protect and support [women] to prevent further trauma.”

Birthrights, a UK charity focused on women’s rights in childbirth, has also sounded the alarm over enduring visitor restrictions and what it has called “an inconsistent, disproportionate and inhumane response by some NHS Trusts" throughout the pandemic.

It could make sense, said Maria Booker, Birthrights programme director, to restrict visitors in small hospitals that don’t have much space for social distancing, or in “COVID hotspots” – which are not in London, Cornwall, Devon or North East Lincolnshire.

Booker said she fears that some trusts have maintained visitor bans simply because “it just feels easier… to stick with the status quo without appreciating that this is a continued restriction on people's rights that may no longer be proportionate”. 

“You can go fishing, horseracing or to the pub… but not when you receive important health news at a scan”

MP Stella Creasy

In total, openDemocracy contacted eleven NHS Trusts across London and only two of them – Homerton University and Chelsea & Westminster – said that women could bring companions to antenatal appointments. 

Outside London, the West Suffolk Trust, where health secretary Matt Hancock is MP, also allows companions – though this area has seen a similar rate of coronavirus cases to Camden and Islington in London, where local trusts have maintained their bans.

NHS Trust Companions allowed at scans? Local authority Local COVID-19 rate per 100,000 (11am BST 22 July 2020)
Whittington Health No Islington 235.4
Royal Free No Camden 271.1
University College London No Camden 271.1
Barts No City of London 312.5
Homerton University Yes Hackney 312.5
North Middlesex University No Enfield 360.3
Chelsea and Westminster Yes Kensington & Chelsea 362.4
Imperial College No Kensington & Chelsea 362.4
Lewisham and Greenwich No Lewisham and Greenwich 399.6
King's College No Lambeth 421.9
Guy’s and St Thomas’ No Lambeth and Southwark 421.9

Elsewhere in England, an NHS trust serving North East Lincolnshire – which has the lowest rate of coronavirus infections in the country, at 132 per 100,000 people on 22 July – says on its website that it’s still forbidding companions at most antenatal appointments

Trusts serving Cornwall and Devon also say online that women need to attend all antenatal, postnatal and ultrasound scan appointments alone. The only exception at some of these hospitals is the 20 week (anomaly) scan where one partner is allowed to attend.

And despite decisions being up to individual trusts, Nottingham University Hospital also says on its website that restrictions on visitors are being implemented “nationally.”

The Welsh government has also issued new guidance allowing women one companion at antenatal appointments. It said: “we are aware that lack of opportunities for partners to attend appointments such as ultrasound scans have caused distress for families”.

The changes that women see on the ground in Wales could be limited, however. The government said: "There may be occasions in individual health boards that visiting, for specific reasons, may be limited further than outlined in this guidance.” 

‘Unnecessary’ restrictions

Under COVID-19 restrictions, pregnant women in dozens of countries have been treated in ways that defy World Health Organization guidance on safe and positive childbirths, a global openDemocracy investigation revealed last week. 

In some places including in Ukraine and Armenia, women still have to give birth ‘alone’ without their partners or other companions, even after other lockdown restrictions eased.

In the UK, the endurance of restrictions on women attending antenatal appointments at some hospitals in England has also prompted outcry on social media. 

“My husband still isn’t allowed to come to my next pregnancy scan but hey, he can now go to the pub and get a haircut that isn’t from me. Priorities!” tweeted London-based Sunday Times journalist Rosamund Urwin this month.

One junior doctor defended these restrictions, saying “people going to pubs have a choice. Women at scans do not,” and that fewer visitors at hospitals means social distancing is easier and it’s less likely staff will catch COVID-19 and pass it to other patients. 

Obstetrician-gynaecologist Benjamin Black disagreed. He tweeted: “The rules are counterproductive to patient centred care, wellbeing & engagement.”

Black, who works at the Whittington hospital in London, told openDemocracy that “there are ways to maintain respectful and woman-centred maternity care, while mitigating infection risks”.

The Whittington trust is one of the nine in London that told openDemocracy that companions are not allowed during antenatal appointments though its website says they can wait for women in the hospital waiting room.

Since the start of the pandemic pregnant women have also been subjected to other restrictions at maternity wards. Whittington said it is currently the only trust in north-central London “to be able to welcome a partner to be with you throughout labour and postnatally”. 

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