Researchers have called for the government to consider ‘urgently’ easing long-standing restrictions that exclude partners from attending some maternity services, over fears of worsening mental health and isolation.

A report commissioned by Public Health Scotland and the Scottish government has found women from more socially disadvantaged backgrounds were most likely to experience poor quality maternity care during the pandemic, especially when replacing in-person appointments. 

Virtual appointments should not be a default approach during or after pregnancy according to the researchers – especially for those under 20 years old, from black and other minority ethnic groups, on low-incomes or with mental health conditions, where at-home care should be prioritised.

Telephone consultations, according to 42% of all surveyed mothers, had stifled their ability to build a good, supportive relationship with their midwife or clinician.

Inconsistent covid-19 restrictions across maternity services and centres, and poor communication of rules by staff, was reported as causing stress and confusion among all groups of mothers.

These measures meant 9 in 10 surveyed women had to attend antenatal appointments alone, with the majority saying they felt uncomfortable or more anxious as a result.

Co-lead on this study, Dr Mairead Black from the University of Aberdeen said:

“The need to physically distance and replace in-person visits with phone or video calls has led some to feel they had a lesser relationship with their doctor or midwife, and staff too have reported a frustration and conflict between what they were allowed to do and what they would normally do to support a pregnant woman and her partner.” 

Currently, one birth partner can be designated as an essential visitor, to accompany on certain appointments, induction, labour and birth, as well as to the postnatal ward – however this depends on local restrictions, which can vary between health boards.

The University of Aberdeen and University of Dundee researchers advised the psychological and practical benefits of partner involvement at all stages of maternity care must be considered as a matter of urgency – and should be eased where restrictions remain in place.

The findings come weeks after a Scottish parliament committee concluded a short inquiry on perinatal mental health, which found many women have been left unsupported during the pandemic despite ‘sharply rising’ cases of post-traumatic stress disorder after childbirth.

Gillian Martin MSP, convenor of the Health, Social Care and Sport Committee, said preventative and community-based approaches to perinatal mental health must be prioritised:

“It is clear that only through accessible, joined up care across both the third sector and statutory services, women and families can get the care they need at this critical time.”

In a letter to the committee, Social Care Minister, Kevin Stewart, said that next year an extra £2.2m has been provisionally allocated toward funding psychological interventions for parents facing challenges.

Of Scotland’s 14 health boards, eight now offer perinatal psychological services, according to Mr Stewart, and 10 run specialised community mental health services. The rest are said to be on track to have perinatal services up and running by the end of the year.

Today’s report said pressures from restrictions and staffing had left many maternity staff unable to deliver the standard of care they wanted, and many women described midwife support as ‘impersonal’.

Nursing and midwifery vacancies were shown to be at their highest recorded level last year, with 5761 whole time equivalent posts unfilled across Scotland as of September.

Mr Stewart confirmed all boards have made ‘significant steps’ in recruiting staff suitable to deliver perinatal mental health services, in line with service recommendations published by the Perinatal Managed Clinical Network back in 2019.

 

Read more: "Fundamental gaps" in perinatal mental health care; Maternity services face “chronic” staffing gaps; 'Warning siren’ over new mums’ mental health;

 

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