Calls to make maternity wards more family-friendly

Parents, medical practitioners and support agencies said that despite a Scottish Government Best Start policy dated February 2017 aiming to “ensure families can stay together”, a postcode lottery exists with some partners forced to leave after visitor hours.

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The call is being supported by the Fathers Network Scotland, who in partnership with the Fatherhood Institute surveyed 1800 fathers across the UK – including almost 600 in Scotland – and found the NHS is failing to provide the “family-centred” services.

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The survey highlighted a mixed picture, with some hospitals including Ninewells in Dundee, Edinburgh Royal Infirmary and Crosshouse Hospital in Kilmarnock, picked out for praise. But some fathers said they felt “ignored”, “invisible” and were not allowed to stay overnight. One slept in his car in the hospital car park for four nights.

Numerous parents contacted by the Sunday National last week said after the births of their babies – most within the past year – partners were not routinely allowed to stay. Mothers said they often returned to wards after birth, exhausted and feeling unfit to cope with their newborn alone.

Though some fathers had been able to stay overnight after special pleading, all believed that no-one should face the stress of separation if unwanted.

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The Royal College of Midwives and the National Childbirth Trust also backed the call, claiming there was clear evidence that supporting the whole family from the outset led to more positive outcomes.

Samantha Pringle, director of the Fathers Network Scotland, said that while she applauded the progress made there was still much to do.

“The policy is very clear,” she said. “The aspiration is there but in terms of what’s happening on the ground it depends not only on where you are but your personal relationships with staff and the lengths you are prepared to go to. A lot of maternity hospitals are still working out of a 1950s building and set-up.”

Abbi Wood, head of campaigns for the National Childbirth Trust, said that many women had raised difficult experiences in maternity wards with the organisation. “When you have a baby your world is turned upside down,” she added. “It can be an incredibly vulnerable time. Women tell us that they feel less anxious when their partner is there.

“Midwives work incredibly hard but we know there are staffing problems. They are absolutely doing their best but they have a lot to deal with.”

However she stressed that the implementation of the policy needed to be carefully handled, taking into account the views of women, including those who had survived sexual abuse, who might feel anxious about having men they don’t know on the ward. She and others claimed involving fathers at the earliest stage, with health professionals flagging any issues before birth, was part of the solution.

According to the the Royal College of Midwives, the way maternity care has commonly been organised in the UK can generate feelings of exclusion, fear and uncertainty.

Dr Mary Ross-Davie, RCM director for Scotland, claimed many health boards in Scotland are now working on the practicalities of this – buying fold-out chair beds so that partners can be accommodated – but said the limitations of older buildings could make this difficult.

A Scottish Government spokeswoman claimed five health boards including Forth Valley and Highland are early adopters of family-friendly policies. She added: “As we work with Boards to implement the recommendations of Best Start, we will expect them to be flexible about the presence of partners, to help ensure families can stay together and mothers can get the family support they need in caring for their babies.”

It's hard to describe the overwhelming joy of a new born baby – the heart-stopping waves of love, the soft weight in your arms, the small, almost animal-like snuffling noises as they sleep. Then there’s that warm, milky yet slightly sharp, newborn smell. “A breath in and everything seems right in the world,” says mother Mhairi-Louise Flanagan.

Yet, for many women and their partners, not everything is as it should be straight after birth. As she nurses her three-week-old daughter, Flanagan remembers the night after her son’s birth at Glasgow’s Queen Elizabeth hospital in June 2015 – she’d had a 30-hour labour and been awake for three days – and the moment when her husband had to leave.

“When I was taken back to the ward at 2am I was still on a catheter,” she says. My main thought was what if the baby cries and I can’t stand up? The midwives said I should just ring the bell but everyone was run off their feet.” Too scared to sleep she waited until her husband returned in the morning before “passing out” with exhaustion.

This time she opted to give birth in Paisley’s less busy Royal Alexandra Hospital (RAH). The birth was more straight-forward and though her heart sank as her husband left, she felt more able to cope. Not everyone on her ward did. “One woman had feeding issues and was really upset,” she says. “I heard her quietly breaking her heart on the phone.”

Yet when Flanagan’s baby later got an infection in her umbilical cord and ended up in the children’s hospital, there was no policy of asking fathers to leave.

Alastair McIver, whose daughter Isabelle is now 10 months old, was allowed to stay at the Princess Royal, also in Glasgow, on account of his wife Nuala Watt’s disability. Watt, who has cerebral palsy and a visual impairment, had an elective section and permission was granted by the consultant for McIver to stay.

Yet when they arrived back on the ward, none of the staff seemed aware of the arrangement – though Isabelle was born just before 10am it was after midnight before a makeshift bed was found for him.

Meanwhile, McIver found that he was ignored. “There was one occasion on which a midwife was instructing Nuala on how to breastfeed,” he says. “She had still not recovered from the drugs. Because of Nuala’s visual issues, imagining space is difficult for her, so the instructions wouldn’t have made much sense to her at the best of times. I tried to explain this, and was blanked. It was weird being just ignored like that.” He thinks change is needed so that men are considered equal partners in the childbirth process.

James Hogg, from Midlothian, whose wife Heather had a baby in March at Edinburgh’s Royal Infirmary, agrees. Although they were able to stay together they feel it should be the norm. “My wife had to have an episiotomy,” he says. “We went back to the ward but she couldn’t move much. Just as dads had to leave our baby was sick – I was able to pick her up and we pushed the call button so we could get some fresh sheets.”

It was just short of five minutes before a helpful midwife was able to respond – not long in a busy unit – but it felt like eternity for anxious new parents, contemplating separation. They pleaded with staff for James to be allowed to stay for the night.

Staff were sympathetic and in the end were able to find a private room for the family. “The support of the midwives was second to none, but having the father there makes a huge difference,” adds Hogg.

Yoanna O’Brien, whose daughter is now almost eight weeks old, is still upset that her husband was only allowed during visiting hours. “My baby would not stop crying unless being held,” she says. The first night she stayed awake all night. The second, midwives showed her how to feed lying down but she was so exhausted she feared smothering her. “If my husband had been allowed to stay, I would have felt much safer and I would have been able to enjoy getting to know my new baby,” she says.

Many wish staff had flagged up that overnight stays were possible. Ailidh and Rhuaraidh Campbell, from Taynuilt near Oban, had to transfer to the RAH in Paisley because the local midwife-led unit did not support twin births. “Rhuaraidh didn’t stay with me the two nights I was in hospital, which was really upsetting and difficult,” Campbell says. “None of the staff suggested it as an option and we just assumed it was out of the question.” They had to return two nights after discharge because one of the twins had jaundice and this time her partner was allowed to sleep on a chair next to her bed. The inconsistency was striking.

For Pringle, getting that consistency in place is key. “We need to support the couple’s relationship at this time,” she says, claiming that its in the best interests of the child. “They need to be able to support each other at what can be a moment of crisis and of great joy.”

A spokeswoman for NHS Greater Glasgow and Clyde said: “There are already occasions where partners stay following the birth of their baby in the postnatal period. This is agreed on an individual basis in conjunction with the woman and taking into account their individual needs. As part of the implementation of the Best Start strategy we are looking at how we can take this recommendation forward across Greater Glasgow and Clyde.”

Professor Alex McMahon, Director of Nursing, NHS Lothian, said: “We have provision for fathers/partners to stay overnight in the Simpson Centre for Reproductive Health at the Royal Infirmary of Edinburgh, and in the Lothian Birth Centre, and have recently expanded this provision. We continually seek ways to improve our services and to enhance the experience of women, their partners and extended families.”