Covid visiting restrictions may have contributed to deaths of new mothers, report finds


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ules which banned partners from attending hospital with pregnant women could have contributed to delays in people seeking care, a new report into a series of maternal deaths suggests.

Meanwhile, public messaging about the Covid-19 pandemic may have also “caused delays” in new mothers and those who lost babies seeking care before they died, the report adds.

The Healthcare Safety Investigation Branch (HSIB) report details how some women died alone in hospital because of restrictions from the pandemic.

Investigators examined 19 maternal deaths in England in the early point of the pandemic.

“National and local policies were implemented to restrict the attendance of partners and families at hospitals to reduce the transmission of Covid-19 to patients, families, and the public,” the report states.

“These policies meant that women were alone when attending hospital… Partners were permitted to be on labour wards only when the woman was in labour and were asked to return home hours after the baby was born.

“This contributed to decisions to delay attendance at hospital or to self-discharge.

“Several fathers told the investigations that they were unable to be present for the birth of their child.”

The report also points to the “Stay Home” messaging employed by the Government during lockdowns.

Health safety investigators said that “public messaging… caused delays in presentation”.

The report examined the deaths of 19 women between March and May last year.

Seven of these women died within 24 hours of the end of their pregnancy.

Eight (42 per cent) of the 19 women included in this report were from black, Asian or other minority ethnic backgrounds – compared to 13.9 per cent of the UK population.

Six women had a pregnancy loss before 24 weeks. Eleven babies were born alive; two were stillborn.

Fourteen women suddenly became unwell or collapsed at home. Of these, three died at home and 16 died in hospital.

Many were admitted to hospital several days before their deaths

“The visiting restrictions at the time meant the women were unable to be with family members during their admissions,” the authors wrote.

“Investigations noted other instances when families did not have the opportunity to visit the woman prior to her death.”

They highlighted the case where one woman was admitted alone because of the pandemic, adding: “This has caused the family great concern as they were unable to be with the woman when she collapsed and died.”

The report highlighted several themes which investigators found when examining the deaths, these include:

– Women being unable to access care through 111 when it was very busy at the start of the pandemic.

– Meanwhile other services were “less accessible” such as GP surgeries and maternity helplines.

– Women fearing catching Covid-19 at hospital; the authors wrote: “There were examples of women staying away from hospitals for as long as they could.”

– Some woman were told to stay at home or were sent home by healthcare staff without advice on when to return.

– An emergency Caesarean section was delayed due to the extra length of time for donning personal protective equipment (PPE).

– Two resuscitation attempts were delayed due to the additional time needed to apply PPE – including one where a patient was in their own home.

The report also described staff stress and increased workloads as a result of pressures on the health service during the pandemic.

It also suggested that some tests were avoided because they added the risk of virus transmission.

The leading cause of death among these women was blood clots.

The leading indirect cause of death was Covid-19.

“This HSIB national learning report has identified changes in access to healthcare during the pandemic, barriers to effective work processes and pressures for staff,” the authors conclude.

“It describes seven themes which may inform decision making to improve patient safety in the months ahead.”

HSIB has made some safety observations, including that more needs to be done to “understand the increased risk of maternal death for women

from black, Asian and minority ethnic backgrounds and those with higher socioeconomic deprivation”.

It has also called on the NHS to develop a “toolkit for local maternity teams to improve communications with women from black, Asian and minority ethnic backgrounds is implemented in all healthcare services for pregnant women”.

“We also recognise the changes made to reduce risk to pregnant women since our investigations took place.

“However, the impact of a maternal death on the family is profound and devastating. We heard their perspectives during this review and how the pandemic had made circumstances even more difficult when experiencing such a loss.”

An NHS spokesman said: “Despite the pandemic, NHS staff have safely delivered thousands of babies over the past year while doing everything possible to protect patients and staff against the risk of the virus, and our guidance for local services to implement has always been absolutely clear that mums should be accompanied by their partners for childbirth.”



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