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Labouring alone: birth companions denied access outside of ‘active labour’ regardless of COVID-19 status

24 January 2022

The Australian College of Midwives (ACM) supports the World Health Organization (WHO) and the International Confederation of Midwives (ICM) recommendation to uphold the human rights of women to have their chosen support person present through pregnancy and birth.

ACM recognises that the COVID-19 pandemic creates unique challenges to pregnancy, birth and postnatal support for women. During these unprecedented times, many local health networks have introduced policies and protocols to limit transmission of the virus. However, these protocols have included removing a woman’s fundamental human right to have a companion of her choice present through her entire pregnancy,  labour and early postnatal period.

Although these changes have been introduced as a matter of public safety, they are not based on current evidence and are harmful to women, babies, their families and the midwives caring for them; all the individuals these protocols have been put in place to protect.

The safety of women and their babies is paramount. It is imperative that there be an appropriate balance between infection control and optimal maternity care, giving consideration to the longer term clinical and psychosocial consequences for the mother, her baby and family.

Companions are integral to women’s care and improve physical and emotional wellbeing as well as reducing clinical workloads for midwives. Real-world evidence demonstrates that some women are not accessing maternity services as they fear being isolated or separated from their partner. Additionally, as these protocols go against midwives’ closely guarded moral responsibility to provide woman centred care, there is a deep-held concern that midwives are at an increased risk of burnout,  leading to reduced working capacity and adversely impacting service provision further.

ACM advocates for:

  • Women to always have a chosen companion present with them at each encounter across their childbearing continuum.
  • Appropriate use of PPE and COVID screening on admission for women and their chosen companion.
  • Unrestricted access to newborns for companions who test negative for COVID-19 – especially in Special Care / Neonatal Intensive Care settings.
  • In the presence of COVID-19 infection, use of the National COVID-19 Clinical Evidence Living Guidelines in Caring for People with COVID-19. This includes supporting usual care for mode of birth, delayed umbilical cord clamping, skin-to-skin contact, breastfeeding support and continued rooming-in of mother and her newborn when they are well.

WHO’s recommendation that all pregnant women, including those with suspected, probable or confirmed COVID-19, have access to a companion of choice during labour and birth.

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