Maternity and neonatal
Key principles for visiting as set out earlier in this guidance are applicable within maternity and neonatal settings. It is important to highlight that birth partners supporting women during hospital visits and parents/primary care-givers in neonatal care, provide essential support and should not be considered “visitors”. All Health Boards should be taking material steps to return to full person-centred visiting in maternity care settings.
Whilst this guidance is primarily for maternity and neonatal settings, it also applies to other settings a pregnant woman may attend for a pregnancy related matter such as the Accident and Emergency Department or within the community such as a GP practice.
Principles for managing visiting in maternity and neonatal units in the event of an outbreak
As noted in earlier sections, it may be necessary at times to restrict visiting in specific areas of the hospital for short periods. The table below sets out minimum principles for essential visits when such temporary restrictions are in place.
Care setting and principles for visiting in the event of an outbreak
- one supportive person to accompany to the booking scan, 20-week scan and any emergency appointments subject to local risk assessments
- one additional family member (adult or adult facilitating child visit) may attend subject to local risk assessments
Labour and birth
- one birth partner throughout induction, labour and birth (except during a general anaesthetic)
- second birth partner, if requested, subject to local risk assessments
- one birth partner (as essential) and subject to risk assessments
- one additional family member (adult or adult facilitating child visit) subject to patient need and local risk assessments
- both parents/primary care givers must be supported to have maximum access to their baby together, subject to local risk assessments
- parents should continue to have access to local facilities such as parent accommodation, parent rooms and kitchens
- siblings permitted to visit subject to patient need and local risk assessment
- any additional family member alongside either parent subject to patient and family need and local risk assessment
These principles should be considered minimum standards. When restrictions are in place Health Boards should consider whether additional family members can be enabled to visit throughout care, subject to local context, risk assessment and individual patient needs. Health Boards should consider exceptions on a case by case basis, for example on compassionate grounds to allow attendance in end of life situations.
Whilst the advice above is intended as general guidance there may be times when something slightly different is required to meet the needs of the mother. Staff should be compassionate and flexible in their application of this guidance.
Women suspected of having COVID-19 during childbirth
Women suspected of having COVID-19 or flu can have a birth partner as an essential visitor during childbirth. A birth partner who also has symptoms may attend and should be provided with the appropriate PPE equivalent to that worn by staff, during childbirth.
Birthing partners with COVID-19 symptoms
Birthing partners with symptoms of COVID-19 or flu can support a woman in labour subject to risk assessment. They will be asked to wear the appropriate PPE equivalent to the PPE worn by staff and as detailed in the National Infection Prevention and Control Manual. Particular attention should be paid to their movements through the hospital for example using shared toilets and canteens, so arrangements would need to be made for access to these and any access via public corridors.
Children attending appointments
In some cases, the family member providing support may need to be accompanied, for example a child visiting a parent or sibling, or a frail elderly person who cannot attend the hospital independently. The presence of the additional person should be facilitated and should not prevent a visit taking place. They should not visit if they are feeling unwell.
Women who have suffered a previous loss
Woman who have suffered a previous loss can have one supportive person to accompany her to all appointments. Every effort should be made to ensure that women who have previously suffered a loss can be accompanied at all appointments and scans subject to local risk assessments.
Changing a designated visitor
We expect Health Boards to be moving away from requiring designated visitors. In circumstances where this may still be in place, a designated visitor can be changed to meet the needs of the patient or family if required. This can include different visitors at different times of the day subject to local risk assessments.
Neonatal unit visits from siblings
Every effort should be made to accommodate visits by siblings particularly where a baby is expected to remain in neonatal care long-term.
Removing face masks
Parents should be supported with opportunities to remove face masks to encourage bonding and support skin-to-skin and kangaroo care with their baby.
Restricting visits due to staff shortages or for reasons other than an outbreak of a communicable infection
Restricting visits e.g. due to staff shortages would not be a valid reason. Having support from family is a fundamental human right. Restricting visiting has been shown to have a negative impact on patient safety and on care experience, resulting in higher levels of complaints and poor relations between clinical teams and families.
If you have feedback on this guidance please email: HQIBMT@gov.scot
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