Mothers and medical staff clash over use of facemasks during childbirth

Pregnant women have raised concerns about a policy introduced at Mater Dei Hospital which demands they wear masks during childbirth, even if they tested negative for COVID-19.

Over 1,200 persons have signed a petition calling for rapid testing to be made available for women who go into spontaneous labour, as well as for women who test negative not to have to wear masks.   

Petition creator Davinia (surname redacted) said that women who go into spontaneous labour will be swabbed upon arrival at Mater Dei. “Pending results, they would have to wear a mask all throughout labour,” she said. “If test results are still not out when the baby is born, the birthing partner is sent home and is only allowed back once the results are out.”

But Davinia said that under the new regulations, even a woman who tested negative for coronavirus, was still expected to wear a mask.

She argued that if rapid testing was made available, it would help families experience a better birth. “Also there would be no plausible reason to remain with the mask on throughout. Negative is negative.”

However, obstetrician Mark Sant told MaltaToday that women were being asked to wear masks – even if they tested negative – because a false negative (where a person tests negative, even though they have the virus) could occur. Because of this, safeguarding the safety of medical staff was of utmost importance, he said.

“If medical staff, especially specialised professionals such as midwives end up in quarantine, or worse infected, it will affect the number of staff on the ward,” Sant said. “It is for that reason we are asking women to wear a mask during childbirth.”

Sant highlighted that this was far from the optimal situation, however staff could not afford to take the risk.

Carmel Pace, chief midwifery manager at Mater Dei Hospital, said that the use of masks was not just to protect staff, but also to protect the mother, partner and baby.

“The mask will minimise the risk of transmitting the virus from one person to another and to the baby,” she said. “That is why it is mandatory.”

Pace said this wasn’t a decision that was taken lightly and that the infection control guidelines were agreed upon during multi-disciplinary meetings.

When confronted with statements issued by the UK’s Royal College of Midwives – which said women should not have to wear masks during childbirth because there was a potential for their clinical care to be compromised – Sant insisted that wearing a mask was not a health risk.

“It might be an inconvenience and ruin the experience, however we need to understand that this is not a situation any of us want,” he said.

He said that there was no way for midwives to keep their distance, or not spend long periods in the birthing room, especially in the case of a long birth.

“There is simply no way around it,” he said, on women having to wear masks.

Pace also explained that women would still receive gas and oxygen. “If the mother is using the Entonox analgesia (gas and air), she can remove the mask and breathe deeply in from the Entonox mask. She then exhales into the same mask that has a filter. When the labour pain or uterine contraction is over, the mother will use the surgical mask again,” she said.

Pace reiterated that the protocols are put in place to protect both the couple, their baby and the staff.

However she advised expectant mothers not to go to the delivery suite early unless they experience vaginal bleeding or ruptures of their membranes, “in which case they should come immediately,” she said.

Sant agreed. “I can’t emphasise it enough: medical staff needs to be the priority. I’ve also had problems at my own practice, people threatening to go elsewhere because husbands are not allowed in the room,” he said. “But what would happen if I tested positive? There would be no one else in my practice who could see patients.”