Hiding the Evidence – Fear of Malpractice suits should not prevent partners video calling into scans.

By Emma Ashworth and Ruth Weston

Image - see no evil, hear no evil, speak no evil

We firstly want to say that we welcome Leeds Teaching Hospital Trust (LTHT)’s allowing of partners to most antenatal scans.  This has eased the anxiety and suffering of many women and their families.

However, we continue to be deeply concerned about their most recent announcement about recording or videoing in scans. This issue is relevant to LTHT as partners cannot attend all scans, partners isolating cannot attend scans, and of course restrictions may return in the coming weeks and months.  It is also relevant to other trusts who still restrict access to the scanning room.

LTHT has now stated that they have decided that women and people will still not be able to call their partner, or record scans for the following reasons:

  • They accept that patients are legally able to record their consultation with a doctor or other healthcare provider, but that scans are “diagnostic tests” and are therefore treated differently.

This is simply incorrect. There is NO legislation in place that says that women can record their consultations with doctors. The law works the opposite way around. There is legislation which limits where recording can happen, and in all other situations it is legally allowed. This is the same for “diagnostic tests” as any other consultation. It is completely disingenuous for LTHT to attempt to use semantics, twisting words, to attempt to remove a woman’s legal rights, which the Trust does not have the power to do.

  • That having someone record or call during a scan will distract the sonographer.

There is absolutely no evidence that a recording or call during a scan would distract the sonographer MORE than having another person in the room. The fact that the Trust has been unable to demonstrate how this is the case on the numerous occasions that we have asked proves this point. All staff have had to come to terms professionally with the new normal – this is the least physically risky professional accommodation they have to make!

  • Staff safety

This reason is deeply worrying. The Trust have previously advised us that they do not want to have scans recorded because a sonographer, in another Trust, had a recording used against them in a malpractice suit. This was most unfortunate for that Sonographer, but should that prevent good practice and compassion elsewhere?

More importantly, if this is really the case, then the trust is admitting the purpose of its policy is to control and suppress any evidence of malpractice from being scrutinised by the courts, if a poor outcome occurred due to sonographer error. In the era of so many obstetric units being under the spotlight following the unnecessary deaths of mothers and babies, this is shocking. How can the LTHT possibly justify attempting to hide evidence of wrong doing?  And why is the Trust prepared to sacrifice the mental health of parents and their right to family life, in order to protect its staff if they are negligent?

And so:

  • We call upon Leeds Teaching Hospital Trust, and every other UK hospital and trust, to immediately revoke their unsupportable ban on the use of recording or telephoning devices during any scan, appointment or consultation. And recognise the rights of people to record or video call during all of their consultations, diagnostic or otherwise.
  • We urge pregnant women and people who wish to call during a scan, or record a scan, to assert their legal right to do so, and politely remind the sonographer that they have no right to stop them from doing so – and that refusing to undertake their scan would be a breach of their duty of care.
  • We ask sonographers to raise their voices in support of the women and people in their care, to recognise that they are skilled, autonomous professionals who do not need to fear accountability. We ask them to refuse to illegally interrupt parents’ right to a family life and pregnant woman’s right to support during pregnancy and birth. We ask that they refuse to allow the Trust’s rules to interfere with their duty of care as a professional and to consider this to be a breach of their employment rights.

Please share this message widely. We are all in this together and while women and people are supportive and understanding of restrictions which support the health and wellbeing of all, they will not and should not have to tolerate restrictions which are simply unnecessary, and based on fear of accountability. A simple phone call is not too much to ask when we are all giving so much.

Further reading:

Alone with loss – a blog by Ruth Weston on the impact of hearing bad news alone.

For whom this bell tolls – a blog by Ruth Weston on the impact of keeping partners from scans.

 

Alone with loss – the devastation of attending scans alone

Broken heart image

Ruth Weston, co-owner of Aquabirths, speaks powerfully of her concerns about partners being banned from scans and consultations. She was forced by hospital policy to go into her scan alone when she had a miscarriage 27 years ago.

 

This story posted on instagram cuts to the heart of the matter:

“Today I went in for my 10 week scan, alone. Due to COVID, spouses aren’t allowed at your appointment which meant when the tech said ‘I’m sorry, there is no heartbeat’ I had to process that information, alone.

I had to get off the chair and collect my things in tears while nurses asked me questions I couldn’t even comprehend.

I had to hold my composure and walk to another room alone to wait for the doctor to tell me what I already knew.

I had to sit, alone, in a room by myself until they finally allowed my significant other to come inside.

How are we allowed to go shopping, drink at bars, and eat at restaurants, but I can’t have support with me when someone tells me my baby is dead? That moment was absolutely soul shattering and I had to do it alone, with no one to turn to because the clinic says “spouses cannot attend ultrasounds”.

Today is a terrible day and it’s one I’ll never forget. Sadly, my significant other wasn’t there to experience it so he will never fully understand what it felt like to look at our baby in real time and see no heartbeat. I saw it, alone, and it was heartbreaking.

If I can shop, dine, and drink, my significant other should be able to attend the appointment to see his child.

✌️❤️ Rest in peace little one.”

Birthrights statement regarding care during the pandemic says:

•One of the most important aspects of respectful care is a woman’s right to companionship of her choice during labour. It is a profound restriction on women’s rights to isolate them from essential support during a life-changing experience. 
•Partners also have a right to family life and to be present at the birth of their child. Birth is a critical moment for the formation of a family with lifelong psychological and emotional impact. Prohibiting birth partners would be a serious infringement of their right to family life. (1)

Women and their families understand the need for restrictions to reduce the spread of Covid 19 but surely there is the creativity and kindness within our maternity services to prevent this kind of life changing suffering for women and their families?  Surely the ‘care’ in Maternity Care includes this?

Along with midwives, doulas, radiographers and parents we have been calling for a more flexible and compassionate approach to the attendance of partners/supporters at scans and consultations  – especially those where bad news is involved. And especially where women have disabilities. Yes, we have intervened in a case where a deaf/blind woman was being denied her chosen supporter at her scan.

We are also calling for the wholesale acceptance of video calling at scans and appointments as this poses no health risk to staff.  We don’t think the fear of litigation is an adequate reason for allowing the suffering expressed above, the denial of women their right for support, and the denial of the other parent their right to family life.

We also note that recording of all medical appointments with or without permission is a legal right that hospitals staff may not refuse. Women also have the right to have their partner or support person on the phone, video or call. Health care staff who refuse to continue with the appointment if the woman is recording it or is on the phone would be breaching their duty of care, and may be liable if a poor outcome occurs due to a delay in the care offered.

We hope this view is shared by all readers and would urge you to do what you can to ensure creativity, flexibility and compassion are the marks of the maternity care delivered in your area.

With love,
Ruth

Resources:
(1) https://www.birthrights.org.uk/news/press/

https://www.birthrights.org.uk/campaigns-research/coronavirus/