Non-emergency caesarean sections have been delayed because of the ongoing NHS strike, with one woman saying she feels she has lost “all control” over the birth of her child as a result.
Both junior doctors and consultants are taking joint action for the first time from today, with Christmas Day levels of cover expected until Wednesday.
It follows two days of strike action at the end of September and will coincide with Rishi Sunak’s first Conservative Party conference as leader and prime minister.
One pregnant woman, who asked to remain anonymous, has a pre-existing condition. “I was told I should not go over my due date,” she added.
After initially being advised by her medical team to be induced on her due date, after discussions with her midwife she opted instead to have a caesarean section at 39 weeks.
“I felt huge relief at this decision,” she said, speaking via the charity Birthrights.
But she has since been told a C-section is no longer possible because of the strikes.
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“The earliest replacement date is more than a week after my due date,” the mother-to-be added.
“I feel like I have now lost all control of the birth as I think will be pushed for an induction before the C-section booking if I have not gone into labour.”
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Matthew Hopkins, chief executive at Mid and South Essex NHS Foundation Trust, said: “We raised this issue as we take delays to planned caesarean births very seriously.
“Our first concern is the safety of women and birthing people and their babies, and all options are considered by our clinical teams before postponing planned caesarean births.”
Twins Trust, a body for parents expecting multiple births, said in a statement: “Timing of delivery is directly linked to safety of the baby for multiple births.
“It’s about what’s best for mother and baby. Any deviation from the planned birth could compromise its safety.”
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Risk of trauma for pregnant patients
Emergency caesarean sections will continue to be available, with hospitals trying to rearrange planned surgeries.
Birthrights co-CEOs Shanthi Gunesekera and Janaki Mahadevan said maternity care needs to be viewed as a priority.
“Under Article 8 of the European Convention on Human Rights you have the right to make decisions about the circumstances of your birth, including the manner in which you give birth,” they said in a statement.
“Substantially delaying or cancelling planned C-sections without adequate communication and without due regard to individual circumstances may result in a breach of human rights law. Especially if a person is forced to give birth vaginally.
“Such situations can have very serious consequences, including for those with pre-existing conditions or previous trauma.”
They also said it is “vital” the government provides meaningful investment in maternity services.
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In June, the government rejected a recommendation to increase the annual budget for maternity services that was made in the wake of one of the worst baby death scandals in NHS history.
A Department of Health and Social Care spokesperson said: “We are committed to making the NHS the safest place in the world to give birth for all women.
“During industrial action, the NHS will prioritise resources to protect emergency care and neonatal and maternity services.”
They said those striking have received a “fair and final pay rise – as recommended by the independent pay review body”:
“The Health and Social Care Secretary is clear his door is open to discuss non-pay issues if the BMA call an end to this damaging disruption,” the spokesperson added.
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A ‘worrying escalation’
Saffron Cordery, deputy chief executive at NHS Providers said the strike was a “worrying escalation” in the NHS’s “long-running dispute with the government”.
“It will mean delay, disappointment and disruption for tens of thousands of patients, including all those who can’t have X-rays, scans or ultrasounds when radiographers also walk out on Tuesday,” she said.
“Nine in 10 patients see a radiographer for acute diagnosis or treatment including in A&E, cancer and maternity services.
“The repercussions of this deadlock on patient care, financial costs, and staff morale should be a resounding wake-up call for both the government and the unions.
“Despite trusts’ hard work to minimise the impact on patients, over a million appointments have been pushed back due to the strikes – hampering efforts to cut record-high waiting lists.”
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Doctors say government is to blame
In August, striking consultants apologised to patients who suffered delayed or cancelled appointments but said the government was to blame.
Professor Phil Banfield, BMA chair of council, said the NHS is used to planning for four day weekends, for example, and that senior medics meet management to ensure the safety of all patients even while strike are going on.
He added: “Obstetricians are used to reprioritising how and when women are scheduled for induction of labour or caesarean section, based on changing circumstances or workloads that means that some women may find their planned interventions brought forward or pushed back a day or two on a daily basis, due to challenges of staffing or capacity.
“Consultant-led maternity services maintain an ability to undertake a caesarean section of induction of labour 24/7, 365 days a year.”
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The women behind the strikes
Health Secretary Steve Barclay has urged doctors to end their strike action.
“I’m deeply disappointed and concerned by further co-ordinated strike action which poses continued challenges for the NHS and disruption for patients, and means more will have vital treatment and care delayed,” he said, with over a million appointments rescheduled already.
“In addition, during previous strike action, the BMA has repeatedly refused to permit some junior doctors to deliver essential care where local clinical leaders considered it necessary. This is further putting patients at needless risk.”
NHS national medical director, Professor Sir Stephen Powis, said: “NHS services have had very little time to recover from the previous action, and to now face an unprecedented three consecutive days of ‘Christmas Day’ cover this week which will prove extremely challenging, with almost all routine care brought to a near standstill.
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“Staff are working incredibly hard to prioritise emergency care, and we’re very grateful to the public for using the NHS wisely during this period of disruption by using 999 in life-threatening situations and 111 online and community services like pharmacies and GPs for everything else.”