Some maternity services are at risk from the rising number of pregnant women without vaccination and with Covid in labour wards, NHS doctors warn.
Senior midwives, obstetricians and others have disclosed that certain units are currently in a “crisis situation”, where staff already stretched are having to leave healthy women in mid-labour to care for the complicated needs of Covid positive expectant mothers.
It has been difficult to separate Covid-positive and non-infected women from birth units. In some instances, midwives were forced to isolate themselves after contracting the disease.
The result was an increase in staff shortages and record number of midwives leaving this profession. This led to closures at birth units. NHS data shows that 300 midwives resigned in May alone – the largest monthly figure since 2009.
These concerns follow Dr Edward Morris (President of the Royal College of Gynaecologists and Obstetricians), who warned in May that patients’ safety at maternity units may be at risk if Covid cases continue to rise.
Experts warn that pregnant women continue to resist getting vaccinated in spite of the best efforts by Ministers and Health Chiefs.
Marian Knight, University of Oxford Professor of Maternal and Child Health, says that we are seeing the same pattern as during the pandemic. She has been following Covid pregnancies closely since last year, in a national surveillance program.
“And a large proportion of those women may become very, very sick.”
Senior midwives, obstetricians and other medical professionals have disclosed that certain units are in a “crisis situation”, where staff already stretched are having to leave healthy women in mid-labour to care for the complicated needs of Covid positive expectant mothers.
According to the best estimates, 85 percent of British pregnant women are still unvaccinated. Many fear that the jab could cause harm to their child and they’re hesitant about getting the shot.
Research shows that Covid deaths in pregnancies are thirteen times higher than those who are not.
Prof Knight’s study shows that 98% percent of Covid-infected women who are pregnant have never had the jab.
Some women end up in ICU. In September, about a third (or more) of 16-to 49-year-old females admitted to ICU by Covid had been or were recently pregnant.
The majority of patients will receive care on both maternity and medical wards.
Experts warn that mothers infected in Covid will require an emergency delivery sooner than expected. The reason is because of the possible decline in mother’s health which could make it less likely for them to have a child.
University of Oxford data show that Covid positive expectant mothers have up to three times the chance of having a preterm baby than their counterparts.
Data this month revealed that 694 babies born prematurely to Covid-positive moms were born between March 2020, and July 2019.
Of these, 604 babies had to be admitted to neonatal critical care – hospital wards reserved for the most unwell infants – where staff are also scarce.
“Maternity services in the UK are not equipped to handle the current situation,” says Dr Mary Ross Davies, midwife and director for professional midwifery at Royal College of Midwives.
“There have been years of a severe shortage in staff, made worse by the pandemic.
The ‘Midwives’ are often exposed to young people who aren’t fully vaccinated. Our work often involves visiting people’s homes, being unjabbed and living in close proximity to them.
“So, we have large numbers of midwives that catch Covid and then having to self-isolate.”
One of these challenges is staffing. Dr Ross-Davie says that there is an enormous pressure for services to provide safe treatment to all women.
“If there are a lot of Covid-positive women, it is time to review the entire system and make sure that patients can be isolated. This is why many midwife-led maternity units were forced to close.
Best estimates suggest that 85% of British mothers are not vaccinated. Some women in Britain remain hesitant to get the jab due to fears about harming their baby.
Chandrima Biwas, a Consultant Obstetrician in a London NHS Hospital, stated: “Last week, I was up all the night with a lady who was otherwise very healthy but had Covid.
‘She was 30 weeks pregnant – so had about two months to go – and deteriorated rapidly. She was taken to ICU, but we didn’t know if it was too soon to give birth to her baby. The baby was able to survive, although she needed urgent care.
“The mother remains ventilated and she is now being transferred to another hospital. She has further deteriorated and doesn’t have the access she requires to specialist care.
Evidence suggests the issue may be already compromising care for non-infected females.
Dr Biswas says that expectant moms with covid positive status in hospitals need to be closely monitored. He is an advisor for the Healthcare Safety Investigation Branch which examines safety issues related to maternity.
They will be required to have detailed heart monitoring done every couple of hours if they are going through labor. One midwife is required for every woman who is pregnant. However, if your Covid patients are being tested every hour you cannot be there with any other woman during labour.
“If there isn’t enough Midwives, then it’s possible that the patient without Covid won’t get adequate care.
The risk of spread was highlighted by midwives last week when Covid positive women were admitted to the same hospital as the non-infected.
“There will be situations in which patients are waiting to receive the Covid results while they wait in waiting rooms, or even on wards that are near women who have not been infected,” Dr Biswas says.
“Generally speaking, we move women into separate rooms once they know that the woman is positive.”
According to Dr Biswas, Covid-infected women are moved around depending on their stage of pregnancy.
“Last week, I saw a Covid positive woman. She wasn’t well enough to give birth so she had to stay on the medical ward.
“But she needed to go to the maternity unit for specialist care. Before she could be moved back. It was not something I liked.
Scientists published most compelling evidence in support of Covid’s most-feared pregnancy risk: The virus spreading from mother and baby.
A few Covid-infected babies have already been born. Although no one has fallen ill from the disease, scientists are still uncertain about how it was transmitted.
University College London scientists analysed tissue from foetus, including the kidneys. The researchers found that receptor cells were present in the gut, giving the virus access to the body.
These researchers found that unborn babies could potentially swallow Covid-infected amniotic water and get the virus.
Asya was 35 when she met Daniel for the first time ten days following his December birth. Before vaccinations were available to her age, she caught Covid and passed it on to Daniel.
Dr Victoria Male from Imperial College London is an expert on reproductive immunology and says that previous studies had looked at the possibility of the virus infecting the placenta.
But we are certain it does. The study found that unborn infants’ guts could be infected.
Julian Tang (clinical virologist, University of Leicester) adds, “The research further confirms that unborn children can be infected.”
“But, it’s relatively rare, and only affects around 2 to 6 per cent of pregnancies,” he said.
Reports last week indicated that one of these women was pregnant.
Asya, a 35-year-old South-East London woman, was diagnosed with Covid in December. She had to give birth at 27-and-a-half week, which is dangerously premature.
She said her Covid symptoms were “bad but manageable at home”, but she realized her baby was not moving as well as before and was admitted to the hospital.
It was unclear if she was suffering from an infection of the urinary tract, or Covid.
The newborn, whom she named Daniel, tested positive for Covid-19 and was transferred to a neonatal unit where he was treated for bleeds on his brain and his lung – related to the birth, rather than Covid – and stayed for eight weeks.
Asya recalls, “We were separated for ten consecutive days.”
“The first time that we met was when he was still in the incubator and I was wearing full PPE even though we had both Covid. It was terrible, though he is now fine.
“It’s sad to imagine what it would have been like if I had the chance to get vaccinated.”
“I’ve had the two vaccines and now I want to receive the booster. It is highly recommended that pregnant women receive it.
On Thursday, the government released safety data that proved the Covid-19 vaccine does not pose a risk to stillbirths, premature births or low baby weight.
The same announcement was made by health officials revealing that 84,000 pregnant mothers have been vaccinated.
Asya (35), from South-East London was diagnosed with Covid in December. She had to give birth at 27-and-a-half week because she was too young.
This is despite the efforts of jab boosters, such as pop-up clinics at antenatal clinics, which have been shown to reduce jab use.
Mixed messages concerning the safety and efficacy of the jab are responsible for the high levels of vaccine hesitancy in pregnant women.
The Joint Committee on Vaccination and Immunisation advised pregnant women at highest risk of Covid to get the vaccination. The decision was based on the fact pregnant women had not been included in the vaccine safety trials – as is standard with any vaccine.
The jab proved safe and effective in April according to data from 130,000 US-born women.
The health chiefs changed their strategy and now recommend that mothers-to be get the jab along with everyone in the age group.
However, UK’s maternity bodies, the Royal College of Midwives and Royal College of Obstetricians and Gynaecologists were slow in updating their information.
The RCOG only started’strongly advising expectant mothers’ to have the jab in July. Thousands of midwives gave incorrect advice.
MoS discovered that more than three quarters of all maternity workers failed to recommend the vaccination for patients in July.
Some mothers-to-be were told by midwives that the vaccine could be ‘another thalidomide’ – the morning sickness drug that caused disability in the 1960s. Other women were informed that the vaccine could lead to miscarriage.
Elsie Gayle, a midwife who worked in the NHS for 30 years before recently starting her own private practice, said: ‘Midwives have always been taught to exercise the utmost caution when it comes to giving any treatment or medicine to pregnant women – including vaccines – because of the unknown risks to the baby.
“Our guidance advises caution when using any drug, including paracetamol. The emphasis is on not forcing pregnant women to take any medicine or have an intervention.
“Now, all of a sudden, the Government tells us to adopt the opposite approach.”
Staffing issues are being exacerbated by the pressure Covid infection is putting on Britain’s Maternity Units. Our NHS staff told us that their workload had become overwhelming even before Covid.
Dr Biswas says that midwives are becoming more sick from stress and Covid.
“And that is because we have gaps. We have to defer inductions if we do not have enough staff.
“So they may have to wait for days on end or be moved to another hospital where there is enough staff.
“Some of the hospitals that we planned to transfer to have closed down because of staffing difficulties, which is another issue.”
The MoS was also informed by other maternity workers of the alarming effects of lack of space. This included women who give birth in corridors.
Kay Knight (a doula) supports NHS patients and says, “I have seen letters from trusts saying, ‘Our maternity doors closed, we don’t have enough beds.
“I recently assisted a mother through homebirth, and her baby was placed at an unsafe angle. The hospital advised her to bring her in immediately.
“But, when we arrived there was no staff. The midwife was not available and there were no pain relievers. We spent more than 2 hours sitting in the corner room.
Knight has joined Gayle and thousands other midwives in calling for the Government’s urgent overhaul of Britain’s maternity units. They also want to recruit thousands more staff, and give raises to the existing staff.
Dr Ross-Davie says that a simple action could help ease the crisis: reintroduction bursaries to student midwives.
The incentive, which granted trainees between £1,000 and £4,000, were replaced in 2017 with a student loan, a move that was said to result in a 23 per cent drop in applications.
Ross-Davie says, “It signifies that we now have a new type of worker,”
“In the past we had many mature students who were able to deal with difficult medical circumstances. However, it is now impossible for older adults to afford three years of education.
The Health and Social Care Committee was prompted to review the country’s maternity services after a spate of maternal deaths in the last five years.
The July publication recommended that urgent action be taken to resolve a variety of problems including the shortage in staffing.
Dr Ross Davis says that staff can run out of steam if a service is chronically understaffed, or even underfunded, for long enough.
“We do not have enough midwives to provide quality maternity services.”