The coronavirus pandemic has undoubtedly shed a light on how vulnerable our society is. Almost overnight, life as we knew it changed; schools were out, transport grinded to a halt and all but essential shops shut their doors to the general public in an attempt to try slow the spread of the virus and flatten the curve.
Healthcare is different though. For obvious reasons you can’t just stop providing healthcare. In fact, during an influenza pandemic it’s quite the opposite, the very nature of COVID-19 means that we need it more than ever.
Although many “non-urgent” operations have been postponed, to free up resources, this isn’t possible with many aspects of healthcare. Emergencies are the obvious example, but even these can be reduced – a side effect of social distancing means that people are in their houses a lot more with sports and public events being cancelled, resulting in less accidents. Figures from the Royal College of Emergency Medicine show that attendances in the fourth week of March were down 21.71% week-on-week, and 33.33% down on the peak for this winter, recorded towards the end of 2019. Some concern has however been raised that these reductions are not only a result of fewer accidents, but also by people not wanting to unnecessarily burden the NHS by avoiding hospital, in spite of injury.
You can’t postpone a due date
Pregnancy is unique as far as healthcare in concerned. It’s one of the few areas where the NHS provide essential care to healthy people who are not ill or injured. It’s also unarguably incapable of being postponed, leaving thousands of parents-to-be wondering “what next?” during the current pandemic.
Expectant parents should be forgiven for any confusion though, as it’s not just them who might be uncertain. At the end of March some hospital trusts banned birth partners during labour, only to quickly backtrack after the The Royal College of Obstetricians and Gynaecologists published guidelines saying that birth partners were not only ok, but emphasised the importance of them for the mother’s well-being. It’s apparent that that understaffed hospitals are having to think on their feet and react quickly to the ever-developing situation, to ensure the safety of their patients, their staff and the general public.
Another concern raised by safety campaigners has been the removal of birth centres and the right to a home birth. This was after a Royal College of Midwives survey found that 22% of heads, or directors of midwifery, reporting that local mid-wife led services had been closed and 32% indicating that homebirths in their area would be stopped.
The official reasoning for these changes has been attributed to shortages of midwives and ambulances (which are required if a hospital transfer is necessitated). The organisation, Birth Rights, has said that they believe “this action may be unlawful and could lead Trusts to be responsible for significant risk to life if women choose to birth without medical assistance”.
Birth Rights have also pushed for, amongst other things, the guarantee that a full spectrum of evidence-backed pain relief options will remain available, including epidurals and birthing pools; and that access to birthing pools is not simply arbitrarily removed, and where this has already been done, the decision is justified or reversed.
How will coronavirus affect your birth?
The best advice we can give is to contact whoever is responsible for your antenatal care. Different trusts are taking different approaches, so it’ll depend on where you are in the country. There are however some national guidelines, that might answer some of your questions:
- The Royal College of Obstetricians and Gynaecologists guidance
- The Royal College of Midwives have guidance for pregnant women
Should the current state of affairs come as a shock, or was it a ticking timebomb?
There’s no doubt that a global pandemic is going to strain even the most prepared health service in the world, but a poorly resourced service is inevitably going to struggle more than others. The most recent analysis done by The Royal College of Midwives, in August 2019, found that England was 2,500 full-time equivalent midwives short.
As you can imagine, these shortfalls have only been compounded by the pandemic. A survey conducted by The Royal College of Midwives in March found that even before the pandemic one in ten midwifery posts were vacant and that this figure has now doubled.
Sadly, the problems aren’t limited to the maternity sector, with providers across NHS England reporting staff shortages of over 100,000 full-time equivalent staff, including 44,000 nurses and 10,000 doctors. It was only January when the Guardian reported that the NHS was “teetering on the brink”.
Despite the Prime Minister making pledges to prioritise the NHS as part of his election-winning campaign, and reiterating these after election, a number of criticisms have already been made about the legitimacy of his pledges.
On the whole, it would be fair to say that the NHS played a cameo in an election dominated by Brexit, with the United Kingdom’s status in the European Union dominating the headlines and dividing the nation, but with this all but behind us, it’s crucial that in this time of crisis, the nation reunite so that we can emerge from this better than we went into it, notwithstanding the difficult losses many of us could face.
It will no doubt be easier to look back, in the months to come, with the benefit of hindsight and see exactly where the biggest holes in our system were. We are already seeing some solutions being put in place, with the Government extending the visas of foreign doctors, nurses and paramedics by 12 months. Although this is a good short term fix, surely the fairest and most simple solution would be to make this extension permanent. This will not only fill the outstanding vacancies after the pandemic, but also reward and thank these people who are risking their health to care for us in our time of need.
If anything positive is to come of this pandemic, let’s hope it is a new, even deeper appreciation of our National Health Service, so that they are appropriately staffed and resourced to allow them to do what they signed up for.