The Nation's Health + [Paramedic]

Maternity Woes

"32 year old female, heavy bleed, contractions every 1-2 minutes"

What a way to start the shift! A materni-taxi! *grumble grumble* Being in labour is not a medical emergency. All other species successfully go through the process without the need for an ambulance and in general, us humans should be no different. Sometimes an expectant mother is caught completely unaware and is suddenly having an urge to push on her living room floor. Others have genuine high risk pregnancies and may need rapid transportation to a maternity unit. These are a rarity though. In my time in the ambulance service I have seen roughly 10,000 patients. Of those, I have delivered 13 babies. The number of women I have driven to a maternity unit because they had a contraction or their waters broke runs into the 100s. There is no need for it. Get a lift, get a taxi, don't call 999 as your first port of call! 25p a week during a pregnancy will leave you enough for a cab, FYI! Most don't even bother phoning their maternity unit first which is just infuriating! On route to the address I had a similar rant to my poor crew mate but managed to enter the house all smiles and laughter!

The patient was 40/40 weeks pregnant and remarkably, today was her due date. Her waters hadn't broken and despite what she had told the call taker, her contractions appeared to be every 8-9 minutes, if that. She hadn't phoned the maternity unit and hadn't considered getting her husband or any of the other 12 adults in the house to drive her to the hospital, in one of 5 cars parked on the over-sized driveway. Yet still I smiled!

"Have you got your maternity notes?"

"Yes, why?"

"So I can phone the labour ward and see if they want you to go in."

"I'm going in. I'm bleeding."

My crew mate took the lady to the bathroom whilst I flicked through the notes. When they returned it was confirmed that she had had a 'show'. Perfectly normal in the early stages of labour. (Actually, what my crew mate said to me privately was that she would probably be able to yield more blood from a medium sized spot!) Perfectly normal in the early stages ofabour. We did her blood pressure and all the other observations that we do. All were absolutely fine so I phoned the labour ward.

"Hello there, my name's Ella, I'm a paramedic from the ambulance service, I'm with one of your patients at the moment."

"Hello dear, what's the problem."

"Normal labour, full term, water intact, had a show, contractions every 8-9 minutes lasting about 15-20 seconds, all her OBs are normal."

"So why has she phoned an ambulance?! Tell her to stay at home and make her own way here when contractions are every 2 minutes. We are full at the moment so there is no room at the inn!"

"Okey dokey, will pass that on, thank you!"

I relayed the message to the patient and her expectant relatives.

"No, I want to go in."

"Well the midwife doesn't want you in yet so we won't be taking you there."

"Yes you will, I phoned an ambulance and I want you to take me in, you can't refuse me."

"I'm afraid we can. I have referred you to the midwife who has told us not to bring you in and you're to make your own way when contractions are every two minutes."

The argument continued for a number of minutes whilst I wrote up my paperwork. They became extremely rude and were livid with us. Don't shoot the messenger! Eventually, through polite smiles we left. Unsurprisingly she refused to sign our paperwork. Another happy customer! Another life saved!

We headed off into the night and my indignant rant continued! We were sent to a drunk on a bus a few miles away so I could turn my mood to bus drivers! A few moments later we received a call from control.

"We've got a call from the patient you just left, she's now in a car around the corner from where you were saying that you refused to take her to hospital despite bleeding. Any other info, over."

"She's in normal labour, the bleeding was a show, contractions are 8-9 minutes apart and the maternity unit is full. The midwife told us not to take her in and told her to make her own way when contractions are every 2 minutes. Over"

"Rog, unfortunately because of the symptoms she is describing and the fact she is now in a public place we are having to send another ambulance. I'll let the crew know what you've told me."

What is wrong with people?! She's now in a car. The hospital is less than two miles away and she's phoning another ambulance because she's in labour! And she's getting another ambulance! I was seething. How can people play the system like this and win?! It is total madness. Being in labour isn't an emergency, it's a part of life! Why do some woman think that an ambulance is the only answer?! And why can't we charge if we are simply being used as a taxi?! Crazy!