The growing number of unvaccinated pregnant women with Covid on labour wards is pushing some maternity services to the brink, NHS doctors have warned.
Senior midwives and obstetricians have revealed that units in certain areas are in a 'crisis situation', where already time-stretched staff are being forced to abandon healthy women mid-labour in order to tend to the complex needs of Covid-positive expectant mothers.
There have been problems separating Covid-positive women in birth units from those without the infection, and in some cases midwives have contracted Covid and been forced to self-isolate.
This has compounded existing staff shortages, with record numbers leaving the profession this year, and even led to birth-unit closures. NHS data shows that 300 midwives resigned in May alone – the largest monthly figure since 2009.
The concerns come a month after Britain's most senior gynaecologist, Dr Edward Morris, President of the Royal College of Gynaecologists and Obstetricians, warned that patient safety on maternity units could be at risk, should Covid cases keep increasing.
Meanwhile, experts say too many pregnant women are still unwilling to get vaccinated, despite the efforts of health chiefs and Ministers to encourage uptake.
'We're seeing the same pattern we've seen throughout the pandemic,' says Marian Knight, Professor of maternal and child health at the University of Oxford, who has been closely tracking Covid pregnancies since last year as part of a national surveillance study.
'And a significant proportion of those women will become very, very unwell.'
Senior midwives and obstetricians have revealed that units in certain areas are in a 'crisis situation', where already time-stretched staff are being forced to abandon healthy women mid-labour in order to tend to the complex needs of Covid-positive expectant mothers
The best estimates are that 85 per cent of pregnant British women remain unvaccinated, with many hesitant about the having the jab owing to unfounded fears that it could harm their unborn child.
In reality, studies suggest that pregnant women are 13 times more likely to die from Covid than people of a similar age who are not pregnant.
And 98 per cent of pregnant women admitted to hospital with Covid have not had the jab, Prof Knight's analysis shows.
Some end up in ICU: since September, roughly a third of all 16-to-49-year-old women admitted to ICU with Covid have been pregnant, or recently pregnant.
But the majority will be cared for on both medical wards and maternity units, including labour wards when they need to deliver.
Experts say if mothers are infected with Covid, it is far more likely they will need an emergency delivery, and much earlier than planned, owing to the risk of a decline in the mother's health that may make them less likely to survive childbirth.
University of Oxford data shows that Covid-positive expectant mothers are up to three times more likely than others to have a premature baby.
And data this month showed that 694 premature babies were born to Covid-positive mothers between March 2020 and July this year.
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 across the country are not set up to deal with the current situation,' says Dr Mary Ross-Davie, midwife and Director for Professional Midwifery at the Royal College of Midwives.
'There has been a chronic staff shortage for years, and the pandemic has made this acute.
'Midwives are exposed to a younger population, many of whom aren't vaccinated. A lot of our work involves going into people's houses, where people are unjabbed, and being in very close quarters with them.
'So we have huge numbers of midwives catching Covid, and having to self-isolate.'
Staffing is just one of the challenges. 'There is a huge pressure on services to find the physical space to treat every woman safely,' says Dr Ross-Davie.
'If you have a large number of women who are Covid-positive, you will have to rethink the whole system to ensure there is space to isolate patients. For this reason, lots of midwife-led maternity units have had to close.'
The best estimates are that 85 per cent of pregnant British women remain unvaccinated, with many hesitant about the having the jab owing to unfounded fears that it could harm their unborn child
Dr Chandrima Biswas, a consultant obstetrician working in an NHS hospital in London, said: 'Last week I was up all night with a woman who was otherwise perfectly healthy, but had Covid.
'She was 30 weeks pregnant – so had about two months to go – and deteriorated rapidly. We took her to ICU but didn't know whether it was too early to deliver her baby. In the end we delivered, and the baby survived, but needed critical care.
'The mother is still ventilated, and we've now had to arrange for her to transfer to another hospital on the other side of London, because she has deteriorated further, and we don't have access to the specialist treatment she needs.'
There is some evidence that the problem may already be compromising the care of non-infected women.
'Covid-positive expectant mothers in hospital need a lot more close monitoring,' says Dr Biswas, who is also an adviser to the Healthcare Safety Investigation Branch, which investigates issues of maternity safety.
'If they are in labour, they will need detailed heart-monitoring every few hours. We're supposed to have one midwife to every pregnant woman. But if you're running those tests on the Covid patient every few hours, you can't be with another woman in labour.
'If there are not enough midwives to go around, it's feasible the patient who doesn't have Covid will miss out on adequate care.'
Last week, midwives spoke out about situations whereby Covid-positive women were treated in the same ward as those without the infection, risking spread.
'There are situations where patients will be waiting for the results of Covid tests in waiting rooms or on wards near non-infected women,' says Dr Biswas.
'Generally speaking, once we know women are positive, they are moved into a separate room.'
Dr Biswas says pregnant women with Covid are moved between wards, depending on the stage in their pregnancy.
'Last week I had a Covid-positive woman who wasn't sick enough to be ready for delivery, so she was on a medical ward.
'But she had to come to the maternity unit to have specialist care, before she was moved back. I wasn't particularly happy about that.'
The concerns were voiced in the same week that scientists published the most convincing evidence to support the most-feared risk of Covid in pregnancy: the virus spreading from mother to baby.
So far, a handful of babies have been born with Covid. None has been seriously ill, but scientists have been unsure as to the route of transmission.
Researchers at University College London analysed samples of foetal tissue, including the intestines and kidneys, and detected the presence of receptor cells, which offer the
