Planned industrial strike action by the London Ambulance Service (LAS)

Important information for anyone receiving maternity care needing an ambulance during London Ambulance action strike dates.

For all pregnant patients

We are writing to you as you are receiving maternity care from Guy's and St Thomas', and might need urgent or emergency care from an ambulance.

You might be aware that there is planned industrial strike action by the London Ambulance Service. On strike days, we understand that it is very unlikely that an ambulance or paramedic will be available to come to your home if you have an emergency. If an ambulance can come to you, there might be a long delay.

The hours and days around the day of the strike will also be affected, and ambulances might take longer to reach you than usual. The LAS have told us that an ambulance will attend a category 1, life-threatening emergency. Unfortunately, the situation is unpredictable and an ambulance might not be available even in those circumstances.

We expect that, in all other circumstances, you will need to use either your own transport, a taxi, or other public transport to get yourself to hospital, as ambulances will not always be available.

If you are planning a homebirth

We strongly advise those people planning a homebirth, who go into labour on or around a strike day, to have their baby in hospital. This is because of the impact that any delay could have when transferring you to hospital in an emergency. There is significant doubt that an ambulance will be able to get you to the hospital in a safe timeframe, or at all.

We understand that this is upsetting and not the birth you planned. Please be reassured that our midwives will continue to provide safe care for you so that you will still be supported to have a midwifery-led birth in hospital. You will also have the opportunity to be supported to labour or birth in water, if you would like to. We have a midwifery-led home-from-home birth centre, which aims to provide a similar environment and midwifery care as within your own home. We would encourage you to talk to your midwife about this, if you have any questions.

If you do not want to come to hospital, the homebirth midwives will still come to care for you during your labour and baby's birth at home. However, this might compromise you and your baby's safety. Without ambulance service backup, in the event of an emergency, there might not be an ambulance available to bring you and/or your baby to hospital. This could result in a delay in treatment that could have a serious impact on you and your baby, including life-changing injury or, in the most serious situations, death. We do not want to alarm you, or cause distress, but we are legally obliged to give you all the information and options, to allow you to make an informed decision.

Emergency situations that can arise unexpectedly include: 

  • moderate or significant maternal bleeding before, during or after the labour
  • fetal (unborn baby) heart rate abnormalities, which can indicate a lack of oxygen that causes brain damage
  • any emergency during labour, such as an umbilical cord accident or breech birth
  • preterm birth

For all other reasons for calling an ambulance, including transfer to the hospital during labour for epidural pain relief, we have been advised that there will be a long delay, and it will be quicker to transfer to hospital in a car. Please plan how you will get to hospital on a strike day, and consider whether you have a car available, and someone available to drive you. We recommend you come to the hospital early if your labour starts at home.

We want to continue to support your choices and decisions, and assure you that those will be respected.

We know that homebirth can usually be considered a safe choice for most women. However, this is only the case if there is access to immediate transport in the event of an emergency. During LAS strikes we strongly advise you to plan the birth in hospital, as outlined above.

If you have any problems with your pregnancy and think you are in labour, or need to come to hospital for another reason, please call your midwife as soon as possible using the number in your maternity notes, or call the maternity helpline, phone 020 7188 1723, for advice. If asked to do so, please come to the maternity assessment unit using your own transport, or public transport.

Last updated: January 2023

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