Woman in Labor Told to Use Shoelaces to Tie Her Baby’s Umbilical Cord by 999 Operator

Women could be at risk of catastrophic pregnancy complications due to poor advice given by 999 call handlers.

According to a new report seen by The Mail on Sunday, worried mothers-to-be who call an ambulance are receiving instructions from telephone operators that run counter to official guidelines.

Call handlers, who are not medically trained, failed to spot serious birth complications or life-threatening emergencies, and simply told the women to prepare for normal labor.

Such mistakes could lead paramedics to arrive unprepared and without lifesaving equipment, experts have warned.

A 39-year-old pregnant woman suffered from heavy bleeding and constant pain – warning signs of a life-threatening complication.

She called 999 and described her symptoms to the call manager, who incorrectly told her she was low risk and fit to give birth at home.

According to a new report seen by The Mail on Sunday, worried mothers-to-be who call an ambulance are receiving instructions from telephone operators that run counter to official guidelines. (archive picture)

Bizarrely, the woman – named only Amy – was then asked to collect items around her house in preparation, including a safety pin to pop the amniotic sac protecting the baby and shoelaces to tie and tighten the umbilical cord .

This advice is not recommended by medical professionals.

“Telling a woman to walk around a house looking for objects while bleeding profusely could lead to a sudden collapse, which could be catastrophic for both mother and baby,” says Dr. Jayne Terry, consultant obstetrician and caretaker. maternity ward at St Mary’s Hospital, London.

The report, by health watchdog the Health Care Safety Investigation Branch, also noted that heavily pregnant women were routinely asked to lie on their backs when feeling unwell – which goes against NHS recommendations.

Lying on your back increases the pressure on the delicate blood vessels in the abdomen, reducing the supply of blood and oxygen to the baby.



According to studies, around 130 babies’ lives a year could be saved if more women slept on their sides during the later stages of pregnancy.

The 118-page watchdog document was drafted in response to a series of patient safety complaints about the quality of advice offered by 999 call handlers.

Dr Ellie Rayner, an NHS obstetrician working in a south London hospital and founder of pregnancy support organization The Maternity Collective, says: ‘It seems some telephone operators are mistakenly assuming that heavy bleeding is a sign normal work.

“In fact, it’s unusual to see a lot of blood in the early stages of labor – it’s almost always a sign of serious complications that require urgent medical attention.”

“If the ambulance service thinks a woman is just giving birth, they may send a paramedic in a car, rather than an ambulance, which may not carry the equipment needed to perform urgent blood transfusions or medications capable of control bleeding.

The report’s chief investigator, Craig Hadley, also raised concerns about “huge inconsistencies” in the information women receive depending on where they are in the UK.

“You might have two women facing the exact same clinical emergency, but the advice they receive is often totally different,” he says.

“This is not the case for other medical emergencies, such as heart attacks. Ambulance services have specific national guidelines on what patients should do before paramedics arrive.

“But it seems there is nothing official for maternity emergencies.”

Joanna Darks, a 37-year-old mother-of-two from Surrey, says a 999 call handler told her she was just in early labor when she called an ambulance in 2015 after suffering a severe blood loss.

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“I was only seven months pregnant, so I was very surprised to learn that this was exactly what labor was like,” says Joanna.

“I bled through multiple sanitary pads and struggled to keep track of how much I was losing.

“The first thing the call handler asked me was if I could see any baby limbs hanging off – which I thought was an odd turn of phrase.

“I told him there was none, but I was losing a lot of blood and struggling to stay conscious.”

About ten minutes later, a paramedic arrived in a car and identified that Joanna was suffering from serious complications and needed to be rushed to hospital. An ambulance followed 20 minutes later.

Joanna suffered from placenta previa, where the placenta blocks the opening of the cervix and prevents the baby from being born.

The disease causes heavy bleeding at the end of pregnancy and fatal lesions at birth.

At the hospital, midwives couldn’t detect the baby’s heartbeat, so doctors performed an emergency cesarean section.

Joanna’s son Eric was born unable to eat or breathe properly and remained in neonatal intensive care for two weeks.

“Fortunately, there were no serious long-term complications, but it was all quite traumatic,” she says.

Experts say the problem lies with the two different computer systems used by UK ambulance services to decide on possible diagnoses.

While most women with complications call their local maternity ward, midwives often suggest calling 999 if the situation is deemed urgent.

Call handlers enter information provided by the patient into a computer program that uses an algorithm to determine what the problem might be and issues specific advice.

Six of the UK’s ten ambulance providers use a system based on international guidelines for emergency care, developed in the USA.

The other four use a UK-based system developed by NHS experts and government health advisers.

It is the international version which, according to experts, is responsible for most of the inappropriate information.

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Hadley says: “For example, the NHS pathway recommends that a pregnant woman lie on her side.

The US system says women must lie on their backs – which is against official NHS guidelines.

Every three months, about 8,000 pregnancy-related calls are made to ambulance services that use the US system, according to Hadley.

It’s a protocol that, according to Dr. Terry, “is not fit for purpose.”

She adds: “It is written by people who do not know motherhood.

“It assumes, for example, that very pregnant women with abdominal pain are in labor, when any expert will know that there are many other things it could be.”

Operators also rely on women to tell them they are having a high-risk pregnancy, when many serious problems can arise in pregnancies otherwise considered low-risk.

The Health Care Safety Investigation Directorate has urged the government to develop a new set of national guidelines for ambulance services – including telephone operators – written by health chiefs from the National Institute for the excellence in health and care.

Dr Terry says: ‘In our confidence, we ask paramedics to spend time with midwives to receive expert training.

“I hope others will start doing the same.”

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