Space constraints mean that the back of a helicopter is not a suitable place to consider delivering a baby, certainly not a premature twin. There is simply not the space for the required equipment and personnel. Extract from the NHS Highland and Scottish Ambulance letter
Local MSP Rhoda Grant, Labour, is calling on the Health Secretary in the Scottish Government, Jeane Freeman, to launch an urgent review into the availability and suitability of emergency air transport for pregnant women across the whole of the Highlands and Islands.
Her plea comes after her further investigation into the case of a Caithness mother who went into labour at 30 weeks with twins. The babies were born 50 miles apart in a dash by a road ambulance to Raigmore Hospital.
Mrs Grant asked NHS Highland, the Scottish Ambulance Service (SAS) and Health Secretary, Jean Freeman, further questions after receiving an edited version of a Significant Adverse Event Review into the incident. She previously asked First Minister Nicola Sturgeon to investigate.
She repeated her call for a full risk assessment to be carried out on such emergency transfers and that a suitable craft can be made available for airlifts.
Rhoda Grant said:
“After receiving the responses, I would sum up the situation as this – for any woman in labour and needing emergency help going by road ambulance is really the only option and air transfer is almost a non-starter.
“Whatever the officials and Government say, most people believe that an air ambulance is still an option when the truth is that it can hardly ever be used due to the constraints of the helicopter and the risks associated with giving birth in the air.
“I’m now calling on the health secretary to instigate a review, to ensure that any emergency aircrafts can be large enough to carry medical equipment and be able take at least one qualified medic on board, particularly to cater for women in labour.
“I realise that pregnancy and labour are risks but we really do need to ensure that everything that can be done is being done to cover eventualities.”
Rhoda Grant discovered that the ScotSTAR service, run by SAS and used to fly in medical experts in emergencies to locations across Scotland, does not have obstetric/midwifery staff and she is now asking Jeane Freeman if this gap can be filled.
Rhoda Grant also wrote to , Chief Executive of the Maritime and Coastguard Agency, which runs search and rescue helicopters, to find out its policy on being called to pregnant women.
Brian Johnson said transfer requests in relation to pregnancy rested with the ambulance service but also said:
“our crews and aircraft are prepared and equipped to respond to deal with maternity care and obstetric emergencies”.
Mrs Grant commented:
“This appears to be at odds with what the health authority and ambulance service are telling me so I’ve written back to him for clarification.”
The MSP stressed front-line staff involved in the twins’ case were excellent and coped with a very difficult and serious situation, but she was worried about the implications for other pregnant women.
The mother of the twins, who wants to remain anonymous, is supporting Rhoda Grant’s campaign for a review.
The mum believed the health service mentioned air transport as a back-up when the maternity service in Caithness was changed to a midwife-led unit and at-risk mothers were sent to Raigmore to give birth.
“Why if the NHS is saying that the helicopter is not suitable for premature labouring women did the team in my case spend two hours trying to get a helicopter when I had already had given birth to one twin?
“A helicopter was sent out but was unable to land. If it’s stated it’s not suitable then it should have never been sent or requested!
“I’ve supported Rhoda investigating this further because I don’t want any other mother going through what I went through, although the staff who helped me at the time were fantastic.”
CGH is a Rural General Hospital, there has never been a neonatal unit in Caithness and this was also the position when the maternity unit was a consultant obstetric-level model.
It would be important to note that, due to the unpredictable nature of childbirth, there will always be a small percentage of labouring women who do not reach hospital in time for the birth of their baby. NHS Highland maternity teams work with service users, SAS and nursing and medical colleagues to ensure training, patient education and emergency protocols are in place to support the safest management and best outcomes in these events. Extract from NHS Highland Letter
Caithness health campaigners, CHAT, fully support Mrs Grant in calling for an urgent review into air transport for expectant mothers in the Highlands.
Ron Gunn, vice-chair of CHAT said:
“Following Mrs Grant’s intervention, it is now apparent, that in an emergency situation, pregnant mothers cannot rely on air transportation or help from the ScotSTAR service,” said
“The only option left is a two-hour transfer by road ambulance. Living in Caithness we are all too familiar with the many problems associated with driving on the A9, especially as we come closer to winter.
“Caithness women need to know they can get help quickly and efficiently when they or their baby needs it.”
Rhoda Grant’s questions also revealed that some SAS pilots were not trained in the use of night vision goggles which meant they could not fly at night – the ambulance service said the search and rescue helicopter could respond in these cases. She has asked Jeane Freeman to grant the ambulance service extra money to ensure air staff get the significant additional training for night work.
The MSP also asked about the plan for delivering babies in Caithness if transfer by road and air was impossible and was told that midwives and the emergency teams at Caithness General undertake regular training in the management of emergency obstetric cases and neonatal resuscitation. In addition, NHS Highland said there was support from consultants using VC from Raigmore Hospital.
Rhoda Grant added:
“However, I do believe the expertise available in Caithness has to be investigated again.
“I believe there is still a lack of obstetric and neonatal expertise there adding to the limitations and deficiencies in the current system for transferring mothers and babies.”