A pregnant woman clutches her rounded stomach and winces at the pain. Something is wrong. She can feel it.
Alone and frightened as the pain becomes all consuming, she reaches for her mobile phone to ring 999 for help. Then, she stops.
She is an undocumented immigrant, who fears she could face deportation or impossible fees for using the NHS. She is faced with two choices: get medical help and risk deportation, or stay away and risk serious harm to her or her baby’s health.
So she stays where she is, alone and without help, as thoughts of harm to her child flash through her mind, but the fear of Home Office agents appearing by her hospital bed on a maternity ward is the only thing which terrifies her more.
She is not alone. There are many undocumented immigrants and refugees who are too frightened to access NHS natal care during their pregnancies for fear of being rounded up and deported.
The charity Doctors of the World runs clinics for women who have been trafficked, are refugees or undocumented migrants. It says women in the UK have been sent letters from the NHS demanding thousands of pounds in exchange for standard healthcare relating to their pregnancies and threatening the withdrawal of care unless they bring their credit cards to appointments.
Phil Murwill, who runs a Doctors of the World clinic in east London, said his team “regularly see women who’ve been put off getting care, which puts both mother and child at risk. We see women who are 40 weeks pregnant turning up at our clinic having received no antenatal care at all. This includes extremely vulnerable women such as survivors of trafficking and sexual violence.”
One worrying case he cited was that of a Chinese woman who was granted asylum in the UK after fleeing persecution in China after she was accused of “promoting Christianity”. She lacked sufficient documentation and was allegedly turned away from her GP while she was pregnant and seeking treatment, after the GP wrongly said she could not get healthcare treatment on the NHS without proof of address.
When she did manage to register with a GP, she was asked by NHS staff to pay £5,000 before the child was delivered. She said: “I felt very scared. There’s no way I can pay that much. I thought about not going to hospital, but I knew I couldn’t deliver a child by myself. I couldn’t cut the umbilical cord... When I was in labour I was thinking about money all the time.”
It is unclear why this is happening. NHS guidelines state that hospitals and healthcare workers are entitled to ask for payment but that if none is forthcoming they cannot deny emergency medical care to someone who needs it. The Department for Health has confirmed that it does not share patients’ non-clinical information with the Home Office to “trace immigration offenders” unless there was a clear basis to do so.
Yet despite official policy, the charity says women are facing these demands and ultimatums regardless and fear is growing among refugees and undocumented migrants.
The causes are unclear; it could be that amid a growing funding crisis, NHS hospitals and clinics are desperately trying to recoup costs where they can. Alternatively, growing anti-migrant sentiment in the NHS could result in staff misapplying the rules. This scenario is not hard to imagine, given that earlier this year it was revealed that 20 NHS hospitals would require patients to show their passports in order to get treatment as part of a pilot scheme to crackdown on “health tourism”.
The causes may be unclear but the larger picture is becoming apparent: pregnant refugees and immigrants have become caught in the crossfire of two of the most dangerous policies of the Government.
Firstly, the idea being rolled out by the Conservatives that free, safe and compassionate healthcare is not a human right, but rather a free market commodity. Over the last seven years we have seen the Conservatives consistently run the NHS into the ground amid creeping privatisation.
The second is the constant attempt to degrade immigrants and refugees, to present them as other, as lesser, as alien.
It is a damning indictment of our society that anti-immigrant rhetoric has whipped us into a frenzy which views pregnant women with distrust and disdain, rather than compassion.