By Nick Harvey

Earlier this year, Sagarika* stumbled into our Bethnal Green clinic breathily heavily. She was in labour and she was terrified. As an undocumented migrant, she’d been too afraid to see a doctor during her pregnancy - she’d had no antenatal scans and she had no idea if the baby she would soon deliver was healthy. 

At our specialist women and children's clinic in London, we regularly see pregnant women who aren't getting the ante-natal care they desperately need, because they fear being arrested or being sent a huge hospital bill that they can't pay. The Guardian has today published an in-depth piece about our clinic and its work.

“The NHS says antenatal care should always be provided, but we regularly see women who’ve been put off getting that care, which puts both mother and child at risk,” says Phil Murwill, who runs Doctors of the World’s London clinic. “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.”

Another of our recent patients is Li*, who fled to the UK from China five years ago after facing persecution for being a Christian. After she became pregnant, her local GP surgery wrongly turned her away because she didn’t have documents to prove her address - everyone in the UK has the right to see a GP for free, regardless of their immigration status, income, or documents.

Luckily, Li came to our women and children's clinic, where we helped her register with a GP and get antenatal care. She gave birth to a healthy baby last year. But we couldn’t stop her receiving a bill for more than £5,000 shortly before she’d even had her baby.

“It was so scary,” Li says. “When you’re a single mum and you see a bill like that, you just panic.”

Undocumented migrants are charged 150% of the usual NHS fee, which means that a complications-free pregnancy costs around £5,000-£7,000. If there are any complications the cost can be many times that amount.

“The women we see get no support from the state, so how are they supposed to pay?” says Anna Miller, Doctors of the World UK’s policy lead. “These bills not only cause extreme stress and deter women from seeking healthcare, women are also often forced into illegal or exploitative work to try to pay them.”

Doctors of the World has seen billing letters to pregnant women that threaten to discontinue antenatal care if the patient does not pay an upfront deposit of £6,500. These letters are clear breach of NHS guidelines, which state that no woman should be denied access to maternity services due to charging issues.

We also regularly see letters that threaten to report pregnant patients to the Home Office if they can't pay. Many pregnant women are already too afraid to see a GP or go to hospital because they fear that immigration officers could use these institutions to track them down. 

The UK government recently admitted that an MOU had been signed between NHS Digital and the Home Office agreeing to share patient information such as addresses. Last month, we shared exclusive evidence with Buzzfeed showing that the Home Office has also been contacting GPs directly to get patient information.

This hostile environment for migrants led to a terrified Sagarika coming to Doctors of the World in labour. Our staff put her in a taxi to the nearest hospital and four hours later she gave birth to a healthy boy. 

Sagarika was one of the lucky ones - we have no idea how many other women in the UK are choosing not to go to hospital and are giving birth at home, alone, with all the risks that entails. And Sagarika will soon no doubt receive the bill for her son's delivery.

* Names have been changed to protect our patients' identities

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