More than 100 nurses and midwives have walked off the job at Blacktown Hospital in Sydney's west and won't return to work for the next 24 hours.
The hospital has been in crisis since last week when 20 senior obstetricians threatened to walk out following the death of four newborn babies in the space of 18 months.
On Thursday nurses and midwives met with hospital management who made a number of offers, including a review of the staffing model.
However the employees rejected the hospital's offers and began industrial action, with many protesting outside the front of the hospital.
The NSW Nurses and Midwives Association said staff felt unsupported and did not trust management to follow through with their offers.
The public can still receive care at the hospital as enough staff are working for the departments to continue functioning.
Last week NSW Health Minister Brad Hazzard requested a full review of the hospital after a number of issues were raised with him, including lack of access to operating theatres for caesarean births.
Understaffing at the hospital, which is one of Sydney's busiest, was also flagged as a major problem.
NSW Australian Medical Association (AMA) president Danielle McMullen has previously said "systemic change" was needed at the hospital.
"Today thankfully we are seeing more action on the ground but the issue has been known for some time, there has been a huge increase in the number of births over the past few years at Blacktown Hospital and they really need some systemic change and increased resourcing." Dr McMullen said last week.
"There is a broader resourcing problem, but in general women have been safe and well looked after, we are just trying to make improvements down the track."
