A dispute over pay and safe staffing levels in the NHS has led to approximately 1,000 ambulance workers going on strike.
On Monday, members of the Unite union gathered at the West Midlands Ambulance Services hub in Erdington to picket.
One million health workers, including members of GMB and Unison, and the government reached a pay agreement in May; however, Unite did not support it.
Employees will receive a one-time payment of at least £1,655 along with a 5 percent pay increase.
Unite representative Mick Hooper has 34 years of experience as a paramedic.
"In the ambulance service, we have a lot of difficulty keeping staff on all levels, from cleaners to the staff that restocks the ambulances," he told BBC WM.
"People join the NHS to serve our nation in a public capacity, but there comes a point where it is no longer financially feasible for them and their families.
"Interest rates are at an all-time high, it can be challenging for younger employees to obtain mortgages, and eventually you have to decide whether to continue doing the job you love or move to a private forum where you can make more money.
"There is never a perfect time to strike, but we must act nonetheless. ".
On Wednesday, the British Medical Association junior doctors' strike will coincide with industrial action by Birmingham's City Hospital staff.
The Yorkshire Ambulance Service's union members will also strike on June 23 and 26.
The demands are unaffordable, the government has previously claimed.
