‘Real changes’ achieved across maternity services

Monday 15th July 2019

Constrained resources, demographic changes and balancing the needs of rural communities with the benefits of centralised services are among the ‘significant challenges’ identified in the latest national audit of maternity and perinatal services.

Also reporting on England and Wales, the audit evaluates what progress has been made north of the border as the Scottish Government implements its five-year forward plan for maternity and neonatal care.

Real changes can be seen across Scotland,’ the report states while acknowledging continuity of carer recommendations will be implemented fully in all 14 regional health boards in Scotland over the next few years, ‘offering relationship-based care between midwives and women and better outcomes for women and their babies.’

Also under the five-year plan, neonatal care is being redesigned to keep families together as much as possible, to enable more preterm babies to be discharged home sooner with support in the community, and to consolidate neonatal intensive care to improve outcomes for the smallest and sickest babies.

In February the Scottish Government committed £12m to a new model for neonatal care that would see all expectant mothers receive care from a primary midwife and enhanced support for babies needing the most specialist care.

A reduction in stillbirths since 2013 and ‘sustained improvements’ in neonatal mortality are praised by auditors, thanks to the ongoing work of the maternity and children quality improvement collaborative that works to reduce serious harm incidents across maternity, neonatal and paediatric care.

An increase in the number of consultant maternity units with an alongside midwife unit in Scotland is also praised.

Commenting on the audit, Birte Harlev-Lam, executive director of professional leadership at the Royal College of Midwives (RCM) said:

The RCM is pleased to see that maternity services are making continuous and considerable efforts to improve and implement recommendations from recent reviews and initiatives.

The results suggest that maternity and neonatal service provision is improving in a number of important areas as well as facing ongoing challenges, particularly around unwarranted variation.”

In March, the Scottish Government announced over £50m of funding to improve access to mental health services for expectant and new mothers.

Perinatal mental health services have expanded, and more women are being given the specialist psychological support they need both in pregnancy and the postnatal period,” says Ms Harley-Lam.

This is particularly true in England and Scotland where there has been an increase in specialist perinatal mental health midwives and in an increase in access to transitional care, so that mothers and unwell babies do not have to be separated.

Separating mothers from their babies at this crucial time affects their ability to bond with their babies and impacts negatively on breastfeeding rates.”

Among the audit’s recommendations – compiled by the Royal College of Obstetricians & Gynaecologists in collaboration with the Royal College of Midwives, the Royal College of Child Health & Paediatrics, and the London School of Hygiene & Tropical Medicine – a call is made for continued improvement in access to electronic maternity records.

Further recommendations and the full report are available here.