Safety fears over home births plan
NHS bid for delivery without doctors
MORE women could give birth at home or without a doctor present in a major shake-up of maternity care.
Expectant mothers with no complications will also be able to have their babies in community hubs instead of on hospital wards.
The plans will be brought in next year and form part of an overhaul of maternity services.
Critics have given the move a ‘cautious welcome’ – but warned that women’s safety must not be put at risk.
Health Secretary Shona Robison said the changes would deliver a ‘fundamentally different’ system of care for mothers-to-be across Scotland.
It would see women only give birth in hospital with a doctor present if they have been identified as having a higher risk of complications.
Others would have their babies either at home or in community hubs, which would be run by midwives and would be either ‘freestanding’ or alongside hospitals.
The community hubs will have birthing facilities – but would not include maternity theatres. If women run into complications, they would be transferred to hospital.
Miss Robison said: ‘The new model will transform patient care and is a fundamentally different way of delivering maternity services to ensure that all women get the best possible experience, with their needs and interests at the centre of care and continuity in who provides that care.
‘The community hub model will see most midwives working in the community.
‘However, there will always be women who require to be in hospital during their pregnancy or after birth. Therefore, maternity wards will remain with access to doctors and consultants provided.’
Five health boards will run pilot schemes of the changes, with trials taking place in NHS Forth Valley, NHS Highland, NHS Lanarkshire and NHS Lothian as well as the Clyde area within NHS Greater Glasgow and Clyde from next year. The boards will assess whether or
‘Should have right to a hospital birth’
not the move can be rolled out within existing facilities.
It comes after a two-year review of services published in January.
It found that fewer than 3 per cent of women give birth either at home or in ‘freestanding maternity units’ – but many more could do so safely as the vast majority of births do not require specialist medical care.
It is expected the community hubs will provide both antenatal and postnatal care, with staff including midwives, obstetricians and other health professionals.
The announcement is part of the Scottish Government’s Best Start Review which advised a new model of care for mothers-to-be.
Scottish Conservative health spokesman Miles Briggs said: ‘I cautiously welcome this move but women should still have the right to a hospital birth.
‘We do not want to see a dangerous situation being created or see women fighting to be in hospital for their own safety.
‘If they want to have that peace of mind, the option should be there. And this should not be a cost-cutting exercise.’
The Royal College of Midwives (RCM) director for Scotland Mary Ross-Davie said ‘Sometimes if someone is in labour you get early warning signs that things aren’t going quite to plan, and in that case the decision would be made to transfer the patient to a consultant-led unit.
‘The five chosen health boards are suitable as they represent the key variations in Scottish maternity care – covering large urban areas, remote and rural areas and mid-size health boards with a mixture of rural and urban areas.
‘The RCM has been proactively engaged with the implementation process.’
Dr Ross-Davie added: ‘We will also continue to provide support and advice to our members locally across Scotland to enable them to plan positively for successful implementation of the Best Start Review recommendations.’