Associate feature: Giving every baby in Scotland the best start

2017 was a pretty big year for women, babies and families in Scotland. The baby box scheme was piloted and then rolled out nationally and the new five year strategy for maternity and neonatal services in Scotland was published. 

As Director for the Royal College of Midwives (RCM) in Scotland I have welcomed both initiatives. I see the baby box scheme as a welcome contribution to tackling health inequalities and ensuring that all families feel that their baby is welcomed. Special needs midwives from different parts of Scotland, who care for some of the most vulnerable women in our communities, with little family support or financial resources, have told me that the boxes have made a big difference to these new families.

I was pleased to see the ‘Best Start’ review key recommendations about basing maternity care on a model of continuity of carer and community hubs. This is where women are able to get to know the midwives caring for them during pregnancy, knowing that they will have a midwife from their small team caring for them during labour, birth and after the baby is born. This model is based on strong evidence that relationship based care has really positive outcomes for women and babies. I hope that the development of ‘community hubs’ will ensure that women can access a much fuller range of care as near as possible to home, reducing the number of women needing to attend the large hospital maternity units.

Implementation of the Best Start recommendations will be a big change for midwives and the wider maternity team. But it will need significant investment in infrastructure, staff training and positive leadership to make it happen. 

The RCM is the UK’s professional body for midwives and the Trade Union for the great majority of midwives in Scotland. As an organisation we are doing everything we can to support our members and the implementation plans. This has included running a series of regional events in the Early Adopter board areas to increase understanding of how continuity models can benefit women and families and also provide high levels of job satisfaction and a positive model of care for midwives.  

We are also lobbying at every opportunity to seek assurances that midwives will be provided with the time, leadership, resources and training to successfully implement, along with our wider maternity team colleagues, such a significant transformation in the way maternity services are provided in Scotland. 

Midwives who have worked in either community or hospital settings for most of their careers will need time, education and support to make a safe transition to providing care across all settings. Midwives will need physical spaces across communities where they can provide care for women, undertake administrative work and provide antenatal and postnatal education for women and families. Midwives will need to have up to date equipment including IT hardware, clinical equipment and access to cars and we will need to ensure that there are enough midwives in the system to provide this high quality care.

I do hope that our fourteen hardworking and dedicated Heads of Midwifery across Scotland will be able to count on the support of national and local politicians and other key colleagues to make the new model of care work, for women and their babies, and for our hardworking and dedicated midwives and maternity support workers.

Mary Ross-Davie is Scotland’s Director of the Royal College of Midwives