Midwife should lead neonatal care, recommends maternity review

Pregnancy - PA

A primary midwife should lead continuity of care throughout pregnancy, birth and in the first weeks of a baby’s life, according a new review of Scotland’s maternity services.

The idea is one of 76 recommendations made by the review of maternity and neonatal services, which reported today.

The Royal College of Midwives (RCM) said it will lead to a “seismic shift” in the way maternity services are delivered.

The report could lead to an entirely new model of neonatal care, with Health Secretary Shona Robison confirming the Scottish Government will seek to implement all recommendations “subject to more work being done to understand the scope and complexity of implementation”.

“Changes to birth rate, demographics and best practice, as well as advances to clinical care, means the services we provide to women and babies must be adapted and updated,” she said.

Recommendations include requiring every health board to offer a full range of choice of place of birth to expecting mothers, supported by wraparound care in the community. Mothers would have support from the same midwife or small group of midwives throughout.

Up to five enhanced neonatal intensive care units should be established across Scotland to care for the smallest and most critically ill babies, the report said.

Robison said continuity of midwifery care would be introduced to some health boards quickly, which was welcomed by RCM Scotland director Mary Ross-Davie.

“What is so important is that this puts women and their families at the centre of care. The focus on continuity of care and carer – that is the woman seeing the same midwife or small group of midwives – is very welcome,” she said.

“There is very strong evidence that better continuity of care leads to better outcomes for the mother and baby.”

The review’s chair Jane Grant said: “As part of the review I visited maternity units within every Health Board area across the country and I would like to take this opportunity to thank the hundreds of staff, parents and voluntary groups who made the time to share their views and experiences.

“This feedback helped to identify the issues which matter most to women and their families and played a key role in shaping the report findings and recommendations.”

To hear the review's chair Jane Grant and Chief Medical Officer Catherine Calderwood reflect on the findings, attend Holyrood's Maternity and Neonatal Services: Delivering Excellence event