1. Women must receive high quality care during childbirth. The care should be based on the available evidence about effective practice and should be woman and baby-centred. A strong multi-professional team approach is vital for the delivery of a clinically effective and seamless service. 2. The principles in
A Framework for Maternity Services in Scotland are robust and are based on best professional practice. All of the principles, including the tiered framework of levels of care provision at the time of childbirth (intrapartum) and for the new-born baby (neonate), should be fully implemented. 3. Maternity care professionals must work to promote the notion of pregnancy and childbirth as being normal life events, but must also have the skills to recognise when either the mother or baby is having problems. 4. One-to-one midwifery care should be the norm for all women during labour and childbirth. 5. The present provision and shape of acute maternity services is no longer sustainable in the light of changes in the number and locations of births in Scotland (demographic changes), training and workforce pressures, and the need to ensure clinically safe and cost-effective practice. 6. NHSScotland should provide services for childbirth as close to women's homes as is consistent with safe clinical care and informed maternal choice. 7. Local planning and commissioning of maternity services, in particular childbirth (intrapartum) services, should take place within a regional context. This will help to ensure that local services reflect regional and national priorities. 8. There is no such thing as 'zero risk' for women who are pregnant or giving birth; an element of risk applies to all pregnancies and childbirth. 9. Women must be informed about risk with unbiased, evidence-based information to help them decide where to give birth. Professionals should balance maternal choice, demand and need against assessment of risks and available services. 10. Maternity care professionals should adopt risk-assessment and management skills as core responsibilities. 11. Professionals at all levels of maternity care must have appropriate training and should have access to regular continuing professional development (CPD) opportunities to equip them with the competencies and skills they need to provide high quality, safe care for women in childbirth (intrapartum care). 12. Networks of services for intrapartum care should be developed on a consistent local, regional and national basis across Scotland, identifying entry points, referral pathways, levels of care, transport services and communication pathways. 13. Information management and communication should be developed to aid the planning, provision and monitoring of intrapartum care throughout Scotland. 14. All maternity units must describe the level of service they offer within the tiered framework of intrapartum care set out in
A Framework for Maternity Services in Scotland. This description should include the maternity unit's role and remit within the wider local and regional network of maternity services for childbirth, neonatal and maternal postnatal care. |