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A Framework for maternity services in Scotland
The framework
This Framework sets out a number of guiding principles for maternity care.
These are grouped in the following sections,
Pre-conception and very early
pregnancy
Pregnancy
Childbirth
Postnatal and parenthood
Service organisation and
provision
Risk assessment and management
Information and communication
Pre-conception and very early pregnancy
Principle 1
Good health before and during early pregnancy benefits the
woman, her unborn baby and the wider family. All women of reproductive age should
be empowered and encouraged to be as healthy as possible.
Principle 2
Specific pre-conception services should be available to women
with a poor obstetric or medical history, a previous poor fetal or obstetric
outcome, or where there is a family history of significant illness.
Principle 3
There should be specific services for women with complications
in early pregnancy.
Pregnancy
Principle 4
Maternity services should provide a woman and family-centred, locally accessible,
midwife-managed, comprehensive and effective model of care during pregnancy
with clear evidence of joint working between primary, secondary and tertiary
services.
Principle 5
Maternity services should provide parent education
programmes that address normal pregnancy and the treatment of complications
developing during pregnancy. A comprehensive health promotion programme and
opportunities for discussion about the effects of parenthood on relationships
should be offered.
Principle 6
A comprehensive antenatal diagnostic and screening service
should be available and offered to women in order to detect, where possible,
any maternal problems or fetal abnormalities at an early stage.
Principle 7
Maternity services should make sure that women's circumstances
are assessed holistically and that social and psychological needs are identified
and managed appropriately.
Principle 8
Health professionals should recognise the important role
of partners, and make sure they are encouraged and supported to take a full
and active role in pregnancy and childbirth.
Childbirth
Principle 9
Maternity Services, including obstetric
and neonatal services, should provide a fully integrated childbirth service
responsive to the needs of mothers and their new-born babies.
Principle 10
One-to-one midwifery care should be given to women during
labour and childbirth in order to make sure they have individualised attention
and support, preferably with continuity of carer.
Principle 11
Women have the right to choose how and where they give birth.
This choice should be supported by high quality information and evidence-based
clinical advice that allows them to take part in the decision making process.
Postnatal and parenthood
Principle 12
Maternity services should provide postnatal care to facilitate
the transition to motherhood by making sure that ill health is prevented or
detected and managed appropriately. Women and their partners should be supported
to make a confident and effective transition to parenthood.
Principle 13
Midwives, Health Visitors, GPs and Professions
Allied to Medicine should adopt a flexible approach to postnatal care working
in partnership with women and other agencies. This will make sure that the most
appropriate and experienced professional is the care provider at any given time
according to the needs of the woman and her baby.
Principle 14
Acute and Primary Care NHS Trusts should jointly plan and
provide a fully integrated neonatal service responsive to the needs of new-born
babies and their parents.
Principle 15
Maternity services should promote, support and sustain breastfeeding.
Women should be informed of its' benefits, while being supported in their chosen
mode of infant feeding.
Principle 16
Women and their partners should be given the opportunity
to reflect/debrief on their experiences of pregnancy and childbirth in the postnatal
period, with a health professional.
Principle 17
There should be a comprehensive, multi-professional, multi-agency
service for women who have, or are at risk of, postnatal depression and other
mental illness.
Service organisation and provision
Principle 18
Maternity care should be organised to provide a flexible,
appropriate, clinically effective and accessible service in response to the
needs of women.
Principle 19
Maternity services should adopt a holistic approach to care
during pregnancy, childbirth and the postnatal period to maximise and improve
continuity of care and continuity of carer for women.
Principle 20
Maternity services should be tailored to the needs of the
individual woman. Services should be provided by multi-disciplinary and multi-agency
teams with an understanding of professional roles to maximise the quality and
comprehensiveness of care, ensuring safety for both mother and baby.
Principle 21
Maternity services should agree arrangements for both in-utero
transfer and the transfer of a recently delivered mother and/or her new-born
baby to a linked secondary or tertiary unit.
Risk assessment and management
Principle 22
All health professionals must have a clear understanding
of the concept of risk assessment and management to improve the quality of care
and safety for mothers and babies, while reducing preventable adverse clinical
incidents.
Information and communication
Principle 23
Planning and provision of maternity services at national
and local level must be underpinned by an appropriate and comprehensive database.
Principle 24
Public and professional consultation must be fundamental
to the planning, development and provision of local maternity services.
Principle 25
High quality communication between professionals and women
and their families, and between professionals and colleagues, must be central
to the provision of excellent maternity care.
Principle 26
Women of reproductive age should have easy access to evidence
based information and to services covering continuous reproductive healthcare
regardless of their initial point of contact.
Principle 27
There should be a national, unified and standardised woman-held maternity
record that is available and accessible to both women and professionals.
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