Women/birthing people and their babies should experience safe, effective and high-quality maternity and newborn care, wherever they live and whatever their circumstances. The terms woman and women are used within these standards to include women, girls, trans men, non-binary and intersex people, who are pregnant or have recently been pregnant.
Maternity care in Scotland is provided by NHS boards and delivered by healthcare professionals working within integrated multidisciplinary and interdisciplinary teams. For the purposes of these standards, the term multidisciplinary is used as an overarching descriptor for both multidisciplinary and interdisciplinary practice, reflecting collaborative, coordinated, and integrated professional working across health disciplines.
The Scottish Government is committed to ensuring high-quality maternity services that reflect current best evidence and practice, demonstrate dynamic learning systems and meet the needs of women, their babies and their wider families. This commitment is outlined in key policies, including The Best Start, the Women’s health plan and the Population Health Framework. These policies outline the importance of maternity care as a significant public health intervention. Maternity services should provide the right care for every woman and her baby, offer continuity of carer and support every child to have the best start in life.
The Best Start emphasises the importance of offering women and their babies a family-centred, safe and compassionate approach to care that recognises their unique circumstances and preferences. To support a family-centred approach, fathers, co-parents, partners and other family members should be actively encouraged and supported to be involved, where appropriate. The term care partner is used within these standards to include anyone that the woman wishes to accompany her to appointments or be involved in any aspect of her care, including birth. The woman’s care partner might be the biological father or parent of the baby, a co-parent, partner, family member or friend. In these standards, the term baby is used inclusively to refer to babies from both single and multiple pregnancies.
It is essential that women are informed about their choices and the support available to them and their babies before, during and after birth. Maternity care should be underpinned by evidence and best practice. Women should be at the heart of decision making, receive tailored information and experience high-quality communication. This will enable care to be provided in partnership and support women to achieve the best outcomes and future health for themselves and their babies.
Recent UK reports and audits have highlighted variation in the quality and consistency of maternity care.1-4 Evidence indicates the need to improve health outcomes for women from underserved groups.5, 6Complications in pregnancy and mortality rates are higher for Black and Asian women and their babies.7 Women from mixed heritage and gypsy traveller backgrounds also experience less positive maternity outcomes, often due to barriers in accessing antenatal care services.7, 8 Missed or late appointments are both a consequence and a driver of health inequalities, with women from socially disadvantaged and ethnic minority backgrounds disproportionately affected.9, 10
The Scottish Government commissioned Healthcare Improvement Scotland to develop standards to support a holistic approach to improving and sustaining quality maternity care across Scotland. The standards aim to ensure all women and their babies who access maternity services, receive consistent, person-centred, compassionate, high-quality care and support, regardless of their individual circumstance or needs.
Scope of the standards
The standards apply to:
all women receiving maternity care in Scotland throughout their pregnancy and extending up to six weeks (42 days) after the birth of their baby
all babies receiving newborn care, until their care is transferred to the universal health visiting or family nurse partnership service (usually at ten days old). To note, the standards do not include babies receiving specialist neonatal care
care partners of women receiving maternity services, where appropriate.
The standards aim to support current and future provision of maternity services. They also promote improvement in the delivery and coordination of maternity care and support for all women and their babies.
The standards cover maternity care delivered in all settings, including midwifery units, community or home settings, hospitals, primary care and prisons.
These standards apply to all NHS Scotland staff involved in the multidisciplinary delivery of maternity services. In Scotland, midwives are usually the main coordinators and providers of maternity care, and all pregnant women are offered midwifery care when they first book for antenatal care. Women with complex care needs may be referred to an obstetrician (specialist doctor in maternity care or medicine) to lead their care.
The standards also apply to other healthcare staff within the integrated multidisciplinary maternity care team, including primary care and allied health professionals. The standards cover locum staff, contracted staff and those covered by reciprocal work arrangements, students and junior staff in training (including resident doctors).
The standards should be read as a collective rather than a linear document. For example, the criteria in Standards 6-11 should be provided in line with the principles set out in Standards 1-5.
Clinical governance standards
As part of a wider approach to improving healthcare across Scotland, Healthcare Improvement Scotland has worked collaboratively with stakeholders to develop clinical governance standards. The clinical governance standards apply to all clinical services planned, commissioned or delivered within the health and social care system in Scotland. They provide detailed criteria on:
leadership and staffing
quality management and continuous improvement
clinical effectiveness
clinical safety and risk management
education and training
service user and patient involvement
data and information.
These maternity care standards should be implemented alongside the clinical governance standards.
Terminology
Wherever possible, we have used generic terminology that can be applied across all maternity care settings. All terminology is described in the glossary.
The term relevant guidance refers to clinical guidance, pathways, protocols or standards, which should be read alongside these standards. Links to relevant guidance are included in Appendix 5.
Maternity standards
