David Stewart : speech in Parliament debate

Support for Midwives

8 May 2019

The International Confederation of Midwives created the concept of the international day of the midwife, to which previous speakers have referred.

Across the world, this year’s theme is:

“Midwives: Defenders of Women’s Rights”.

The organisation has a strong international message that is also applicable to Scotland here and now:

“Midwives uphold and protect the rights of women every day”,

“Midwives need safe and enabling environments to work in”


“Women have the right to make choices about their care during childbirth”.

It is worth repeating the truism that maternity and neonatal care are crucial to the health and wellbeing of Scotland’s people.

As the Scottish Government’s report on the best start plan said last year:

“Services have largely developed over time, rather than being designed around the needs of women and families, leading to different approaches and care across Scotland.”

As previous speakers have said, we all know that the birth rate in Scotland has been falling, but work for midwives is not dropping proportionately, because of increased levels of birth complexities, more inductions and a rise in the numbers of older women and women with very high BMIs becoming pregnant, as we have heard from Alison Johnstone and others.


That means that there are changing needs in the population and that services need to change and develop, because some are no longer fit for purpose.

My colleague Rhoda Grant will shortly provide a case study based in the area around Caithness.

I know from my experience as convener of the cross-party group on diabetes that long-term conditions, such as obesity and mental health problems, need a strong pro-active response from health services.

Other members around the chamber know that too.

I have referred to the concept of health inequalities many times in the chamber, and in the Health and Sport Committee.

We all know that women from disadvantaged communities face particular challenges during pregnancy and birth.


To address those problems, the best start plan has a number of key principles, such as the continuity of the carer, a particular focus on rural areas and the enhancement of telehealth and telemedicine, as well as wider targets like a single maternity network

“along with a single Neonatal Managed Clinical Network for Scotland.”

Is it working? One midwife working in Glasgow who gave me feedback about the best start plan said today:

“I just can’t see how it will work safely for both women and midwives.

"We are being failed as it is, completely rewriting the system won’t fix that.

Honestly, this is the hot topic at work and people are so scared of this.”

We all know that midwives are on the frontline of the NHS.

They bring new life into the world in a job that is heartbreaking, hard and beautiful.

The fact that some feel that they have no choice but to leave the job that they love tells us that something must be done.

As we have heard from my colleague Monica Lennon, on this side of the chamber we believe that transformational change to midwifery is needed, but it is crucial that that is not done on the cheap.


The existing midwifery workforce is already under significant pressure with a high level of vacancies and increasingly complex cases to manage. In addition, the State of Maternity Services Report 2018 – Scotland from the Royal College of Midwives found that the number of midwife vacancies had quadrupled over the previous five years.

I echo earlier speakers who called for an urgent investigation into the concerns raised by the midwives from NHS Lothian who believe that they do not have the resources needed to deliver the new models of care.


The skills and commitment of Scotland’s midwives need to be recognised and celebrated today.


Let us ensure that all midwives have the time, training and resources to do their job properly.

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