Maternity care pathways - clinical guidance and schedule and birthplace decisions leaflet: CRWIA

Conclusion

7. As a result of the evidence gathered and analysed against all UNCRC requirements, what is the potential overall impact of this proposal on children’s rights?

There are positive impacts with increased family resilience through improved health and wellbeing of parents, children, and other siblings.

8. If you have identified a positive impact on children’s rights, please describe below how the proposal will protect, respect, and fulfil children’s rights in Scotland.

Article 24 Health and health services, 2(d) - To ensure appropriate pre-natal and post-natal health care for mothers.

The revisions made to the Guidance and leaflet update the terminology used, moving away from high/low risk care and midwife-led/obstetric-led care to the model of continuity of carer and personalised/individualised team care. This therefore has the potential to positively impact young mothers throughout their pre-natal and post-natal care.

9. If a negative impact has been identified, please describe below. Is there a risk this could potentially amount to an incompatibility?

No negative impact was identified.

Mitigation Record

What options have been considered to modify the proposal in order to mitigate negative impact or potential incompatibility issues?

N/A

Issue or risk Identified per article/ Optional Protocol

N/A

Action Taken/ To Be Taken

N/A

Date action to be taken or was taken.

N/A

10. As a result of the evidence gathered and analysed against all wellbeing indicators, will the proposal contribute to the wellbeing of children and young people in Scotland ?

The proposal could potentially contribute towards the Scottish Government’s National Outcomes for Children and Young People and Health.

The proposal could also contribute to the Wellbeing indicators:-

• Healthy - having the best physical and mental health possible. Access to good health care. Support to make healthy and safe choices.
• Respected - having a voice and being involved in decisions that affect them.

11. How will you communicate to children and young people the impact that the proposal will have on their rights?

The revised Pathways of Maternity Care: Clinical Guidance and Schedule and Birthplace Decisions Leaflet will be published on www.gov.scot, Health Boards will distribute the leaflet as appropriate.

Response to the public consultation will be published on the Scottish Government website (www.gov.scot) and via Citizen Space (www.consult.gov.scot)

The CRWIA will be published on gov.scot so those wishing to access it can do so. The CRWIA in so far as possible has also been written in accessible language so those wishing to access it should be able to understand its content and the potential impact on their rights.

12. Planning for the review of impact on children’s rights and wellbeing.

Safety of maternity services is an ongoing priority. Safety of maternity services is underpinned, monitored, and reviewed through a number of key elements:

• Audit and data: Scotland participates in 3 national audits of maternity and neonatal services to monitor key data themes and provide advice on improvements to care. In addition, Public Health Scotland publish data dashboards outlining local and national data for benchmarking and to enable monitoring of key trends.
• Improvement: The Scottish Patient Safety Perinatal Programme works with all Boards to drive improvement in outcomes maternity and neonatal care, including reducing stillbirth and neonatal death. The Scottish Perinatal Network brings clinicians together to develop national guidelines and supporting service improvement across Scottish maternity and neonatal units.
• Scrutiny and assurance: Healthcare Improvement Scotland are currently developing a set of maternity standards to support consistency of service design and delivery across Scotland. In addition, they will initiate inspections of maternity services in 2025 to provide assurance around the care women and babies can expect to receive, with inspection reports being published and improvement plans developed.

We are also working to tackle the well-evidenced inequalities in maternity outcomes for mothers from Black and minority ethnic backgrounds. The Short-Life Working Group on Racialised Health Inequalities in Maternity Care, launched in January 2023, has developed its draft deliverables. These are currently being finalised and we expect them to publish early in 2025.

13. Sign off.

Policy Lead Signature & Date of Sign Off: Sophie Rogers, 10 October 2024

Deputy Director Signature & Date of Sign Off: Mairi MacPherson, 17 December 2024

Date CRWIA team first contacted: August 2024