Health inspectors raise serious concerns over ERI maternity care - Susan Dalgety
Childbirth without good healthcare is dangerous. While giving birth in a rich country like ours is now mostly a safe medical event, it remains dangerous in low-income countries, particularly in sub-Saharan Africa, which accounts for 70 per cent of the world’s maternal deaths.
But there was a time when giving birth in Edinburgh was as dangerous as anywhere in the world. My first husband’s grandmother often spoke about her dice with death after childbirth.
She contracted puerperal sepsis (childbed fever), and would have died if her doctor had not intervened. She was one of the first women in the country to receive penicillin, which saved her life.
I suffered pre-eclampsia with both my pregnancies, and if it had not been for an emergency caesarean, my youngest son would have likely died at birth. Home births may be fine in theory, but I have always been a big fan of well-equipped maternity hospitals and expert midwives.
So, I was alarmed to read the serious concerns raised by healthcare inspectors about the maternity unit at Edinburgh’s Royal Infirmary (ERI). A report by health watchdog Healthcare Improvement Scotland (HIS) makes for difficult reading.
It highlights worries about patient safety, shows evidence of mistakes in medication made by student midwives and describes staff shortages and a lack of visibility by senior management.
Unbelievably, the number of women experiencing tear injuries during childbirth at the ERI has been above average for almost a year. These injuries, which are avoidable, leave women at risk of long-term pain and incontinence.
HIS found 26 areas where the required standards have not been met, including delays to the induction of labour. Some women were forced to wait for more than a day for the procedure to start. Others were left alone for hours on end, without access to help or even a call bell to ask for support.
And worryingly, staff told inspectors of their fears for the safety of both women and their babies while in the care of the hospital.
Health Secretary Neil Gray has expressed his deep disappointment and concern at the report’s findings and said he has sought reassurances from NHS Lothian’s chief executive, Professor Caroline Hiscox, that she will act immediately to implement the watchdog’s recommendations.
She in turn has apologised to the women who use the Capital’s maternity services and promised the issues are being taken “extremely seriously”.
It is clear from the report that it is a toxic culture as much as a lack of resources that is the problem in Edinburgh. There is poor communication between staff and patients. Staff feel overwhelmed and unsupported. Women describe being abandoned by the system.
The sorry – in fact, downright dangerous – state of the city’s maternity services leaves me with the uneasy feeling that NHS Lothian simply doesn’t care enough about pregnant women to provide a proper service.
In light of the damming report, the Scottish Government has set up a national Maternity and Neonatal Taskforce to listen to “women’s experiences of maternity services”.
But this is 2025, not 1925. Scotland’s NHS should know exactly what women need for a safe and happy childbirth. And they should be able to deliver it.