Meeting of the Parliament (Hybrid)

Meeting date: Wednesday, May 4, 2022

Official Report 1034KB pdf

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International Day of the Midwife

The final item of business is a members’ business debate on motion S6M-03813, in the name of Audrey Nicoll, on international day of the midwife, 100 years of progress. The debate will be concluded without any question being put.

Motion debated,

That the Parliament recognises the International Day of the Midwife on 5 May, which will celebrate 100 years of progress throughout the global midwife community; understands that this has included advocating for quality midwifery care to improve newborn and maternal health; recognises the vital role of midwives in Scotland in aiming to deliver person-centred, high-quality care for mothers and babies throughout pregnancy, birth and following birth; commends the positive impact that midwives can have on the health and life chances of women and babies; recognises what it considers the commitment of midwives caring for women during the COVID-19 pandemic and the impact on maternal mental health as midwifery services were modified, thereby impacting women’s choices during pregnancy and birth; acknowledges the policy, The Best Start: A Five-Year Forward Plan for Maternity and Neonatal Care in Scotland, to make care locally accessible, with midwives providing high-quality care to women across Scotland in homes, communities and midwifery-led and consultant-level services, and recognises what it sees as the pivotal role of educators, researchers and students, including those based at the Robert Gordon University in the Aberdeen South and North Kincardine constituency, in supporting the delivery of midwifery services in Scotland and beyond.

17:49  

I thank all members from across the Parliament for their support for the motion, and I extend my thanks to the members who will speak today in support of international day of the midwife, which will take place tomorrow, on Thursday 5 May. I realise that members will want to get up the road quite quickly this evening. I acknowledge the support for preparing for today’s debate from Fiona Gibb of the Royal College of Midwives and Andrea Lawrie, a former colleague of mine at Robert Gordon University.

I want to celebrate the role that midwives play globally in the holistic health and wellbeing of mothers and babies; the outstanding care and professionalism that was shown by midwives during the Covid-19 pandemic; and the important role of education in supporting the global midwifery body in their practice and in providing holistic maternal healthcare.

The theme of this year’s international day of the midwife is 100 years of progress. The theme marks the centenary of the International Confederation of Midwives, which currently comprises 143 midwives associations, representing over 1 million midwives across 124 countries. European midwives first came together at international meetings in the 1900s. In 1920, they formed the International Midwives Union, which later became the International Confederation of Midwives.

The ICM works closely with the World Health Organization, the United Nations, the International Council of Nurses and other global healthcare and non-governmental organisations to advance midwifery globally and improve sexual and reproductive, maternal, newborn and child and adolescent health through the delivery of a range of projects, including supporting education and training, strengthening services and capacity building, and developing leadership and advocacy skills, particularly for young midwives.

The publication “The Best Start: A Five-Year Forward Plan for Maternity and Neonatal Care in Scotland” sets out a vision for maternity and neonatal care that puts women, babies and families at the centre. The plan aims to support strong family relationships and to help reduce inequalities and deprivation, which can have longer-term health consequences for families.

Over the past two years, midwives have faced the extraordinary challenge of the Covid-19 pandemic. During a recent debate on perinatal mental health, I spoke about constituents who were worried for the mental wellbeing of their partner, sister or daughter who had just given birth or who was struggling with the choices that they faced as they awaited the birth of their new baby. Women have faced difficult decisions about the Covid-19 vaccine and the risk of adverse pregnancy outcomes. Black, Asian and minority ethnic women are at disproportionate risk of adverse outcomes from Covid-19, which is compounded during pregnancy.

There have been modifications to services such as home births. Sometimes, no birth partner has been present or women have attended scans or received devastating news alone, all of which profoundly impact on maternal mental health. The removal of choice and the prospect of giving birth alone significantly impact on holistic maternal health. Women in rural areas, who are already more likely to experience perinatal mental health problems, have faced particular challenges in accessing services. In that debate, I welcomed the minister’s response regarding the Scottish perinatal mental health pathways into care. In this week, which is also perinatal mental health week, I am delighted to acknowledge the new NHS Grampian community perinatal mental health team.

I turn to the wider global context. Although nearly 300,000 women die annually from preventable causes at or around childbirth, progress has been made to reduce preventable maternal deaths. According to the United Nations Population Fund, since the year 2000, the global maternal mortality ratio has fallen by 38 per cent, from 342 maternal deaths per 100,000 live births in the year 2000 to 210 in 2017. Many countries have halved their maternal death rates in the past 10 years. However, every death is a tragedy.

The United Nations report “The State of the World’s Midwifery 2021” highlights the positive impact of high-quality midwifery care on women and families and recognises midwives as core members of the sexual, reproductive, maternal, newborn and adolescent health workforce. In the face of Covid-19 restrictions and overburdened health systems, midwives became and remain vital for meeting the sexual and reproductive health needs of women.

Of course, delivery of high-quality care relies on high-quality education and training. I commend all our educators for the crucial role that they play in developing and delivering high-quality contemporary education to undergraduates, those already in practice and those returning to practice.

Scotland has a long history of innovation in midwifery education, with Joseph Gibson appointed the world’s first chair of midwifery by Edinburgh Town Council in 1726. The textbook for midwives that was written in the 1950s by Margaret Myles, a one-time resident in Aberdeen, has become a globally recognised essential text, which is now in its 17th edition.

The school of nursing, midwifery and paramedic practice at Robert Gordon University in my constituency has a strong reputation for producing skilled and compassionate graduates. The university was the first in Scotland to receive the United Nations Children’s Fund baby-friendly initiative gold award. That was a recognition of the university’s world-class training and commitment to global best practice.

Although today’s debate is celebratory, it is right to acknowledge the challenges that the profession faces with workforce shortfalls and service transformation. The Scottish Government has been committed to addressing those and other challenges, and I look forward to perhaps hearing a bit more about that from the minister in her response.

I could not be prouder to stand today for midwives and their associations ahead of international day of the midwife, as they stand for the rights, dignity and health of women, newborns and families everywhere. I hope that this milestone will offer an opportunity to value how global midwifery has evolved over the past 100 years and to acknowledge the next 100 years and what we as members can do to ensure that midwives in Scotland and beyond receive the enabling environment and support that they deserve.

17:57  

I congratulate my friend and colleague Audrey Nicoll on securing this evening’s debate and I thank her for advocating on behalf of the global midwife community and for highlighting the significant progress that has been made over the past 100 years in the fields of neonatal and maternal health. The debate gives us all the opportunity to recognise the crucial contribution that midwives make. We can all agree that our midwives are highly educated and skilled in ensuring that women and babies have safe and effective maternity care, and that babies receive the best possible start in life.

Although many people accurately picture midwives as supporting women in childbirth, they contribute far more, including antenatal and postnatal care, family planning services and breast and cervical cancer screenings. With counselling and information, they can also help to prevent female genital mutilation, support gender-based violence survivors and provide reproductive health services to adolescents.

It is not unusual for midwives to play the role of surrogate mother or partner for those who do not have close family nearby. That role has been particularly valuable throughout the on-going pandemic, during which expecting and new mums have faced the additional challenge of going through pregnancy without the usual support network that would ideally be available to all.

In my view, midwives, maternity support workers and student midwives have been the unsung heroes of the pandemic, putting their health at risk to provide excellent care to women and their families. Their impact on the mental and physical wellbeing of new and expecting mothers is impossible to quantify but, to say the least, we would be hard pressed to find a mother who is not thankful for the presence of their midwife, especially in the past two years.

When I had my daughter 32 years ago, the trainee midwife who looked after me at the time urged me to convince her supervisors to allow her to stay on after her shift had ended, just so that she could see the birth of my daughter through to the end. She was with me the whole time, and I was truly grateful for the kindness and support. That is just my personal experience but, even after all these years, that one act of kindness has always stayed with me. She could have just gone home after her shift finished, but instead she stayed. I know from countless other stories from parents that that is indeed business as usual, with midwives regularly going above and beyond their call of duty out of the goodness of their hearts.

Sadly, as recent headlines suggest, misogyny remains an ever-present issue that plagues our society. Thankfully, issues that specifically affect women are increasingly being given the attention that they deserve, but historically they have been denied. Globally, over the past 100 years, midwives have been on the front lines against misogyny, faced with the challenge of caring for and supporting mothers in societies that have often undervalued both midwives and women in general.

Fortunately, the midwifery profession is beginning to receive the praise and support that it deserves, partly because of the increased recognition of national health service staff as a result of the pandemic and just maybe through television shows such as “Call the Midwife”. Perhaps that has contributed to the 4.2 per cent annual increase in the number of midwives in Scotland.

However, with over 6,500 midwifery and nursing vacancies left to fill, which is a record high in Scotland, it is important that we all fully support international day of the midwife on 5 May, to show all potential and current midwives that they are valued, respected and needed. The absolute minimum that those in the midwifery community deserve is a day to recognise their contributions to Scotland and the rest of the world. Therefore, to all midwives out there, I say, “Happy international midwife day—you have more than earned it.”

18:01  

It is an honour to speak in the debate. This is my tribute to the extraordinary midwives in Scotland, in the UK and around the world—including my own sister, Cath, who has been a midwife for some 40 years. She says that she was “born a midwife”. For Cath, midwifery was a calling, and I know that it will forever remain a part of her, as it is for many midwives.

There is a remarkably special bond between women and their midwives. From antenatal appointments to the delivery room and the early postpartum period, midwives and the women in their care navigate the journey to new motherhood together. It is a truly unique partnership, and the Covid-19 pandemic brought that into sharp relief as pregnant women accessed antenatal services without the support of their partners. For many women, their midwives were all that they had.

Midwives provide care to mother and baby from those early weeks of pregnancy to the post-birth period, but they do so much more. It is a highly skilled profession, but their value too often goes unrecognised. They listen, they offer emotional support, they facilitate and they advocate. They see women at their most vulnerable and at their most empowered.

The journey is not always straightforward. Midwives help to bring new life into the world, but they also bear witness to the fragility of life. Debilitating pregnancy symptoms, complications during pregnancy, the devastating emotional and physical aftermath of baby loss, difficulties during and after delivery—those are just some of the profound and distressing challenges that a midwife must contend with.

During my own pregnancy, I had pre-eclampsia—a condition that affects more than 2,500 pregnancies in Scotland every year. My midwives spotted the signs and intervened. They saved my life and they saved my son’s life. I am eternally grateful to them for their wonderful and professional care.

Midwifery can be rewarding work, but it is often highly pressured and stressful. The past two years have been extremely difficult for midwives. They have continued to provide exceptional care to pregnant women and new mothers not just in hospital, but in the community, visiting new families in their homes, carrying out newborn check-ups and providing breastfeeding support at the height of the pandemic.

The Royal College of Midwives recently surveyed its members on their experiences in the workplace. The full results of that survey will be published next week, but a preview of its findings makes for alarming reading. Midwifery is “near breaking point”; three in four RCM members are considering leaving their posts; 88 per cent reported experiencing work-related stress; and 92 per cent worked without breaks over the past 18 months. Only 6 per cent of RCM members believe that their workplace is consistently safely staffed.

For the health and wellbeing of midwives, for the student midwives whom they train and for mothers and their babies, I implore the Scottish Government to respond to those findings. The Scottish Government’s five-year plan for maternity and neonatal care in Scotland, “The best start: five-year plan for maternity and neonatal care”, emphasises:

“The health, development, social, and economic consequences of childbirth and the early weeks of life are profound, and the impact, both positive and negative, is felt by individual families and communities as well as across the whole of society.”

Midwives have issued a clarion call. I do hope that the Scottish Government will act.

Carol Mochan is joining us remotely.

18:06  

I thank Audrey Nicoll for bringing this important debate to the chamber and the members who have spoken so far for their contributions. On behalf of Scottish Labour, I also welcome international day of the midwife, which is being marked tomorrow, and pay tribute to all those who have contributed to the development of the field as we celebrate 100 years of progress throughout the globe and the global midwife community.

It is right that I begin my remarks by noting and commenting on the work of midwives during the Covid-19 pandemic. The pandemic put significant pressure on all aspects of our health service, but midwifery is a very obvious example. In many cases, the partners of women who were giving birth were not able to be with them in the room, so a midwife would be their closest support during childbirth. For many of those women, their midwife would also be their trusted confidante when it came to taking up the offer of a Covid-19 vaccine—something that many pregnant women were understandably sceptical about in the early stages of the pandemic.

On that note, I pay tribute to the Royal College of Midwives for its strong calls for everyone to get the vaccine, importantly noting the impact that severe Covid-19 symptoms could have on both mother and baby and the potentially negative impact of women entering maternity wards without having been vaccinated. The work of midwives throughout the pandemic has been admirable. They have kept services running during the most difficult of times and have provided the support that has been required by so many.

However, there are clear and significant problems in midwifery surrounding the fact that there are over 5,000 vacancies in nursing and midwifery in Scotland at the moment and the feelings of many of those who are already employed in nursing and midwifery that they are underpaid, underresourced, and undervalued. It is expected that agency work will be relied on, in some instances, to fill the gaps. However, the scale of the agency support that is being provided to the Scottish NHS is simply unsustainable. More investment must be put into education and training to ensure that more young people who are leaving school consider a career in midwifery. It is an excellent career for many people.

The Scottish Government must act to pay nursing and midwifery staff the wages that they deserve, ensure that the workplace conditions that they experience daily are improved, and support a workforce that has been under pressure during the pandemic.

Ahead of last year’s Scottish Parliament elections, the Royal College of Midwives, as well as asking for the midwife staff shortages to be brought to an end, called for investment in midwifery to tackle social deprivation. As I have said many times in the chamber, health inequalities remain one of Scotland’s biggest challenges. I would encourage the minister to consider how midwifery services can continue to provide the best start in life for children, protect women as they go through pregnancy, and remain in contact with both mother and child in order to protect mental health and wellbeing and to promote choices for healthy living.

There has been significant progress in the global midwife community in the past 100 years, which is evident in the first-class treatment and services that many members have mentioned today, which are provided by midwives across Scotland and beyond. However, to ensure that, in 50 or even 100 more years, when similar debates are had again, we must have a collective endeavour to overcome the challenges that currently exist in workplace environments and in vacancies. Moreover, we must show collective ambition to use midwifery as a vehicle for tackling the social and health inequalities that continue to grow in our society.

Again, I welcome international day of the midwife and the contributions from all members, and I thank all the midwives in my region of South Scotland and beyond for the incredible work that they have done and continue to do in serving their communities.

18:10  

I congratulate my friend and colleague Audrey Nicoll for securing this debate to mark international day of the midwife, and I pay tribute to the work that she did when she was at Robert Gordon University Aberdeen, working with our student midwives and nurses.

Not so long ago, people could not study midwifery specifically; we trained nurses and they would go on to specialise in midwifery. It is a massive step forward that midwifery is now recognised as a complex and substantial clinical discipline in itself and that it is offered in Scotland as an undergraduate degree combining tutorials and lectures with comprehensive placements in all the disciplines within midwifery, from community midwifery and working on postnatal and antenatal wards to theatre work, infant feeding teams and perinatal mental health work, to name but a few. The Scottish Government has prioritised the training of midwives, along with the training of nurses and paramedics, for the allocation of support in the form of a non-means-tested bursary. Scotland is the only nation in the UK to do so.

We must, however, recognise that Robert Gordon University Aberdeen, Edinburgh Napier University and the University of the West of Scotland, which are the only universities offering this specialised undergraduate course, cannot currently meet demand because of the number of applicants who want to enter the field. I am therefore hugely supportive of more universities providing this specialist training. Action on the availability of training places might go a long way towards relieving the pressures on our existing workforce.

As Audrey Nicoll mentioned, the Health, Social Care and Sport Committee undertook an inquiry into perinatal mental health, which we reported on at the start of this year. Inevitably, a lot of the lived experience that we heard about came from mothers who had given birth during the pandemic. I will not rehearse the points from that debate, but it pointed to a wider theme that midwives in postnatal wards often cannot have the time that they would like to have to spend with new mums. It also highlighted that issues around infant feeding could give rise to anxiety and could be a precursor to more serious mental health issues. I want to praise, in particular, the work that is done in Aberdeen maternity hospital by the two-woman team of midwives, Gill Swinscoe and Karen Morrison, who spend time with new mums to give them the support that they need to breastfeed. The importance of that support cannot be underestimated.

As it stands, not every midwifery student gets to do a placement with an infant feeding team, but it is an area of expertise whose importance cannot be underestimated in the care of a new mother and baby. If feeding is going well, not only does baby get the best nutritional start in life, but the wellbeing of mum is significantly better, too. It may be billed as the most natural thing in the world, but it can be very hard and it does not automatically come naturally. Our midwife-led infant feeding teams in hospitals and our home-visiting community midwives are worth their weight in gold, not just because they safeguard the physical health of mother and baby, but because they identify perinatal mental health issues as well.

I will conclude—probably quite embarrassingly for one particular person—by declaring an interest, as my 19-year-old daughter Eve is currently in her second year of midwifery studies at Robert Gordon University Aberdeen, which is in Audrey Nicoll’s constituency. Eve is taking part in placements all over Scotland, from Raigmore hospital and Aberdeen maternity hospital to the communities in Aberdeenshire and, this month, in Edinburgh. It was all that I could do not to make my entire speech about her experiences and enthusiasm for her chosen profession—or, indeed, my incredulity and pride that, to date, my baby has herself delivered 14 other people’s babies. What a rewarding career awaits her. I wonder whether, in the years to come, I will be talking about her having had a lengthy career in midwifery such as Tess White spoke about.

It is not just the new recruits whom we must cherish; it is the existing experienced staff, of whom we have asked so much, particularly in the past two years. We must address the reasons why so many of our midwives feel burnt out, and we must act to address their concerns so that we can keep them in the service. Their experience is too precious to lose. I again thank Audrey Nicoll for the chance to pay tribute to them today.

18:15  

I thank my friend and colleague Audrey Nicoll for bringing this, her first members’ business debate, to the chamber. It gives us the opportunity to celebrate the hard work and importance of midwives in Scotland and around the world.

Having a baby is one of the most exciting times in any woman’s life, but it also comes with anxieties and fears, especially for first-time mums. The supportive role that midwives offer is key to women’s experience of their journey from pregnancy to holding their newborn baby and beyond. As the NHS Scotland website says,

“One of the most important aspects of the job is making sure mothers and their babies have a positive experience.”

Tomorrow is international day of the midwife, when we take the chance to celebrate 100 years of progress and the amazing role that midwives play in bringing a baby into the world. We look back at the long history of midwifery, from the howdie of the 17th century, to the nurse midwives of the 1950s and 1960s as depicted in “Call the Midwife”, to the midwives of today.

A woman’s journey to motherhood may be exciting, but it is also very scary. I remember that all too well from my pregnancies—the highs and the lows and often having to speak to my midwife to seek reassurance and make sure things were okay. At my first meeting with my midwife when pregnant with my first child she said, “After this you are gonnae be greeting at everything.” I laughed and said, “That is just not me”. Guess what? She was right. Midwives do know a thing or two.

We must also recognise that being a midwife is not an easy job. They also support women through traumatic events, including miscarriage and stillbirth. Their job, as Audrey Nicoll and others have already said, has been particularly difficult throughout the pandemic, when the support of partners, family and friends was not available due to Covid-19 restrictions.

The Scottish Government’s five-year plan, “The Best Start”, was a hugely positive development in this country’s maternity and neonatal care. The education and training body of NHS Scotland, NHS Education for Scotland, reported in March 2021 that implementing person-centred, relationship-based care as prescribed in “The Best Start” could bring significant benefits, such as reducing intervention, preterm births and foetal loss. That would ultimately reduce dependency levels and consequently workforce demand. The long-term effect of that could be significant, benefiting new mums while alleviating the pressure on our midwives, who are suffering due to high workload and burn-out. As our population changes and more women with varying needs are having children later in life, I welcome a continued focus on implementing “The Best Start” plan.

In conclusion, a midwife on the BBC’s brilliant docu-series “Yorkshire Midwives on Call” said:

“Every time I see a birth, I just think, ‘women are incredible’. Women really are amazing.”

My response is that midwives are incredible and midwives really are amazing. I, for one, certainly could not have done without mine.

18:19  

I feel like the token male, although it is important to hear a male voice in the debate. All the speakers have rightly said how good midwives are with the expectant mother and baby, but let me tell you, they are also very good with the fathers who are standing there probably causing more problems than the expectant mother.

I will make two brief points at the conclusion of the debate. The month of May is important for my family: my twin girls’ birthday is at the end of it. My wife went through quite a difficult pregnancy and I know the support that she and I received, and that we as a family received while going through that. As many people have said, midwives go the extra mile and they stay on longer. Both my sister and my mother-in-law were midwives. In fact, my mother-in-law was a midwife in Gateshead in the 1960s and 1970s and she still tells the story of waiting around for 24 hours in someone’s house for a child to be born.

We can see from watching things like “Call the Midwife” how things have progressed and the improvements that have been made in the last 30 or so years. It is important to acknowledge the work that goes on day in, day out, often unseen. We need to look at whether more universities should offer midwifery courses, because we do need more midwives in Scotland.

May, however, is also a difficult month for our family. Next Tuesday, 10 May, will be the 13th birthday of my little girl who was born asleep. The minister and I have spoken about this previously and I know that the SNP Government is moving on this, but when we look at what progress there has been, I think that more needs to be done for those who go through stillbirth or whose babies are born asleep. I know that the minister is looking at different reviews, but I would encourage her and the Government to move as quickly as possible on this. Again, I think that there has been progress, even in the last number of years, in regard to ladies going through stillbirth being able to be away from where other babies are being born. That is really important, as is the support that the third sector is getting in regard to supporting mums and dads when they go home. However, there is more that can be done. I know that the minister wants to do more and I encourage her and her colleagues to move on that.

The loss of any child is devastating. The death of a baby who is born asleep is hard. It is hard for the mum not just when it happens, but can go on for many years and can affect people’s lives. I welcome what the Government is doing, but encourage them to keep moving quicker.

18:22  

I am very pleased to be able to respond on behalf of the Government this afternoon as we mark the international day of the midwife. I thank Audrey Nicoll for lodging this important motion.

As my colleagues have highlighted, it is important to reflect as we celebrate 100 years of progress. In Scotland, we are very fortunate to have a highly educated, skilled and compassionate team of midwives who lead and deliver high-quality care that is so valued by women and their families during their pregnancy and, as we have heard many times today, as they prepare for their birth and the first few precious days and weeks with their baby. Our midwives support the whole family. We heard that very powerfully from Jeremy Balfour. That matters, because evidence tells us that experience in the early years can make a real difference to health and wellbeing later on in life, and support for new parents needs to start pre-birth.

I acknowledge of course that one of the greatest impacts and challenges of the Covid-19 pandemic in the last two years has been marked changes to maternity care, so let me begin by thanking every single midwife in Scotland and every young midwife in training—including Eve, and it was lovely to hear an update of her progress—for their dedication to the role and to the people of Scotland.

Despite those changes, colleagues have highlighted how midwives throughout the pandemic sustained their efforts to deliver person-centred, high-quality care for mothers and babies throughout pregnancy, birth and following birth. The pandemic has placed and continues to place demands on all front-line staff in a way that was previously unimaginable.

Does the minister agree that the latest RCM survey findings are alarming, with three out of four midwives considering leaving their post and only 6 per cent—that is 6 per cent—believing that their workplace is staffed safely? Will the minister please say what she will do to hear the midwives and act on what they are telling her?

Government will absolutely pay attention to that survey. We are in regular contact with the profession. Just yesterday I met a group of 12 midwives to hear some of their concerns about the implementation of “The Best Start” report in the area where they are working. I am absolutely determined that we will listen, we will learn and we will make sure that midwifery is sustainable well into the future, because it is a very precious resource.

We are absolutely incredibly proud of the midwifery response to the pandemic, they had to—as everyone else did—adapt to rapid change and demonstrated fully what a critical role the profession plays in very difficult times.

Midwives make a vital contribution to the quality and safety of maternity care. That is why the Scottish Government has invested over £16 million in reforming maternity care in Scotland, as set out in “The Best Start” report. It sets out a future vision for maternity and neonatal care that focuses on putting women, babies and families at the centre, and ensuring that they receive the highest quality of care according to their needs.

The pandemic highlighted the importance of certain aspects of “The Best Start” model of care and accelerated progress in many areas, such as providing care closer to home, the importance of partners’ support and involvement in care, and the ability of staff to work flexibly and across traditional boundaries.

The Scottish Government recognises the staffing challenges being experienced and the challenge that this presents in being able to implement a continuity of carer model. Midwives play a central role in making sure that women receive the care that they need, when they need it most. That is why, as part of that priority work, we are working with delivery partners to ensure that Scotland has the right midwifery workforce, in the right place, with the right skills and competencies. Growing our workforce is absolutely crucial. Student intakes have increased over 10 consecutive years, culminating in a target intake of 301 midwives for 2022. That is a 5 per cent uplift on 2021. It is absolutely vital that we have new midwives coming into the profession.

Midwives play a central role in all circumstances of pregnancy. Last year we committed to improving miscarriage care in Scotland in our Programme for Government. That included taking forward the recommendations made in The Lancet series “Miscarriage Matters”, alongside a commitment on the provision of dedicated facilities for women who are experiencing unexpected pregnancy complications. To enable us to gain a better understanding of health board readiness to implement both the Scottish Government commitments and The Lancet series recommendations, we have designed and are imminently to launch a questionnaire to gather information on the current service provision across Scotland.

We really appreciate respondents within the NHS taking the time and effort to complete the questionnaire so that we can better understand and improve miscarriage provision. We have already spoken with families who have gone through miscarriage and will consider how more women and their partners with lived experience can have an opportunity to inform the work and make the services stronger. I want to place on record my thanks to those families for speaking to us about such traumatic issues.

Colleagues have spoken today about the unique opportunity that midwives have to identify those at risk or in need of more support and the work that midwives do to ensure that those individuals get the care that they need at the earliest opportunity. The pandemic was a challenging time for women and their families, but all maternity services in Scotland were committed to offering women choice, taking account of their individual needs and the best available evidence for care options.

It is really important, as Tess White said, that we listen to staff on the ground and it is vital to learn from what is working well, to help services manage pressures effectively. The Government is committed to doing that and to strongly supporting recovery to improve satisfaction for women and midwives and, most importantly, to improve outcomes for women and their babies.

We have introduced the National Wellbeing Hub website for the whole health and social care workforce, their families, carers and volunteers, with advice, tips and signposting on a range of issues, including sleep, mental health and finance, and made over 1200 hours of coaching available to staff. We have also set up a dedicated wellbeing support phone line for NHS staff, hosted by NHS24, and are working with boards to ensure that staff have access to welfare facilities set up during the early stages of the pandemic.

We have lots to celebrate in Scotland and the international day of the midwife is a time for us to do that. We know that the public values and admires midwives but we may not always truly articulate their role. I really encourage midwives to proudly tell their stories so that we all develop a better understanding of the breadth and diversity of midwifery roles and expertise, and the impact that the profession has on individual people and on our society as a whole.

Presiding Officer, I would like to close the debate by thanking those who have shared today. I also want to recognise the dedication of educators, researchers and students, including those based at the Robert Gordon University and beyond, who are all working with us to ensure delivery of the best midwifery services.

I absolutely agree that our midwives are a precious resource and I am delighted to celebrate them. I assure them that the Government values their work and the difference that they make to Scotland.

Meeting closed at 18:30.