Fears of increase in roadside births after maternity unit mothballed for a second time

Doctors and campaigners have said they fear roadside births will increase and claim rural cancer patients get less specialist care, with poorer survival, as services are centralised.

They are calling on the Scottish Government to address what they have described as “inaction” from health boards tasked with reviewing how services are performing.

The calls come as a maternity unit in South West Scotland was mothballed again this week - meaning a 140-mile trip for expectant mothers continues.

Galloway Community Hospital in Stranraer, where women with low-risk pregnancies could give birth, was shut in 2018 due to low staff numbers.

It has meant over the past six years, families have had to make the 70-mile trip to Dumfries to have their babies delivered.

Mothers have spoken about how they have ended up giving birth on the side of the road since the unit was first closed, with one woman explaining she had her child in 2021 "in a lay-by on the Gatehouse bypass" after not getting to the main hospital in Dumfries, 50 miles from her home, in time.

Former GP Dr Angela Armstrong, who worked in Galloway, said: “I’ve been horrified that over the years since it closed, women have been in touch saying they had to give birth on the side of the road.

“I am afraid this will increase and it won’t stop and there’s a chance it will become worse.

“I don’t think the health management understand what it’s like for people living far away from hospitals.”

An independent review, however, decided the maternity unit will remain closed “for the foreseeable future”, with chairman of the board Andy McFarlane saying there is “confidence in the maternity services as they stand currently across the region, including Wigtownshire”, where the unit used to run.

In the Highlands, the Caithness Health Action Team (CHAT) has been fighting an eight year-long battle to reverse the downgrade of the region’s maternity unit in Wick on behalf of local women who regularly have to travel 200-mile-plus return trips to Inverness for maternity appointments.

Meanwhile on Skye, there has been growing anger that improvements to health services recommended six years ago have not been fully implemented.

An independent review in 2018 said the out-of-hours service at Portree Community Hospital (PCH) should be available 24 hours a day, seven days a week, but the Skye Save Our Services (SOS) group said it is still waiting for changes to happen.

Deputy First Minister Kate Forbes called for an investigation this year after saying she was "hugely concerned" by reports that emergency access to PCH was limited when a woman took unwell at a local festival and died.

Scotland's first minister also had to apologise to a woman earlier this year who nearly died while waiting almost an hour for an ambulance after going into anaphylactic shock. Eilidh Beaton, 27, was just 200 yards from PCH when she suffered a severe allergic reaction, only to find the medical facility was closed and all available ambulances were on other calls.

John Swinney said the recommendations were made “some years ago”, and “it is a matter of deep concern to the government that that has not happened.”

The widespread concerns have been formalised in a letter, seen by The Scotsman, signed by two former GPs and leaders from CHAT and SOS.

The letter reads: “Rural Scotland is awash with health boards’ inaction following expensive reviews: Skye and Wigtownshire acute services, Wigtownshire cancer, Caithness and Wigtownshire maternity reveal a need to change yet years later remain undelivered.

“Data shows rural cancer patients get less specialist care with poorer survival. Unaccompanied roadside births in transit are increasing for rural women. A/E services in Skye have recently been cut with a near miss fatality incident.”

While there is no specific data on the number of roadside births for Scotland, the number of women travelling more than one hundred miles from Caithness to give birth is increasing, records show. Only eight women had their babies at the region’s General’s midwife-led unit in Wick in 2022. In 2015, when the unit was consultant-led, there were 266 births. A few more – less than five according to official figures – were born in the hospital’s accident and emergency unit but the vast majority of mothers were travelling several hours to Inverness to give birth. 

The same happens in Wigtownshire, where former obstetrician and GP Dr Gordon Baird, said: “There hasn’t been a planned birth in Wigtownshire for about five years, maybe one. They happen in Dumfries, which means you have these mothers travelling 75 miles in some cases to give birth.”

Dr Baird, one of the signatories on the letter, said he found the decision not to reopen the mothballed maternity unit “extraordinary”.

The review, which led to its closure, said: “The rates (births in transit) for Dumfries and Galloway are not significantly different from those for the rest of Scotland.”

Dr Baird said this was “misleading” as the risks in the region are different to other areas: parked at the roadside of the A75, he said, is “dangerous and illegal”, and the “remoteness from a warm dwelling and absence of phone signal add risk.”

The review also concluded: “There are a number of areas that have similar distances between rural areas and their main delivery suite, for example Argyll and Bute and the Highlands.”

Dr Baird said this was also misleading as, unlike the current maternity care plan in Dumfries and Galloway, other maternity units it was compared to “have local 24/7 midwifery, effective ambulance protocols and medical support available.”

He also pointed out the review revealed one in four Wigtownshire households has no access to a car or van, which he said was “given little significance in the conclusions.”

Dr Baird added: “We have to escalate this to the Scottish Government. We are looking for a formal advocacy process because there is no meaningful connection between what’s going on here where people live, what the health board perceives, and what the executive tells them. The politicians are even further from it.”

Dr Armstrong, who also signed the letter, said: “If you look at Stranraer, the statistics show this area is one of the most economically deprived areas in Scotland.

“Lots of people don’t have cars, the buses are becoming non-existent, so are the trains, so how are these mothers supposed to get to Dumfries?

“On top of that, the A75 between Dumfries and Stranraer isn’t dual. There’s a lot of traffic from the farming community here and the lorries travelling back and forth from the ferry that leaves from near Stranraer.

“The decision to not reopen the maternity unit here is dangerous, and we need to do something about it.

“Along with Skye and Caithness, we are going to escalate this to the Scottish Government.”

The Scottish Government did not respond to concerns raised in the letter, but on the maternity unit in Wigtownshire, a spokesperson said: “Following an independent local review of maternity services, NHS Dumfries and Galloway has decided to keep their current service model which has been in place since 2018.  

“Women in the Stranraer area continue to have the option of a midwife-led home birth and care for women before and after birth will remain the same as it is now and will either be provided at home, the Oaktree Family Centre in Stranraer or for more complicated cases, at Dumfries and Galloway Royal Infirmary.”