Scotland's maternity services have hardly improved in the 50 years since I gave birth – Susan Dalgety

I was 19 years old, single, 65 miles from home and suffering severe pre-eclampsia, a condition of pregnancy that, if left untreated, can lead to strokes, kidney failure and still birth. Before I had been wheeled down to the Dumfries labour ward on the morning of July 10, I had spent the previous six weeks on complete bed rest, fed a daily diet of strong sedatives and prodded and poked by an aloof consultant and a constant stream of curious students.

I had no smartphone and very few visitors to distract me, only jigsaws and dog-eared women’s magazines. I passed my long days and even longer nights carefully measuring my urine output and liquid input. Woe betide me if I missed a glass of water or forgot to log a bed pan.

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A lasting legacy of a dangerous pregnancy

The ward sister had a sharp tongue, and if she had a heart of gold, she hid it well. It was the 1970s in rural Scotland and I – a pregnant university drop-out – was “no better than I should be”. My only saving grace as far as she was concerned was that I was not giving the baby up for adoption.

At nearly midnight, I gave birth. The umbilical cord was twice wrapped round my tiny son’s neck, so there was a moment of drama while he was freed from the noose – if I had been at home and alone, it would likely have strangled him before he took his first breath.

Chronic high blood pressure is the only lasting legacy of my dangerous pregnancy, and as I watched my son yesterday, celebrating his 50th birthday with his wife and three children, I was grateful that five decades ago, I had received such good, if impersonal, care.

Fifty years on and one of the most significant health policy issues facing Scotland is maternity services. In just five years, between 2019 and 2024, there were around 500 mother and baby deaths. Health Improvement Scotland (HIS) found there are widespread issues, including bullying, poor training, understaffing and unnecessary delays in induction. Women living in areas such as Caithness and Wigtownshire still have to travel long distances for consultant-led maternity care, just as I had to in 1976.

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Maternity services in ‘crisis’

Last month, under pressure from campaigners, the Scottish Government announced an independent review of maternity services, chaired by Professor Christine McCourt, one of the UK’s leading experts in maternity care. The review, expected to take ten months, will examine a range of issues, from culture to rural services, but the recently appointed independent Patient Safety Commissioner, Karen Titchener, is not impressed.

She told the Sunday Post last weekend that “our maternity services are in crisis” and she supports calls for her remit to be expanded to include them. “It is just not enough to know what good maternity care looks like in Scotland. We need someone independent to systematically check what is actually happening and be able to report that back to parliament without fear or favour.”

We also need a government and a National Health Service that understands and prioritises women’s health. It is a fact of life that Scotland’s 2.85 million women and girls have very different health needs to those of men and boys, not least because of our complex reproductive system, which though miraculous can also be life-limiting when it goes wrong, sometimes even fatal.

In almost all areas of medicine, women’s bodies react differently to men’s, from heart disease to cancer. A 2025 study shows that even hot weather has a worse impact on women than men, putting a bigger strain on our cardiovascular system.

READ MORE: SNP accused of 'abysmal' workforce planning over unfilled midwifery shifts

Swinney’s lack of interest in women’s rights

Yet one of John Swinney’s first acts as First Minister following the May election was to axe the post of women’s health minister. Instead, a junior minister, Maree Todd, now has responsibility for women’s health, abortion, child and maternal health and sexual/reproductive health, as well as the nation’s mental well-being, public health, alcohol and drugs, with sport thrown in for good measure.

Tackling Scotland’s shameful record of drug deaths, or challenging our complex relationship with drink, would seem a gargantuan enough task for a single politician, but adding women’s health to an already extensive portfolio suggests it was an afterthought by a male First Minister with little interest in women’s rights.

Bathgate and Linlithgow MP Kirsteen Sullivan, chair of Westminster’s cross-party group on endometriosis, has raised the loss of this “single dedicated voice on women’s health” in the House of Commons, and a coalition of healthcare and women’s organisations, led by the highly respected British Pregnancy Advisory Service, has written to Swinney urging him to reinstate the post, but he shows no sign of changing his mind.

For the past decade in Scotland, women have had to argue for their sex-based rights as far as the UK Supreme Court. Campaigners were dismissed as bigots for insisting that their biological sex was not an ‘identity’ that could be worn at will, but affected every aspect of their lives, not least their reproductive health.

We may be recovering from the madness that gripped the Scottish Government and the NHS – where the term “pregnant women” was deemed divisive and “birthing people” was used instead – but 50 years since I gave birth 65 miles from home, Scotland’s maternity and wider healthcare services have barely improved.

As the World Health Organisation observes, maternal health not only shows the quality of a country’s national health system, but is a strong indicator of women’s social and economic status. In Scotland, it seems that women are still considered second-class citizens.