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ALLIANCE response highlights enduring systemic challenges and calls for more inclusive maternity standards

  • Area of Work: Policy and Research
  • Type: News Item
  • Published: 7th November 2025

The response welcomes ambition of draft standards but identifies key gaps in inclusion and communication

The ALLIANCE has responded to Healthcare Improvement Scotland’s (HIS) consultation on draft Maternity Care Standards.

Our response draws on lived experience evidence from ‘Trauma, Abandonment and Isolation’ – a 2023 joint research report by Engender and the ALLIANCE which captured the voices of more than 200 women about their experiences of maternity care in Scotland during the COVID-19 pandemic. While many of these accounts were pandemic specific, they also revealed long-standing systemic challenges within maternity services. Additionally, our response includes experiences shared during a focus group facilitated by the ALLIANCE, on behalf of Healthcare Improvement Scotland.

The ALLIANCE welcomes the ambition and overall direction of the draft standards, which mark a significant and positive step towards more consistent and person centred maternity care across Scotland. We particularly welcome the strengthened focus on continuity of care across the maternity pathway, more considered integration of mental health and wellbeing, the attention to bereavement and loss support, and the commitment to improving access to unscheduled and urgent care.

However, the ALLIANCE identifies several critical gaps that must be addressed to ensure women and birthing people’s rights are fully realised in practice. First, the ALLIANCE strongly advocates for the creation of a standalone standard on communication, recognising that effective and accessible communication underpins every aspect of safe, equitable maternity care. Second, the absence of abortion and limited reference to miscarriage are significant omissions. Finally, the standards should explicitly acknowledge the lasting psychological impacts of COVID-19 on those who were pregnant, gave birth or experienced loss during that period.

The ALLIANCE further recommends the additional priorities to strengthen the draft Maternity Care Standards;

  • Inclusion of care partners throughout full maternity care pathway
  • Integrating ongoing lived experience feedback loops
  • Greater emphasis on intersectionality and trauma-informed training
  • Ensuring accessible complaints process and information

You can read the full response via the resource links below.

Resources:

HIS draft Maternity Care Standards - ALLIANCE response - pdf version
Download PDF Document (367 KB)
HIS draft Maternity Care Standards - ALLIANCE response - word version
Download Word Document (362 KB)
Download all document resources

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