Dramatic rise in Raigmore births for far north mums
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MORE expectant mothers from Caithness are having their babies delivered in Inverness as a result of a lack of specialist facilities within the maternity unit at Caithness General Hospital to cater for high-risk pregnancies.
Almost a third of women last year either chose or were recommended by staff to have their birth at Raigmore Hospital in Inverness due to the limited services available at Wick.
Out of the 288 pregnancies by women who are registered to live in Caithness, 89 of those gave birth at Raigmore – 30 per cent of the total and the highest rate on record.
This compares to seven years ago when 289 women from Caithness gave birth, with only 30 babies (12 per cent) delivered in Inverness.
According to the figures, released by NHS Highland, the biggest jump in recent years in the number of Caithness women giving birth in Raigmore was from 15 per cent in 2008 to 25 per cent in 2009.
Raigmore-based consultant obstetrician Russell Lees said the growing number of far north mothers giving birth in Inverness is not significant but said that services at Caithness General are not suited to cater for high-risk pregnancies.
He said: “There have always been a small number of mothers who choose to deliver at Raigmore but numbers have not changed dramatically in recent months.
“Their choice to come south reflects the relatively limited services available at Caithness General, such as no round-the-clock obstetric or anaesthetic on-site service, limited blood transfusion and intensive care facilities, and no neo-natal paediatric service.
“The majority of Caithness residents delivering here do so on the basis of medical and midwifery advice and are in the main high-risk cases.
“Raigmore did take an increased number of lower-risk inductions for post-maturity last year for a few months, when there was a midwifery staffing problem at Caithness General Hospital but those cases are now offered for delivery locally.”
The top-floor maternity unit in Wick is consultant-led with obstetricians and anaesthetists providing a service seven days a week with an on-call service in the out-of-hours period.
There is no intensive adult or neo-natal care unit and no consultant paediatric support on site and all women are screened to ensure any high-risk pregnancies are referred to Raigmore.
Unlike Caithness General, Raigmore offers an epidural service for pain relief in labour and, according to NHS Highland North lead midwife Mary Burnside, some women choose to go to the city hospital for this reason alone.
She said that the number of births at Caithness General depends on a number of variables but said more women choose to give birth in the county than travel south.
“The number of referrals for delivery at Raigmore will be dependent on previous obstetric history, medical conditions and also the fact that a normal low-risk pregnancy can change and become high risk at any point in the ante-natal period,” she said.
“It should also be noted that over the years we have seen an increase in the number of complex, high-risk cases on maternity caseloads. This is due to a host of changing health profiles such as an older age group of first-time mothers, advances in fertility treatments and the management of medical conditions, and an increase in the number of women with problems related to obesity and diabetes.
“These types of cases will be referred to the main consultant maternity unit at Raigmore, where specialist, intensive adult and neo-natal services are on site to respond to the potential complications that can occur with some of these conditions and health factors.
“Women have the right to choose where they wish to give birth and the advice given by professionals is based on clinical risk assessment and aims to ensure the best outcome for mother and baby.”
The maternity unit has been reviewed three times in the past decade, the last in 2010 when NHS Highland sought to do away with the three consultants and put midwives in charge of the unit.
Former Highland Health Board vice-chairman John Rosie said a review into how services at the maternity unit could be improved must be considered as part of the drive to create jobs and stem a fall in population in the wake of the rundown of Dounreay.
“When families consider moving to a new location, the two main things they consider are education and health services and, in particular, maternity services,” said Mr Rosie, one of Thurso’s three Highland councillors.
“We clearly want the best range of services available and that is becoming more important than ever in Caithness.
“A lot of energy will be required to attract young people to the county to work in the marine energy industry associated with the Pentland Firth. A lot of these people will have partners who will become mothers and it essential that the best maternity services are in place.
“It is important to emphasise getting the best services is more important than getting the most convenient services.”
