Rapid engagement with recent users of maternity services to inform the Maternity Services Independent Review

This document presents the findings from a rapid engagement exercise conducted by Healthcare Improvement Scotland in July 2026, aimed at gathering views from individuals with recent experience of NHS maternity services in Scotland. The engagement was designed to inform the Scottish Government’s Independent Review of Maternity Services by exploring priorities for improvement, expectations for change and how women, parents, and families should be involved in shaping future maternity care services.

Introduction and engagement approach

Healthcare Improvement Scotland used two engagement methods: in-person pop-up sessions and online conversation cafés, both utilising structured questions to explore experiences and suggestions related to maternity care. Recruitment targeted community groups supporting parents and families, resulting in 27 participants from seven NHS board areas, including diverse perspectives from ethnically diverse communities and one care partner participated as a father. The engagement aimed to capture timely, qualitative insights rather than statistically representative data.

Key Findings

What matters most in maternity care

Participants emphasised that the quality of maternity care is defined not only by clinical safety but also by the quality of relationships.

Feeling listened to, respected, informed, and supported were central to positive experiences.

Compassionate, trauma-informed, and psychologically safe care was highlighted as essential.

Clear communication and the ability to make informed choices fostered trust and control.

Continuity of care and person-led approaches that involve families and provide coordinated support throughout pregnancy, birth, and postnatal periods were valued.

Safety concerns extended beyond clinical measures to include reassurance and support.

What works well and areas for improvement in maternity care

Positive experiences were linked to compassionate relationships, consistent midwifery support, clear communication and involvement in decision making.

Participants appreciated being listened to and taken seriously.

However, challenges included staffing pressures, long waiting times (including triage waits of up to 8–9 hours), inconsistent follow-up, and gaps in communication and coordination.

Aftercare was frequently cited as an area needing improvement, with calls for more time and support post-birth.

Equity and consistent service provision across locations were also concerns.

Priorities for the national review of maternity services

Participants wanted the review to focus on foundational elements: adequate staffing, high-quality clinical care, continuity of support, and clear communication. Staffing shortages were seen as a root cause affecting safety and quality. The review should consider the entire maternity journey, from prenatal care through birth to antenatal care, in both community and hospital settings. Human connection, empathy, respect, and trauma-informed care were seen as a priority. Enabling informed choice through clear, consistent communication was also prioritised.

Desired changes and improvements

Participants sought practical improvements in everyday maternity care, including better staffing and resource allocation to reduce stress and improve outcomes. Enhanced communication with both women, parents and families was desired, alongside care that feels compassionate rather than rushed. Improved postnatal support, including opportunities for birth debriefs, physiotherapy, and specialist services, was a key concern. Participants also wanted services to be more responsive to feedback, emphasising listening, respect, and person-led care. Reducing variation and improving equity in service quality were also highlighted.

Involvement of women, parents, and families in shaping services

Participants expressed a desire for ongoing partnership in shaping maternity services rather than one-off consultations. They recommended continuous feedback mechanisms, co-design approaches, and shared decision making. Practical suggestions included a dedicated contact point for feedback, education sessions from staff to patients to empower self-advocacy, and regular opportunities for input throughout the maternity journey. Trusted professionals like midwives and health visitors were seen as key facilitators for engagement. Inclusive involvement of partners, families and diverse communities was stressed, along with transparent demonstration of how feedback influences change.

Responses when care does not go as expected

When care falls short, participants advocated for compassionate, transparent responses that provide emotional support and honest explanations. Standard debrief sessions, clear communication about what happened, and outcomes of complaints were considered essential. Services should demonstrate accountability by investigating incidents, acknowledging errors, and communicating lessons learned. Participants emphasised the importance of using adverse experiences as opportunities for learning and for making visible improvements in practice, staff development and service delivery to enhance future safety and quality.

Conclusions

The engagement suggests that participants are not primarily seeking entirely new models of maternity care. Rather, they want maternity services to consistently deliver the fundamentals well.

Relationships and communication are central to good maternity care: Participants consistently described positive experiences as being shaped by feeling listened to, respected, informed and supported. Compassionate, person-led, and trauma-informed approaches were viewed as fundamental to quality care alongside clinical expertise. Clear communication was considered essential for building trust, supporting informed decision making, and helping women and families feel safe throughout their maternity journey.

Safety, quality, and experience are closely interconnected: Participants did not view safety as solely a clinical issue. Instead, they linked safety to staffing levels, communication, continuity of care and the ability to raise concerns and be heard. Physical and psychological safety were both seen as essential elements of high-quality maternity care. This finding aligns with Healthcare Improvement Scotland’s definition of “quality” in which care is safe, effective, equitable, person-centred, accessible, efficient and integrated³.

Staffing pressures affect both care quality and experience: Many of the challenges identified by participants, including waiting times, inconsistent support, communication difficulties and reduced continuity of care, were attributed to workforce and service pressures. Participants frequently viewed adequate staffing as a prerequisite for delivering safe, responsive and person-led care.

Continuity, coordination, and postnatal support require greater attention: Participants valued ongoing relationships with maternity professionals and described continuity of care as important for trust, communication, and personalised support. At the same time, postnatal care emerged as a significant area for improvement, with participants calling for better follow-up, access to specialist support, opportunities for birth debriefs and more coordinated support after birth.

The review should focus on the whole maternity journey: Participants emphasised that maternity care should be viewed as a connected pathway rather than a series of separate services. They wanted improvements that span pregnancy, birth, and the postnatal period, ensuring that communication, coordination, support and clinical care work together to provide a consistent experience.

People want meaningful involvement and visible learning: Participants wanted women, parents and families to play an ongoing role in shaping services through feedback, co-design and shared decision making. They also expected services to learn transparently from concerns, complaints and adverse experiences, demonstrating how feedback has informed improvements to care and outcomes.