Reducing Antenatal Health Inequalities: Outcome Focused Evidence into Action Guidance

This guidance details the specific actions needed to strengthen antenatal healthcare at NHS Board and national level.


I am delighted that this evidence into action guidance has been developed in response to the recommendation in the Equally Well Task Force report that ' NHS Boards should improve the capacity of antenatal services to reach higher risk groups and identify and manage risks during pregnancy'. I am launching this guidance alongside the refreshed Framework for Maternity Care in Scotland as a key component of the Framework's implementation.

High quality healthcare during pregnancy makes a crucially important contribution to the reduction of health inequalities at birth, in infancy, throughout childhood and across the whole of an individual's life course. We now know that the antecedents of many lifelong conditions and illnesses in the middle and later years have their roots in the antenatal period.

Improving universal antenatal healthcare and supporting women with multiple and complex health and social care needs will help improve the health of newborns and pressures on neonatal services as well as improve later outcomes. Crucially these improved outcomes will not only be health outcomes but will include educational, social and economic outcomes as well.

We know from the work of the child and maternal confidential enquiries, and other key evidence reviews, that some women and their babies are at higher risk of poor and unequal health outcomes. We also know that often it is those 'high risk' women who do not access and or benefit from antenatal healthcare. Equity in the quality of care provided is a key component of NHSScotland's healthcare Quality Strategy. Improving access to antenatal care and the quality of the care received amongst high risk groups must therefore be seen as a vital NHS contribution to wider early years work.

This guidance is based on the evidence gathered for the Early Years Framework, Equally Well and a recent rapid review of the evidence carried out by NHS Health Scotland to specifically inform this guidance. The actions detailed are specific to the NHS and lie within the remit and direct sphere of influence of NHS Boards. The Scottish Government will ensure the national actions detailed in the guidance are carried out to ensure NHS Boards have the support they need.

I am grateful to the antenatal working group and NHS Health Scotland for their work in developing this guidance. I know from the group's engagement with maternity services and other key stakeholders that this guidance is welcome. I am aware that staff involved in providing antenatal healthcare have a real enthusiasm to raise the profile of the important role of antenatal care so as to ensure that all women receive the information, care and support they need before their babies are born. I am therefore delighted to commend this guidance to NHS Boards and all services providing maternity care.

Shona Robison, Minister for Public Health and Sport

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