Engender blog

New report reveals devastating impact of Covid-19 on access to pregnancy and maternity services 

Engender and the Health and Social Care Alliance Scotland (the ALLIANCE) have today published a new report spotlighting women’s experiences of pregnancy and maternity services during the Covid-19 pandemic. 

The report, ‘“Trauma, abandonment and isolation”: Experiences of pregnancy and maternity services in Scotland during Covid-19’, draws on survey responses from over 200 women across Scotland. It documents the profound and negative impact that public health restrictions had on access to vital healthcare across all aspects of these services from antenatal care, fertility treatment, to miscarriage and baby loss, birth and the postnatal period. 

Key findings include: 

• Confusing, contradictory and limited communication about Covid-19 mitigation measures caused extreme anxiety and distress for pregnant women. 
• The shift away from in-person care to remote appointments was a barrier to adequate standards of care. 
• Isolation as a result of restrictions negatively affected all aspects of pregnancy and maternity care. Women underwent invasive procedures, gave birth, and suffered miscarriage and baby loss without support, suffering trauma as a result. 
• Inflexible and inconsistent application of guidelines across different health board areas and health settings led to uncertainty and perceptions of unfairness. 
• A narrow focus on labour and delivery meant wider health needs were overlooked, including mental health and breastfeeding support. 

• Gendered health inequalities, such as pain management and the lack of an intersectional approach, were exacerbated by the pandemic. 
• Ongoing impacts include gaps in mental health support and experiences of trauma relating to isolation and poor care. 

Jill Wood, Policy Manager at Engender, said:

“This research indicates that Covid-19 guidance and its application fundamentally failed to take account of women’s diverse needs and experiences during pregnancy and early motherhood. Confusing and contradictory communication, lack of in-person care and support, inflexible restrictions and inconsistent approaches across health board areas all undermined access to safe, dignified and quality healthcare.”

“The trauma caused by attending procedures and giving birth alone and the subsequent isolation, lack of support and adequate care, will stay with women long into the future."

"Scottish Government must learn from this, improve maternal health more broadly, and  deliver on commitments on women’s health.” 

Jane Miller, Academy Programme Manager at the ALLIANCE, said:

“Pregnancy and early parenthood can be challenging at the best of times. Our research shows that mitigation measures brought in during the pandemic exacerbated isolation and anxiety for many women in Scotland.” 

“There is now an urgent need to centre the experiences and priorities of women in the ongoing Covid-19 Inquiry, and in the development of any future emergency guidance regarding healthcare. We must mitigate the risk of isolation and adopt flexible, person-centred approaches grounded in human rights and gender equality.” 

A research participant said:

“It is essential that Scotland learns from people's experiences during the pandemic to improve maternity services and public health messaging. To do otherwise would be to fail, and further compound the trauma, of thousands of parents over the last few years.” 

The report concludes with a series of recommendations aimed at the Scottish Covid-19 Inquiry and decision-makers in Scottish Government and health bodies. It highlights the need for a gendered and human rights approach to crisis management regarding healthcare, and for policy and services to take account of women’s particular experiences and needs at all life stages. 

The report will be submitted as evidence to the Scottish Covid-19 Inquiry. 

Read the report online here.

Call for expert working group on decriminalisation of abortion accepted by Scottish Government

Abortion care in Scotland is in urgent need of modernisation, with the current framework acting as a drag on services and as a barrier to timely access. In June we wrote to the First Minister on abortion rights, alongside 16 other equalities, abortion and health organisations. In the letter, we welcomed the commitments made on the leadership campaign trail and called for creation of an expert working group on decriminalisation of abortion.

We are delighted that this suggestion has been accepted by Scottish Government. We now look forward to sharing how women in Scotland can feed into the review of current structures, and to Humza Yousaf’s commitment on decriminalisation being set out in this year’s Programme for Government. Read the letter and see a list of signatories below.

Dear First Minister,

We hope this letter finds you well and congratulate you on your appointment as First Minister of Scotland.

During your leadership campaign, we welcomed your commitments to protecting and advancing abortion rights. The implementation of nationwide buffer zones, consistent provision of abortion care for all that need it, and removal of abortion from the criminal justice system are vital elements of modern abortion healthcare in Scotland. We also need action to tackle growing capacity gaps across services, to ensure equality of access to person-centred abortion care, and to ensure that NHS staff are working in fully equipped and well-resourced services.

Steady progress has been made regarding abortion in recent years. The NHS Scottish Abortion Care Providers Group has worked closely with Scottish Government to advance commitments set out in the Women’s Health Plan, including early medical abortion at home, telemedical care, and improved provision of mid-term abortions across the country.

We now look forward to further progress under your leadership, and to working with the Scottish Government and Women’s Health Champion towards delivery of your commitments. We are aware that Scottish Government already has regular engagement with the NHS Scottish Abortion Care Providers Group, which will, of course, continue to be invaluable. Building on your commitment to move forward decriminalisation of abortion, we believe that an expert working group would be of assistance to Scottish Government Ministers on this topic, and would welcome the opportunity to discuss this further.

Women's economic, social and cultural rights in Scotland

We recently submitted a shadow report, signed by 20 organisations, to the Seventh periodic report of the government of the United Kingdom on measures taken to give effect to ICESCR. In this blog, we share our gender edit of the List of Issues published by the CESCR Committee and take a look at some key issues raised.

The UN Committee on Economic Social and Cultural Rights is currently examining the UK on its performance under ICESCR (the International Covenant on Economic, Cultural, and Social rights). In 2022, the UK submitted its state party report (including input on devolved matters from Scottish Government), and the Committee received ‘shadow reports’ from civil society. Earlier this year we submitted a shadow report, co-signed by twenty organisations, which maps women’s rights in Scotland across the articles of ICESCR and highlights potential areas of focus for the Committee’s scrutiny. You can read more about our shadow report here.

Safe access to abortion services in Scotland

Engender recently submitted a response to the consultation on the proposed Abortion Services (Safe Access Zones) (Scotland) Bill. We’ve given a brief rundown of key points in this blog. You can access the full submission here, which covers the specific questions raised in the consultation around implementation of safe access zones locally and nationally, the size of potential safe access zones, the effect of current protests on women and staff, as well as the impact on human rights and other measures needed to improve abortion services in Scotland.