Implementing A Framework for Maternity ... - Scottish Government

Risk assessment and management
6. The mother and baby are the focus of risk assessment and management. Risk assessment
should be based on the understanding that certain risk factors may rule out a particular
option for childbirth rather than determine where the mother should deliver, and should be
reviewed regularly throughout the pregnancy.
Principles
2.6 Risk assessment should be based on exclusion rather than inclusion criteria.
7. Risk assessments carried out in clinical areas have tended to concentrate on clinical issues
such as general medical and surgical health and obstetric history. These are unquestionably
important, but consideration must also be given to non-clinical factors, such as:
• geography and predicted weather conditions
• nature, condition and use of available emergency equipment
• nature of emergency back-up and support
• transfer arrangements.
Principles
2.7 In addition to clinical factors, services should also consider non-clinical factors in risk
assessment.
8. Attention must also be paid to the existing evidence from research and audit which
demonstrates that avoiding medical interventions in women with low-risk pregnancies has
positive outcomes. Problems may arise in any pregnancy, however. Some of them will be
serious or life-threatening, with one in 1,000 mothers per year requiring admission to
intensive care units in Scotland. Services must ensure they have assessed risks in each
case and planned responses appropriately.
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