ABSTRACT
A representative survey of antenatal care in Scotland in 1989 demonstrated a very standard package of consultant-led shared care with virtually all deliveries taking place in hospital settings. In Scotland CRAG-SCOTMEG’s Working Group on Maternity Services had given recommendations for planning and provision of maternity care. In exploring the difficulties of interpreting trial evidence of clinical effectiveness and costs as well as patient and staff satisfaction in alternative models of maternity care, some of the possible barriers to implementation may have been highlighted. There is no single objectively correct definition of equity and the equity of access by patient preference as described above, is only one possible definition. NHS maternity services have been at the forefront of progress towards efficacy in health care provision. Recent government policies continue to seek clinical effectiveness and efficiency throughout all NHS services and also emphasise that care should be patient-focused, with improved continuity, and include the patient in choices and decision-making.
