New mothers often laugh about the dreaded middle-of-the-night dash to hospital when contractions start, but it’s no joke if the hospital is more than 100 miles away, on a dangerous road in winter.

When Lynne Duncan went into labour with each of her three babies there was only a short distance to travel from her home in Wick to the town’s Caithness General hospital, where a consultant obstetrician was on hand when complications developed during two of her three births. But now the threat of closure hanging over her local hospital has forced Duncan to rule out the possibility of having a fourth child.

“It would be too risky to have a baby without a consultant on hand,” she reckons. “So, like first-time mothers, or women who have not had straightforward deliveries before, I would need to go to Raigmore hospital, more than 100 miles away in Inverness. I couldn’t leave my children and my husband — a council worker — doesn’t get paid leave, so it is impossible.”

From Greenock to Caithness, the closure or threatened closure of maternity units has provoked anger and concern. Last week a report by the Scottish Women’s Convention, an organisation funded by the Scottish executive, claimed the downgrading of maternity units means that women all over the country are being poorly served.

The report states that the consequences of centralising maternity services are greater than merely the inconvenience of long-distance travel. According to its findings, women who travel further to hospital are more likely to have caesareans and are at a greater risk of suffering from postnatal depression.

Unfortunately, these conclusions are at odds with some medical opinions and the policy of many health boards. Across the country there is a move towards closing or downgrading maternity units. The argument is that there are not enough babies being born to justify retaining full-time consultants. Instead, specialist units are being confined to larger hospitals with expert care on hand to deal with medical emergencies.

The report’s authors say they hope Andy Kerr, the health minister, will consider their findings and act upon the recommendations of maternity specialists. Kerr has yet to comment on the report.

“On the medical side, we don’t meet their numbers,” says Duncan. “But on the geographical side — for transport, location, weather and roads — then common sense dictates that we require a consultant. “There has been no death to a mother or child for many years, but it is just tempting fate to say that all mothers should be transferred.”

Her own experiences at Caithness General convinced Duncan of the benefits of giving birth close to home. Her first child, Emma, now seven, had to be induced and underwent a forceps delivery, overseen by a consultant. Her second child, Jack, four, was also a forceps delivery. Given her medical history, Duncan was advised to book into hospital in Inverness to give birth to her third baby. She refused and delivered Abigail in Caithness with the help of a midwife.

Concerns about the increased risks attached to travelling affect many expectant mothers, says Debbie King, who helped compile the maternity services report. “I think there are huge concerns where services are centralised. Distance will inevitably have a knock-on effect on how women choose to have their babies,” she says. “Safety issues are a huge concern if they need to travel one or two hours, sometimes much longer in bad weather.

“In Caithness, if they have to go to hospital early, the impact on home life is huge. Partners have to come up to visit, which has a social and economic impact on families and communities .”

A campaign to save the maternity unit in Caithness is already in full swing. “A woman and her baby died in the back of an ambulance 40 years ago, which was the reason why an obstetrician was appointed here,” says George Bruce, the chairman of North Action Group (NAG). “We don’t want to go back to those days.”

More recently, two emergencies could have had tragic consequences if a consultant wasn’t on hand. “If there had been no consultant and the women had had to go to Inverness, either they or their babies would have died,” says Molly Baikie, a former maternity nurse at Caithness and a NAG member.

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