IT began as a small clinic in Glasgow, often sneered at for the work it did to help pregnant women with drug, alcohol, HIV and mental health problems.
But the system used at Glasgow Women’s Reproductive Health Service, set up in 1990, has now helped to model similar services around the world.
The guidelines and recommendations used by the clinic, now known as the Special Needs in Pregnancy Service (Snips), are now in place UK-wide and internationally recognised as the correct way to treat socially disadvantaged mothers-to-be.
Dr Mary Hepburn was the driving force behind the introduction of the clinic after fighting for years for a change in the way women from such backgrounds were dealt with by the health system.
The consultant obstetrician and gynaecologist has now travelled around the world with Unicef helping to set up maternity services in Russia, Moldova, Ukraine, Kosovo, Romania and India -– particularly aimed at preventing the transfer of HIV from mother to baby.
And a recent visit by the Duke and Duchess of Cambridge to a Canadian charity modelled on the Glasgow clinic, which was officially opened by Prince William’s mother, Princess Diana, has again thrust the project into the spotlight.
Dr Hepburn said: “This wasn’t a defined career path for me, it just seemed to happen. But one of the huge privileges has been working with some incredible people worldwide, and meeting some inspirational women, a lot of whom are involved in doing a huge amount of good work in their local community.
“I’m very proud Glasgow was at the forefront of this and proud of what we achieved there.
“Obviously it sadly means that Glasgow has such a high level of deprivation, but I’m pleased and gratified we have been able to use that for a good purpose.”
Dr Hepburn came to Glasgow in the 1980s when drug use was rife and the HIV epidemic was beginning.
She quickly realised women from deprived backgrounds were not attending maternity services and began to question why.
“The problem was so great, but when I asked about it, I was told ‘oh, that’s just the women’.
“But that wasn’t true, and even if it were true, we still needed to do something about it.”
The medic soon discovered the services were very judgmental of the women, who did not want to attend because they did not see the service as relevant to their lives.
She began to argue the case of treating them with a specialist service, in a similar way to mothers with special medical conditions, such as diabetes.
Dr Hepburn said: “I was just in the right place at the right time. There was already a sea change towards treating these women differently and I was able to argue successfully for these guidelines to be introduced.”
The new clinic created a multi-disciplinary service for deprived mothers, with midwives and medical staff working closely with social work and addiction services.
In the first year, it had just 12 patients, but that number grew to 64 in the second, then to more than 130 in the third.
Figures from NHS Greater Glasgow and Clyde now show about 300 women a year attend Snips, which has also had many visitors from around the world coming to Scotland to study the model.
Women from disadvantaged backgrounds are now much more likely to attend maternity appointments, while Dr Hepburn, who has now retired from the service, said she did begin to see more mothers able to keep their babies and fewer crises in pregnancy.
However, she warns that with the gap between the rich and the poor growing, health services are now seeing even more poverty-related illnesses.
“We are not able to deal with these problems in one generation, we can’t expect perfect outcomes, but at least women are engaging with services,”she said.
“The model is now recognised as the appropriate way to treat women. That’s what I feel most happy about. We’ve made progress – we’ve not by any means dealt with the problem, but at least there is an agreement in place.”
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