MORE than half of mothers in Scotland are overweight or obese for the first time and the number giving birth aged over 45 is at a record high.

A report on maternity care in Scotland warns that the increase in older and overweight mothers who are at greater risk of complications during pregnancy and birth is piling pressure on midwives at a time when vacancies have soared.

Read more: Births to mothers over 45 growing faster in Scotland than anywhere else in UK 

While the Royal College of Midwives (RCM) stressed that the staffing situation is "much better"compared to England and welcomed the Scottish Government's investment in training new midwives, it flagged concerns over shortages in the north of Scotland and the threat posed by a sudden exodus of midwives to retirement with 40% of the workforce north of the Border now aged over 50. This compares to 32% in England.

The 'State of Maternity Services' report found that 51% of pregnant women in Scotland in 2017 were obese or overweight, the first time the proportion has exceeded 50%.

This puts them at greater risk of gestational diabetes, high blood pressure, and premature birth.

Meanwhile, a total of 158 babies were born to women aged over 45 last year - the highest number to date, and up from 29 in 2000. The number of births to women aged 40 to 44 has increased 68% over the same period.

On average, older mother require more care and support during pregnancy and birth as they are more likely to have complex medical conditions or be giving birth to twins and triplets on account of IVF.

Read more: Risk of heart attacks and strokes increases the more children a woman has 

The report states that these demographic trends have contributed to an increased workload for midwives despite falling birth rates.

At the same time, the vacancy rate for midwives has increased from 1.3% in September 2013 to 5% in March 2018 - equivalent to 127 empty posts.

Recruitment problems are toughest in Grampian, Highland and the Western Isles.

Looming retirements were also highlighted, particularly in the context of the redesign of Scotland's maternity services following the Best Start review which will see mothers allocated a named midwife for all their pregnancy, labour and postnatal care.

It could see a shift away from fixed shifts to an 'on-call' model that would see midwives responding whenever a mother on their caseload went into labour.

The report states: "This model of care has strong evidence of benefits for women, families and, potentially, for midwives.

"However, the introduction of such a significantly different way of working also brings with it uncertainties for the future workforce.

"Some older midwives may choose to retire rather than take on a new way of working and it is also not yet clear whether the new model of care will require more midwives.

"The impact of the implementation of the Best Start review recommendations on the workforce will start to be seen over the next one to two years."

Read more: Only two in 300 mothers in Scotland having a home birth

However, the report praised the Scottish Government for maintaining bursaries and free tuition for student midwives at a time whether they have been axed in England and fees imposed for the first time.

The student midwife intake was also "very significantly increased", meaning there will be 230 starting the three-year training courses in Scotland this year compared to 178 in 2016.

Mary Ross-Davie, RCM director for Scotland, said: “There are some great things happening in our maternity services in Scotland, not least the very ambitious Best Start maternity programme.

"The Scottish Government has also delivered real increases in the number of student midwives, which we welcome.

“However, pressures on our midwives are increasing – the care needs of the women in our care are rising, while the number of unfilled midwifery posts is also rising. I am still concerned about the age profile of our midwifery workforce, though it is encouraging to see the ‘green shoots’ of higher numbers of younger midwives joining our service.”

Health Secretary Jeane Freeman said: “While there has been an increase of 5.7% in the number of qualified nurses and midwives under this Government, we’re determined to go further to ensure we have a sustainable midwifery workforce long into the future.

“That’s why we’re investing a Return to Practice Programme, where 55 former midwives returned to service, and a shortened midwifery course in the north of Scotland to meet the specific recruitment challenges in that region. We’ve also recommended an increase in midwifery student intakes.”