Women are saying no to more children in an area of Scotland facing population decline because of "horrific and terrifying" birth experiences that have left many suffering from psychiatric disorders.

Most first-time mothers in Caithness or anyone with a higher-risk pregnancy faces a three-hour journey to Inverness because the area's hospital was downgraded to a midwife-led unit in 2016 for safety reasons due to consultant shortages.

New research has shed light on the traumatic experiences of women who are forced to make 100-mile or more journeys in labour to Raigmore Hospital along the A9, in some cases when their nearest hospital is 15 minutes away.

The Herald:

One mother said cuts in maternity provision risked depopulating the area in the same way as the 19th-century Highland Clearances.

She said: "Today in 2024 just a few generations later, the people of the far north face a new clearance, and it is - once again - economic.

"Remove the vital services [including] healthcare and the population will again be forced to move to the faraway cities, leaving this once beautiful and vibrant county to become nothing more than a vast windfarm."

The Herald: New Highland Clearances

Women described pregnancies filled with anxiety because they were aware they would be required to travel hundreds of miles on a road that is frequently blocked in winter - and told of their fears that the would give birth in a layby.

One mother said some of the joy of having a first child had been replaced by "panic and worry" while another said her childbirth experience had left her suffering night terrors.

She said: "The experience has made me unsure about having more children as I don’t feel I could go through that again without serious detriment to my mental health."

The Herald: The A9 is currently closed between Helmsdale and Dunbeath

Another woman who was an emergency transfer said she "could have lost her baby" during the long journey.

Interviews involving 178 mothers found that more than 85% had given birth at Raigmore Hospital and 83% said they didn't feel as if they had any choice in this.

One mother said: "Had a horrendous journey to Raigmore in the back of an ambulance, strapped to the chair. Was in labour, no gas and air. It was a horrendous journey where I was sick the whole way."

Another said: "Horrific. Peak NC500 tourist season, unpredictable driving. Scared if anything happened during the drive. It was an awful car journey of nearly 3 hours of contractions." 

A report by Highland Council, following last year's Census warns that areas of the Highlands are being drained of people in the western Highlands, Sutherland and Caithness in particular.

Caithness has a population of 25,347 people and birth rates here and across Highland have decreased over the last decade. In 2020 there were 197 live births. 

The Herald:

From 2002 to 2021 there has been 42% increase in the 65+ age group and a 17% reduction in those aged under 16.

One woman said she developed PTSD and is still on daily medication "to live a normal life".

Many described giving birth in a high-pressured environment at Raigmore, being denied appropriate pain relief and feeling as if they had been forced into inductions that were "planned to suit bed numbers." 

READ MORE:

Hannah Perriewood, from Thurso, had to book into a B&B near Raigmore when she went into labour with her first baby, Peyton, in 2022 because she was told by midwives that she wasn't ready to be admitted and the hospital accommodation that is used by staff was full.

"I was quite a bit of pain but they said I didn't look like someone that was about to give birth so they sent me back to the B&B," said the 36-year-old who is a manger for BT.

"Within 15 minutes I was back in the hospital having my baby.

"They apologised," she said. "It was very overcrowded in the hospital. You could tell they were trying to push me back to the B&B for a reason. There wasn't space for us.

"You can claim the money back and that's fine but I'm sure there are people who can't afford £80. 

The Herald: Hannah Perriewood described the birth of her second child, Penelope, in Wick as fantasticHannah Perriewood described the birth of her second child, Penelope, in Wick as fantastic (Image: From family) 

"My sister, who was pregnant at the same time, came down the following day and had an even worse experience," she said.

"She was in labour and they induced her and they shouldn't have. She didn't recognise the feelings - it was her first as well - and there was no space within wards. 

"She wouldn't be able to have her second baby in Wick because she has a blood complication. The situation has sort of put her off [having another baby] and living here as well."

She had her second child, Penelope, at Caithness General in May 2023 and describes it as a "fantastic" experience. She was told her baby was only the fourth to be born there that year.

"It all went brilliantly but I was told I had to phone when I was in labour to make sure they had the staff for me to go to Wick," said the mum, who is married to Darren, 30, a financial advisor.

Analysis: NHS Highland, healthcare, and Scotland: How does it compare?

"The midwives were excellent, they spent millions on this new unit and you can see that. It was beautiful and I think some people are scared so I think it's important to say that it's a good experience for most."

She said a friend and her husband had to make seven trips to Inverness during her pregnancy because she had experienced bleeding. She said: "Her mental health was affected and you when see it when she had her baby. It might have been different if she had been able to pop through to Wick.

Ashley Millar, 35, who lives in Wick, is mum to Alfie, 15 and Rosie, nine, who were both born at Caithness General before the service was downgraded. She had planned caesarean sections because her pelvis was too small to deliver vaginally.

The Herald: Ashley Miller Ashley Miller (Image: From family)

"If we were to make the decision to have baby number three we would have no choice but to go down to Inverness," she said.

"So my husband and I actually made the decision not to have any more children because of that because it would put my anxiety levels through the roof."

Maria Keiss, who led the research, is secretary of the Caithness Health Action Team (CHAT), a campaign group that was formed after maternity services were downgraded.

They want to see the maternity model used in Orkney replicated in Wick, which is midwife-led but supported by a consultant and allows most women to give birth locally.

She said her own daughter was among the mothers who have decided against having any more children.

She said: "The basic human rights for women and babies are not being considered nor met and the survey results from women clearly describe this.

"Women were terrified of the dangerous journey in labour and this feeling of intense fear travelled with then throughout their pregnancy."

A spokesman for NHS Highland said it has emergency protocols in place to ensure women can be transferred to Raigmore in cases of adverse weather and said the board is currently carrying out an internal review of maternity services.

He added: "We continue to work with Scottish Government in respect of ensuring we move forward optimising the possibility of both midwifery and consultant-lead births across Highland and Argyll and Bute."