Hansard

My apologies, Presiding Officer.

I am delighted to have secured the very first members’ business debate in this session of Parliament, and I thank all members who supported my motion to make it possible.

May was national pre-eclampsia awareness month, and 22 May was world pre-eclampsia day. I believe that it is right and fitting that there is global recognition of this important maternal health issue. Pre-eclampsia is a condition that develops during pregnancy or shortly after birth and is characterised by high blood pressure and protein in the urine. It can affect the heart, liver, lungs, kidneys and brain, and it can cause blood clotting and lead to eclampsia, which is life threatening and involves seizures.

The World Health Organization estimates that pre-eclampsia affects between 3 and 8 per cent of women worldwide. A study that the WHO conducted only last year found that hypertensive disorders in pregnancy, including pre-eclampsia, are responsible for 16 per cent of maternal deaths globally.

Around 76,000 women and 500,000 babies die worldwide each year from eclampsia. While I welcome the focus that world pre-eclampsia day brings to this important issue, I believe that, given the stark figures that I have cited, pre-eclampsia should receive much more focus than it currently does.

I pay tribute to the work of Action on Pre-eclampsia, which is a United Kingdom charity that works to raise awareness of this life-threatening condition. As a first step, expectant mums should be aware of the symptoms of pre-eclampsia, as being aware could save their life and the life of their baby. Suffering during pregnancy from headaches, high blood pressure, blurry vision, upper right pain in the tummy, swelling and shortness of breath are all classic signs. More work needs to be done to ensure that pregnant women are provided with that information so that any symptoms can be investigated and addressed at the earliest opportunity.

Women who are at risk could, and should, benefit from preventative measures such as low-dose aspirin by 20 weeks or when antenatal care begins; calcium supplementation in settings with low dietary intake; and treatment of any pre-existing high blood pressure or associated conditions. Sadly, the picture is not what it needs to be in Scotland or across the UK, where it is estimated that 10 per cent of pregnancies are impacted by hypertensive disorders, including pre-eclampsia.

Specific data on the number of women in Scotland or the UK who are impacted is—astonishingly—not publicly available. Perhaps the Minister for Mental Wellbeing, Public Health, Sport, Alcohol and Drugs can tell us why that is. The information is held at national health service board level, and freedom of information requests would bring it into the public domain, but that should happen already. Unless that information is collated, a proper and robust strategy to track the long-term health of women who suffer from pre-eclampsia, and who may face serious health risks as a direct consequence, cannot be undertaken effectively. I therefore urge the minister to ensure that specific data on the number of women in Scotland who are impacted by pre-eclampsia is made publicly available.

According to Action on Pre-eclampsia, more than 5,000 pregnant women in the UK each year suffer from pre-eclampsia and 1,000 babies die from causes related to it. The lifelong health implications for those women are serious and potentially fatal, because they will have a fivefold increased risk of hypertension; three times the probability of a stroke; twice the risk of cardiovascular mortality; and a fourfold risk of suffering a major adverse cardiovascular event. In addition, such women have an increased risk of diabetes, kidney disease, liver disease and thrombosis.

We do not know whether pre-eclampsia causes those increased lifelong risks, or whether pre-eclampsia is caused by underlying conditions that elevate a woman’s likelihood of developing cardiovascular and other issues. We know, however, that women in Scotland—despite those extremely serious lifelong and life-threatening risks—have no long-term monitoring following pre-eclampsia in pregnancy.

The NHS Scotland website highlights potential long-term risks, but that falls very far short of what is required to address them. I understand that, in March, the Scottish Government indicated that women who have had pre-eclampsia would receive annual health reviews and long-term blood pressure monitoring as part of the Scottish cardiovascular disease risk factors programme. I welcome that, and I ask the minister what the timeline for the implementation of monitoring is. I am also keen to know whether that monitoring will be retrospective in order to include women who suffered from pre-eclampsia in years gone by, given that the health risks are lifelong.

I ask that because I suffered a stillbirth at full term in 2009 after developing HELLP—haemolysis, elevated liver enzymes and low platelets—syndrome, which is a very extreme form of pre-eclampsia and which, along with the mismanagement of my treatment, killed my son and very nearly killed me. After spending 10 days in intensive care and recovering for a further nine days in high dependency, I was discharged. No one, at any time, mentioned to me that I faced long-term serious health risks; it was not even touched on. Members can imagine my upset and anger when I discovered that purely by accident.

I am sure that many women have been impacted by pre-eclampsia with no, or very little, idea of the extremely serious health risks to which they have been exposed, and that is truly shocking. The minister is clearly not responsible if some clinicians do not make their patients aware of very important health risks that they face, but I ask her what she can do to ensure that clinicians share important medical information about health risks and to ensure that that falls under the statutory rights of patients.

The reality is simply that women who are impacted by pre-eclampsia are not always provided with that vital information, and that cannot be right. I know that good work on the issue is taking place in NHS Lothian, but the need is urgent across Scotland, including in my own Cunninghame South constituency.

I have spoken about the symptoms of pre-eclampsia and how pregnant women should be informed of them. When those symptoms appear, women do not always realise the danger that they and their babies might be in. Ensuring that expectant mums recognise the symptoms is important, but it is also vital that, when they present with symptoms, they are not dismissed and fobbed off, as I was. Half of all stillbirths occur after women present with concerns and are shooed away and told not to worry. Had I been listened to, my baby would not have died, my liver would not have ruptured and my husband would probably not have had to be asked to come to the hospital to bid me farewell because clinicians thought that I was going to die.

Will the minister work with the NHS to ensure that women, as a right, are better informed about pre-eclampsia symptoms as part of their antenatal care; are provided with vital information about the lifelong risks to their health following a birth that was impacted by pre-eclampsia; and receive lifelong monitoring of their health, particularly cardiovascular health, following pre-eclampsia? It would be good if that monitoring could include women who suffered pre-eclampsia in past years and who still face greater risks to their health.

Finally, will the minister work with health boards to centrally collect and collate data on the incidence of pre-eclampsia? That will enable a proper and robust strategy to track the long-term health of women who have suffered from pre-eclampsia. Such actions would do much to reassure me, and all women who face serious long-term health risks to which pre-eclampsia has given rise, that women’s health is an absolute priority for the Scottish Government.