A Scottish Government decision to cut GP’s out of maternity services,
has been seen as controversial.
Women will no longer see their GP during their pregnancy. The old tradition
of women visiting their family doctor to have their pregnancy confirmed
and to have basic health checks carried out will be scrapped and the job
taken on by midwives.
The new rules, to be launched throughout Scotland later this year, are
aimed at healthy women with normal pregnancies who are not experiencing
any complications. But GPs last night expressed their “anger and frustration”
at the scheme, insisting they are best placed to spot potentially dangerous
problems.
When GPs conduct the first antenatal appointment, health and any child
protection issues are usually discussed. Under the new system, women who
have tested positive in a home pregnancy test and are phoning their GP
surgery for an appointment will be booked with a midwife unless the woman
voices a specific objection or has serious health problems such as diabetes
or obesity.
The move is part of a Scottish Government strategy, Keeping Childbirth
Natural and Dynamic, aimed at “normalising” pregnancy, and putting midwives
in charge of most women. GPs will be asked to send relevant health records
to midwives whose job it will be meet the woman and carry out a risk assessment
of the pregnancy by around six weeks of her pregnancy. If she is assessed
as being “normal” then she will continue to see her midwife but she will
be referred to an obstetrician if the midwife deems it necessary.
Dr Jim Cowan, a GP representative on a group examining the issue, said
his colleagues were “disappointed”. Cowan said: “We are being sidelined.
We feel we are being excluded from this important part of a woman’s medical
history. There seems to be a desire to hive off that bit to midwifery
and keep GPs out of it. “There may well be a holistic benefit from seeing
a doctor. You may well be able to offer advice and discuss the pregnancy
and the context of that woman’s particular life situation,” he added.
The move was also discussed at a recent meeting of Lothian Local Medical
Committee. A minute from the meeting reveals many GPs are “angry and frustrated”
at the scheme.
But Gillian Smith, director of the Royal College of Midwives, welcomed
the strategy as a policy for treating women as individuals throughout
their pregnancy. She said: “I think this is a good piece of work. I think
it’s the midwives working as a linchpin, and as the first point of contact.
Quite a lot of GPs have a lot of work to do, although this is a nice part
of their job they will be reluctant to relinquish.”
Cynthia Clarkson, maternity services convener for the National Childbirth
Trust, who helped draw up the plans last night said she was “delighted”
they are going ahead. A Scottish Government spokeswoman said: “Keeping
Childbirth Natural and Dynamic aims to ensure women giving birth have
as natural an experience as is safely possible.”
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