NCT response: King's Fund 'The role of GPs in maternity care'

Released on: 20 July 2011

A report out today by the King’s Fund: ‘The role of GPs in maternity care - what does the future hold’, suggests that GPs could take a more active role in delivering high quality maternity care by sharing responsibilities with midwives and obstetricians, particularly for women with ongoing medical conditions.

Commenting on the new report suggesting a greater role for GPs in maternity care Belinda Phipps, Chief Executive, NCT, says;

 

"This report comes at a time when maternity services are under close scrutiny and though it makes some useful suggestions, the preferred model of care would be to continue to provide choice of carer and to actively promote midwife-led care to women. 

 

“The current problems in maternity care are caused not by the principle of less GP involvement but rather by the lack of supportive systems to make the role of the lead carer, midwife or consultant obstetrician, easier and seamless.  A partnership needs to emerge between the health professionals involved in the care of pregnant women, when they are well and when they are unwell. 

 

“Birth is a normal, physiological process and the majority of women who are healthy, with a straightforward pregnancy, do not require medical involvement either at general practitioner or hospital consultant level. A social model of care is therefore preferable which is why midwife-led care should be offered to all women. Some women will benefit from the involvement of a GP or require specialist help from dieticians, substance abuse services or social services and some will want to maintain their relationship with their GP. However, many women find getting to know a midwife they can trust and who will be with them thought their pregnancy and birth is vital.

“Pregnant women in England currently have a choice to receive their care from their GP or a midwife. The midwife will explain this choice to them when they book their first visit.

“GP knowledge on maternity issues has fallen behind current evidence and a considerable amount of retraining will be required to enable them to fulfill their role in pregnancy in relation to the health of the woman and the baby who have medical needs. Even more training would be required if GPs are expected to deal with the pregnancy and birth and the post partum period, as a midwife would. 

“In the current, cost conscious climate, the most effective solution would be for a pregnant woman to book in with a midwife, for the midwife to have her medical records on her first visit, and the midwife then informing the GP of the pregnancy of one of their patients. Where there are pre-existing medical problems, the woman should be referred by the midwife to the appropriate service, which may be the GP or may be other services.”