Doctors: We're being cut out by empire-building midwives

Published on Thursday 11 March 2010 21:35

DOCTORS are being sidelined in the care of pregnant women, increasing risks for mothers and babies, a conference of GPs has heard.

A new system, launched this year, means that women who find out they are pregnant are urged to go straight to make an appointment with a midwife, rather than being referred by a GP.

But a national doctors' conference yesterday heard many had concerns that they were being marginalised in the care of their pregnant patients, not allowing them to deal with problems such as diabetes.

The British Medical Association Scotland conference, held this year in Clydebank, also heard that in some areas phone lines set up to allow women to refer themselves to a midwife were not even up and running.

Posters advertising the new service have appeared on bus stops, telling women to see a midwife early in their pregnancy.

Dr Catriona Morton, a GP in Edinburgh, said problems such as obesity, heart disease and coming from a deprived background increased risks during pregnancy.

"There must be early GP involvement, because of the long-term knowledge we have of our patients and of their risks," she said. "Instead, we are being distanced from maternity care.

"Women are told, by bus shelter ads, to sidestep us altogether, part of an ongoing fragmentation of primary care. Healthy women may like the added choice, but the vulnerable, already many times more likely to die, may be further endangered."

William McAlpine, an Ayrshire and Arran GP, said that, because midwives were dealing with basic, early care, trainee doctors were now not getting this experience.

John Rankin, a Forth Valley GP, accused the Royal College of Midwives (RCM) of "empire-building", because they believed they were the "be-all and end-all of antenatal care".

Dean Marshall, the head of the BMA's Scottish GPs committee, said they had warned the Scottish Government of the potential problems with the strategy, which is called Keeping Childbirth Natural and Dynamic.

Maria Wilson, chief midwife at NHS Lothian, admitted there had been problems. She said: "We are implementing a telephone helpline for newly pregnant women as part of the national campaign. This service will be operational later this month. Unfortunately, the number was circulated prematurely, as part of an information pack explaining the campaign to GPs."

Gillian Smith, of RCM Scotland, denied midwives were empire-building.

"It is about trying to get women to refer as early so you can get them in the best health to go forward in their pregnancy," she said.

"I see the midwives as a 'sign-poster'. If a woman has a medical problem, then the most appropriate person she sees is the GP."

A Scottish Government spokeswoman said: "GPs provide excellent primary care to patients of all ages, but evidence shows women benefit from being seen by specialist pregnancy services as early as possible.

"NHS Health Scotland have been keeping GPs fully up to date on progress. All women still have the choice to see a GP at any point in their pregnancy."