GPs to be bypassed in move to 'normalise' childbirth

WOMEN will no longer see their GP during pregnancy following a controversial Scottish Government decision to cut medics out of maternity services.

The decades-old tradition of women visiting their family doctor to have their pregnancy confirmed and undergo health checks 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.

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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.

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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.

Women have also voiced caution. Sally Russell, director of the online parenting network Netmums said: "Many women feel that they trust midwives and develop a relationship with them. But I do worry that it's not one-size-fits-all and people would prefer to have the choice."

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."

'I don't know what I would have done without my doctor's support'

WHEN Stephanie Herrera found out she was pregnant she saw her own GP immediately. Stephanie had a difficult time during her pregnancy, not only was she carrying twins but her mother died shortly before they were born

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Stephanie says she does not know what she would have done without the support of her doctor and says the relationship is too important to abandon during the antenatal period.

Speaking from her home in Aberdeen she said: "My midwife was very nice, but I only saw her a couple of times. I was referred to a multiple birth specialist who was only really concerned with the health of the babies, but my GP was incredibly understanding of both my physical and emotional needs."

Stephanie, a marketing manager, is a patient at Camphill Medical Practice, and saw her GP, Dr Marga Hogenboom, about a dozen times during her pregnancy. The GP confirmed the pregnancy and referred Stephanie for scans and checks. "With my mother being diagnosed with cancer and dying two weeks before the twins were born, it was a horrendous time," she added. "I was worried about the health of the babies because they shared a placenta which can cause problems. My GP made numerous home visits and the surgery was an oasis of calm.

"My midwife was lovely, but if I was to become pregnant again I would still want to see a doctor and have the GP involved.

"I would feel happier having my overall health assessed by a GP and I feel strongly they should have some involvement with antenatal care because they are going to be involved with me and the child afterwards. The person you have an ongoing relationship with is the GP, not the midwife, who you stop seeing six weeks after the baby is born."