Not sure if this is relevant to your question. I worked ( both in-house and
attached) to a large regional referral unit with 5000 births per year. Women
would book in the community with the midwife or team at their local GPs. All
care would be led by the midwives. Any problems and the women would be
referred to the relevant specialist obs, eg. haematology, drug dependency
etc. A low risk woman could get through her entire pregnancy and postnatal
period without any contact with a dr. She would be offered an appt at 36wk
with her GP. Often they didn't want it, so didn't make the appt. It worked
the opposite way to Australia. Midwives were trusted to determine if a woman
needed to see a dr - not the dr determining if she could have midwifery-led
care.
As for antenatal examinations and visit scheduling- we followed NICE
guidelines, but adapted it to the individual woman. Women would often want
to hear the FH - so we did it for her. Some women needed more visits for
emotional support etc.
So, it can be done. Where there is a will there is a way. I think in
Australia you will find it very difficult to prise the drs fingers off the
control button. We had a few problems with GPs. They got irritated that the
women did'nt bother to see them at 36wks (it was up to the women to book the
appt). The GPs liked to 'touch base' with them because they would be
providing care for the new family in the future (fair point). But, the women
obviously didn't feel they needed to 'touch base'.
Rachel
From: "Sonja & Barry" <[EMAIL PROTECTED]>
Reply-To: [email protected]
To: <[email protected]>
Subject: [ozmidwifery] Obs first visits
Date: Sat, 22 Oct 2005 11:02:03 +1000
Dear all,
I am hoping for some information about midwifery/maternity units that don't
require women to be seen by an obstetrician at any stage throughout their
pregnancy. Info I need is do the midwives listen for heart sounds etc, do
they see a GP, or is this all quite irrelevant and thus no needs to do any
of these checks? Some places call this a first visit, whilst others may
use these checks to "allow" women access to birth centres etc. I hope this
makes sense.
Regards Sonja
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