Management of labour in an isolated rural maternity hospital

Abstract

Objectives-To evaluate the use of a maternity unit run by general practitioners and midwives, describing the outcome of labour in an unselected group of women and quantifying the contribution made by general practitioners.Design-Retrospective population based review of obstetric patients who had access to an isolated rural maternity unit.Setting-Rural area 120 km from a consultant maternity unit.Subjects

Child births in a modified midwife managed unit: Selection and transfer according to intended place of delivery

“…Of the selected low-risk group of women admitted to the midwife managed unit only 41 (8.6%) were transferred to the central hospital. This transfer rate is lower than reported from other studies (13-16%) (2,15).…”

“…A similar uptake rate of 70% is reported from New Zealand (13) where midwives during recent years have replaced general practitioners as providers of obstetrical care in small district hospitals. Others (2,14,15) have reported lower rates (46-55%). Of the selected low-risk group of women admitted to the midwife managed unit only 41 (8.6%) were transferred to the central hospital.…”

Prospective regional study of planned home births

“…In addition, many women who had booked a home birth were later transferred to hospital for delivery, both before and after the onset of labour. Despite the small number of primiparous women in this study, this happened almost twice as often as in other British studies of women booked for home birth14 15 or birth in a unit staffed only by midwives and general practitioners 16 17 18…”

Committee is out of touch with needs of profession

“…I question the motives behind the General Medical Services Committee's recent advice about the provision of intrapartum care 1. A G Baird and colleagues confirm the ability of most general practitioners to provide a satisfactory intrapartum obstetric service,2 and, in accord with Jeremy Bradbrook and colleagues, I consider the committee's advice to be damaging 3…”