GPs’ lack of involvement in maternity care is undermining the care of pregnant women and their families, according to a report published for The King’s Fund’s Inquiry into the Quality of General Practice in England.
The inquiry pointed out that the GP’s role in maternity care has all but disappeared over the past 30 years, with recent policy and guidance omitting any reference to their role in caring for pregnant women. Under the terms of the new GP contract introduced in 2004, GPs are no longer paid for each pregnant woman they look after. In addition, many GPs have opted out of providing out-of-hours care, resulting in sick pregnant women going to A&E with pregnancy-related problems – or simply not knowing what to do if they are ill. Women can also now self-refer to a midwife, though many still do see a GP hoping to confirm pregnancy. Increasingly, midwives are also now based at children’s centres, further removing them from GP surgeries. The King’s Fund warned that there is one maternal death a week due to obesity, heart disease or mental health problems and called for a more joined up approach – with GPs involved throughout every stage of the pregnancy, working closely with midwives and consultants. Responding, Dr Laurence Buckman, chairman of the BMA’s GPs Committee, said: “There has been a succession of health policy changes in recent years, which have led to the wider primary care team becoming increasingly fragmented. Many GPs have watched with growing concern as long-established and valued midwife colleagues have been withdrawn from practice teams and continuity of care for pregnant women has been lost. “GPs want to be more involved in maternity care because they see it as an important part of their job. Like the King’s Fund we think those who have specialist training should take the lead role in maternity care, but GPs do have a significant role to play.” A Department of Health spokesperson said: “GPs have a vital role in providing continuity of care for women and their families from before pregnancy through to the baby’s first visit to the GP. The recent White Paper gives GPs even more of a chance to become involved as they become part of the local maternity networks being set up, which will help parents to move between the different services that they need and will put mothers’ choices at the heart of maternity services.”
