General Practitioner Training Antenatal Care 26th May 2004 Geraldine Black Community Midwifery Manager
Does the GP have a role in maternity services? Post NHS the GP was described as the lynch pin of maternity services 1970 The Peel report 1980 The Short report
1991 Maternal & Early Child Health [WAG] 1993 The Cumberledge report [changing childbirth] 2000 RCM Vision 2000 2002 Realising the Potential [WAG] 2004 NICE Antenatal guidelines.
So what is the role of the GP? Are GPs obstetricians Are GPs carrying out the role of the midwife Are GPs seeing women on a social basis Whatever role you choose, ensure that you have the skills, knowledge and competencies.
The changing role of the midwife Midwives are practitioners of normal midwifery NMC Scope of professional practice Advanced midwifery practitioners Responsibility and sphere of practice. Rule 40 GPs and midwives must work in partnership
The HOMG and WAG advocate the midwife as first point of contact. NICE recommend prophylactic anti D Neonatal examination for home births, births in home from home units and early transfers. Increase in the number of Midwifery Managed Units.
So what do GPs need to know? G P contracts and EWTD have and continue to influence the way in which maternity services are provided. GPs need to define the role that they wish to take in the provision of maternity services. Drug administration by midwives The NICE guidelines Pathways of communication
From January to May 2004 60% of women were booked for midwifery led care. 50% of women who delivered in the same period had no medical intervention. 4.5% of women delivered at home or in a midwifery managed unit. HOMAG set a target of 10% by 2007.
NICE Clincal Guidelines 6 These are guidelines for routine care for the healthy pregnant woman. 10 visits primips 7 visits multips Womens risk factors must be identified at initial contact.
At 1st point of contact woman should be offered information about pregnancy care and options available, lifestyle considerations, including dietary information and screening tests. The environment in which antenatal appointments take place should enable women to discuss sensitive issues such as domestic violence, sexual abuse, psychiatric illness and illicit drug use.
Each antenatal appointment should be structured and have a focused content. A system of clear referral paths should be established so that pregnant women who require additional care are managed and treated by the appropriate specialist team when problems are identified.
Referral Paths Direct referral to consultant obstetrician ANDU EPAU [Ffrancon- not yet established] Antenatal Screening midwife.