Abstract
BACKGROUND: The reorganization of maternity services in England following the report Changing childbirth is likely to impinge upon general practitioners' contribution to maternity care. Professionals and managers are increasingly expected to take account of patients' views when reorganizing services. AIM: This study aimed to elicit women's views about the involvement of general practitioners in maternity care and to establish the extent of continuity provided by general practitioners. METHOD: A prospective cohort postal questionnaire survey was undertaken in the Bath health district to elicit the views of pregnant women about the general practitioner's role in maternity care, the continuity provided, patient satisfaction and the general practitioner-patient relationship. Responses were rated on five-point Likert scales. Women completed questionnaires at 24 and eight weeks before the birth and at two and eight weeks after the birth. RESULTS: Of 164 women entering the study (28 of whom were booked for home delivery and 136 for hospital delivery), 116 (71%) completed all four survey questionnaires. Of respondents 68% agreed that general practitioners play an important role in routine antenatal care and 53% that they have an important role in normal labour. These opinions appeared to be stable over time. Most women (73%) were cared for throughout their pregnancy by one general practitioner whom they knew well; such continuity was desired by nearly all the women in the study. Approximately three quarters of women were satisfied with the antenatal, postnatal and overall care provided by their general practitioner. Over half of respondents (56%) wished to get to know the doctor who would be present at the birth: the general practitioner was involved in 19 labours (16%), being present at the birth for only nine women. Women delivering at home were significantly more likely to agree with the statement that they knew the doctor present at the birth compared with those women delivering at hospital. Most women (91%) had their final six-week postnatal check with their general practitioner. CONCLUSION: Most women in this study believed that general practitioners are important in maternity care, providing continuity of antenatal and postnatal care but not of intrapartum care. These beliefs might be an indicator of the future situation in the United Kingdom when more women give birth at home and under non-consultant care. The vocational training and continuing education of general practitioners should accommodate their possible future roles in maternity care.
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