I am aged 83 and was a GP for 34 years from 1954. I was on the GP obstetric list in Bradford, Yorkshire and so had responsibility for home deliveries of my patients. I was appalled to see on the television yesterday that a report published in the BJOG1 stated that babies born at home who needed to be rushed to hospital as emergencies were eight times as likely to die on transfer as average. The reason is that there are no obstetric flying squads available now.
When an urgent call came from a district midwife or GP to a maternity hospital for the flying squad, an obstetrician and a hospital midwife (and in later years a paediatrician) rushed to the mother's home by ambulance with bottles of blood and equipment. The baby and mother were treated and if necessary the mother was transfused before moving them to hospital.
Paramedics cannot resuscitate babies as adequately as paediatricians could in the mother's home and do not have the specialised equipment in which to transfer them to hospital.
It is important to consider the history of British maternity services. Before the 1930s it was accepted that women and babies could die in labour at home but in the late 1930s the National Blood Transfusion Service was established. About the same time Mr Harvey Evers, a consultant obstetrician in Newcastle, pioneered the obstetrics flying squads.
In 1958, Mr GW Theobald, a consultant obstetrician in Bradford, pioneered the early discharge of suitable mothers 24–28 hours after delivery. This made it possible for all mothers in Bradford to have hospital deliveries. As a GP there I thought it was a brilliant idea and it worked well. The perinatal mortality rate in Bradford fell from 45.8 per 1000 in 1956 to 31.8 per 1000 in 1962.
Every home delivery is potentially dangerous with a risk of the mother dying or of her baby getting brain damage or dying.
But the Chief Medical Officer, Sir Liam Donaldson, in his personal letter to me seems to think that they are safe. No surgical operation traumatically equal to childbirth would be done at home in 2008. It would be classed as malpractice. Nobody listens to old, retired GPs.
- © British Journal of General Practice, 2008.
