Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1991 Mar 23;302(6778):698–700. doi: 10.1136/bmj.302.6778.698

Community obstetric care in West Berkshire.

P Street 1, M J Gannon 1, E M Holt 1
PMCID: PMC1669136  PMID: 1878023

Abstract

OBJECTIVE--To assess the effects of a revised obstetric booking policy whereby all low risk pregnant women received their antenatal care entirely in the community. DESIGN--Comparison of the distribution of antenatal clinic attendances, transfers, and perinatal mortality rates for 1987 and 1989, before and after introduction of the revised policy. SETTING--West Berkshire Health District. SUBJECTS--All women who delivered with a registrable birth in the district in 1987 (5817 women) and 1989 (5372). MAIN OUTCOME MEASURES--Attendances at community and consultant antenatal clinics; bookings transferred from community care to consultant care; perinatal mortality rates. RESULTS--Of 5372 women delivering in West Berkshire in 1989, 3185 (58.3%) were originally booked for general practitioner-midwife care, of whom 1567 (49.2% of general practitioner-midwife bookings) were transferred to consultant care. 1618 women (30.1% of all women delivered) received their entire obstetric care from general practitioners and midwives. Attendance at hospital antenatal clinics was reduced by 16%. In 1989 the perinatal mortality rates (1987 values) for the district were 6.3 (7.6) per 1000 births overall; 8.2 (8.3) per 1000 consultant bookings; 5.0 (4.7) per 1000 for community bookings; and 10.2 (14.4) per 1000 for women transferred to consultant care. CONCLUSION--Antenatal care of low risk pregnant women may safely be provided by their general practitioner and midwife.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brudenell J. M. Future of general practitioner obstetrics: discussion paper. J R Soc Med. 1983 Mar;76(3):197–199. doi: 10.1177/014107688307600309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bryce F. C., Clayton J. K., Rand R. J., Beck I., Farquharson D. I., Jones S. E. General practitioner obstetrics in Bradford. BMJ. 1990 Mar 17;300(6726):725–727. doi: 10.1136/bmj.300.6726.725. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bull M. GP obstetrics: making the most of shared care. Practitioner. 1989 Feb 22;233(1463):211–215. [PubMed] [Google Scholar]
  4. Chamberlain G. NHS review. Obstetrics after the white paper. BMJ. 1989 Jun 24;298(6689):1702–1703. doi: 10.1136/bmj.298.6689.1702. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Loudon I. Obstetrics and the general practitioner. BMJ. 1990 Oct 3;301(6754):703–707. doi: 10.1136/bmj.301.6754.703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Marsh G. N., Cashman H. A., Russell I. T. General practitioner obstetrics in the Northern region in 1983. Br Med J (Clin Res Ed) 1985 Mar 23;290(6472):901–903. doi: 10.1136/bmj.290.6472.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Reynolds J. L., Yudkin P. L., Bull M. J. General practitioner obstetrics: does risk prediction work? J R Coll Gen Pract. 1988 Jul;38(312):307–310. [PMC free article] [PubMed] [Google Scholar]
  9. Sangala V., Dunster G., Bohin S., Osborne J. P. Perinatal mortality rates in isolated general practitioner maternity units. BMJ. 1990 Sep 1;301(6749):418–420. doi: 10.1136/bmj.301.6749.418. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Taylor A. Maternity services: the consumer's view. J R Coll Gen Pract. 1986 Apr;36(285):157–160. [PMC free article] [PubMed] [Google Scholar]
  11. Taylor G. W., Edgar W., Taylor B. A., Neal D. G. How safe is general practitioner obstetrics? Lancet. 1980 Dec 13;2(8207):1287–1289. doi: 10.1016/s0140-6736(80)92348-x. [DOI] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES