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The birth of perinatal medicine in the United Kingdom
1Perinatal Medicine and Child Health, University of Bristol, Southmead Hospital, Bristol BS10 5NB, UK. p.m.dunn@bristol.ac.uk
Insights
Medical care for newborns faced setbacks but saw renewed interest with pediatrics and the NHS. The establishment of perinatal services and specialized units improved care for the fetus and newborn infant.
Area of Science:
- Medical history
- Perinatal medicine
- Obstetrics and Gynecology
Background:
- Maternal and infant care progressed slowly from the 16th-19th centuries.
- A 20th-century shift towards gynecological surgery temporarily halted progress in infant care.
- The development of pediatrics and the National Health Service (NHS) spurred renewed focus on fetal and newborn health.
Observation:
- Special Care Baby Units (SBCUs) were established in the 1960s.
- Obstetric technology advanced, leading to increased hospital births over home deliveries.
- Neonatal intensive care emerged in the 1970s, but resource limitations hindered progress.
Findings:
- Government and professional bodies recognized the need for improved perinatal services.
- Newborn infants were recognized as NHS patients from birth in 1982.
- The discipline of perinatal medicine became firmly established by 1983.
Implications:
- The evolution of perinatal medicine highlights the importance of specialized care for newborns.
- Advancements in obstetric and neonatal technology have transformed delivery and infant care.
- The establishment of dedicated perinatal services is crucial for advancing fetal and infant health outcomes.
Abstract:
Slow but steady progress in the medical care of mothers and their infants during the 16th-19th centuries received a setback early in the 20th century following a shift of focus from the baby towards gynaecological surgery. The development of paediatrics after 1928 and the formation of a national health service in 1948 led to a renewed interest in the fetus and newborn infant. Special care baby units (SBCUs) were created in the 1960s. At this time, too, obstetric technology arrived in the delivery room and domiciliary birth largely gave way to hospital delivery. Neonatal intensive care arrived in the 1970s. However, a severe lack of resources retarded progress. Many medical reports in the 1970s drew attention to the deplorable situation. In 1980 a House of Commons working party called for the establishment of a sound perinatal service. In 1982 the Government recognized all newborn infants as NHS patients from the moment of birth rather than after their registration. That year too the Royal College of Obstetricians and Gynaecologists (RCOG) acknowledged the need for a subspecialty in maternal and fetal medicine. Meanwhile, a paediatric perinatal pressure group, arising in 1976, became a multidisciplinary association of perinatal medicine in 1981. By 1983 the new discipline of perinatal medicine had become firmly established.
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