Can perinatal regionalization be reconciled with family-centered maternal care?

Perinatal regionalization is necessary because of the enhanced quality of the outcome of high-risk pregnancies in hospitals that either have their own units or who use such centers regularly. Antenatal transfer of high-risk mothers is necessary but creates potential problems relating to separation from spouse and family. These can be minimized through closer working relationships between family physicians and perinatologists. The family physician has a responsibility to help the perinatal center increase its sensitivity to the needs of families that wish to be more involved in maternal care--even in a high-risk situation. Separation of the sick neonate from mother and family raises a set of similar but more severe problems that can also be modified by active involvement of the family physician with the perinatal team. Awareness of the interactional issues consequent to separation and attachment failures will help the family physician to anticipate and modify these unfortunate consequences of both the high-risk pregnancy itself and the neonate separated from the mother/family.