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Community midwives' and general practitioners' perspectives, of antenatal care in the community
1Department of Midwifery and Child Health, School of Nursing and Midwifery, University of Sheffield, Jessop Hospital for Women, UK.
Objective:
to ascertain who was providing antenatal care in the community in a defined geographical area in the north of England, and whether the care could achieve the government objectives presented in Changing Childbirth (DoH 1993).
Design:
a questionnaire was used to obtain demographic information and semi-structured interviews were held with care providers in order to assess the perspective of those providing care.
Participants:
a purposive sample of nine community midwives and six general practitioners (GPs).
Findings:
the midwife was the professional undertaking most of the antenatal care although in most instances there was a GP available on site if required. GPs saw the midwife as the main provider of care with themselves as 'back up'. Conflict over responsibility for care was an issue in some instances. Whilst changes in antenatal care provision had been, or were about to be made, only one midwife expressed a clear positive feeling towards midwife-led care. Giving women the opportunity for choice provoked an overwhelming feeling of helplessness for midwives. Midwives and GPs believed their education adequately prepared them to provide antenatal care in the community, however, GPs did not attend regular updating sessions.
Implications For Practice:
whilst it was recognised that midwives are taking increasing responsibility for antenatal care, GPs still believe that overall responsibility lies with them; therefore, there is a need to clarify roles. The majority of midwives expressed reservations about midwife-led care.