Opinions of general practioners in Nottinghamshire about provision of intrapartum care

BMJ 1994;309:777-779 (24 September)

General practice

Opinions of general practioners in Nottinghamshire about provision of intrapartum care

D J Brown

Department of Public Health Medicine, Nottingham University Medical School, Nottingham NG7 2UH Correspondence to: 226 Radford Boulevard, Nottingham NH7 5QG.

Abstract

Objective : To examine the beliefs of general practioners concerningintrapartum care.
Design : Postal questionnaire survey.
Subjects : All general practioners with patients in NottinghamshireFamily Health Services Authority in September 1993.
Main outcome measures : General practioners' current involvementin maternity care, and beliefs on intrapartum care.
Results : Of 694 general practioners sent questionnaires, 550(79.2%) replied. 529 of these were on20the obstetric list; 437had not attended a delivery in the past 12 months; 36 had attendedtwo or more; 358 general practioners did not wish to providemore intrapartum care; 349 did not feel competent to do so.Reasons for not wanting to provide intrapartum care includedcurrent workload (453), disruption to personal life (407), andthe fear of litigation (377). General practioners who alreadybooked women for home delivery were more likely to20wish todo more deliveries (62/42 v 61/316, X²=85.3; P<0.0001) andto have more positive attitudes towards increasing women's choicein maternity care (90/22 v 195/151, X²=227; P<0.0001).
Conclusions : The involvement of general practioners20in intrapartumcare in Nottinghamshire is20low, and most general practionersare unwilling to increase their role. However, general practionerswho already book for home delivery are keen to do more.

Practice implications

Practice implications
The contribution of general practitioners to intrapartum care has dropped over the past 50 years to almost zero
Two government reports have recommended that this trend should be reversed
In this study most general practitioners were unwilling to increase their involvement in intrapartum care
Reluctance was due to fear of litigation, current workload, disruption to personal life, and perceived lack of competence
Attempt to increase general practitioner intrapartum care should concentrate on the minority of general practitioners who are enthusiastic about home delivery

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Relevant Article

GPs' opinions about provision of intrapartum care: J Frain
BMJ 1994 309: 1231. [Extract] [Full Text]

This article has been cited by other articles:

Davies, J, Hey, E, Reid, W, Young, G (1996). Prospective regional study of planned home births. BMJ 313: 1302-1306 [Abstract] [Full text]
Baird, A G, Jewell, D, Walker, J. (1996). Management of labour in an isolated rural maternity hospital. BMJ 312: 223-226 [Abstract] [Full text]
Frain, J (1994). GPs' opinions about provision of intrapartum care. BMJ 309: 1231c-1231 [Full text]