WHO CAN PROVIDE ANTENATAL CARE - THE VIEWS OF OBSTETRICIANS AND MIDWIVES

Objective: To describe the types of antenatal services in NSW maternit y hospitals and examine the views of midwives and obstetricians about who can provide adequate routine antenatal care. Measurements: A mail- out questionnaire to nursing unit managers (NUMs) explored the types o f antenatal services available in their hospitals. The questionnaire f or 196 midwives and 114 obstetricians asked whether they believed six provider/service types could provide adequate antenatal care either al one or in conjunction with an obstetrician. Findings: 80% of hospitals had GPs providing antenatal care, 53% had obstetricians and 3% had vi siting midwives; 33% had a public antenatal clinic, 28% a shared care program with GPs and 26% midwives' antenatal clinics. Midwives were mo re likely than obstetricians to rate the following as able to provide adequate care alone: hospital antenatal clinic (4.7 times more likely) ; independent midwife (42.9x); and community midwives as an outreach h ospital service (17x). Obstetricians were 8.2x more likely than midwiv es to rate private obstetricians as being able to provide adequate car e. Midwives were more likely to perceive that independent midwives (24 .7x more likely) and community midwives as an outreach hospital servic e (15.3x more likely) were able to provide adequate care either alone or in conjunction with an obstetrician. Conclusion: Most NSW hospitals have GPs providing care, but midwives' clinics and independent midwiv es are less available. While midwives and obstetricians hold similar b eliefs about GPs providing care, substantial differences emerged about the midwife's role. Such disparity in opinion may be central in provi ding options and consistency in care for women.