GENERAL-PRACTITIONERS ATTITUDES TO THE DEVELOPMENT OF MIDWIFERY GROUPPRACTICES

Background. The report Changing childbirth (1993) has led to the devel opment of midwifery-led schemes that aim to increase the continuity of maternity care.Aim. To determine the impact of midwifery group practi ces on the work of general practitioners (GPs) and their perceptions o f midwifery group practice care.Method. Postal questionnaires were sen t to 58 GPs referring women to the care of midwifery group practices ( group-practice GPs) and a shorter questionnaire was sent to the remain ing 67 GPs (non-group-practice GPs) within the same postcode area as a comparison group. In-depth interviews were conducted with 12 GPs. Res ults. Questionnaires were returned by 71% of group-practice GPs and 81 % of non-group practice GPs. One third of the group practice GPs felt that they were seeing group practice women too few times, and 50% thou ght midwives discouraged women from visiting their GP for antenatal ch ecks. Over 80% of group practice GPs believed that midwives had the sk ills to detect deviation from the normal, and 66% would confidently re fer women to their care. However, only 14% of group practice GPs belie ved that their own role was clear, while 64% agreed that communication with group practice midwives was poor, and concerns were expressed ab out the level of consultation before establishing schemes. Of the non- group practice GPs, 87% said they would consider referring women to th e care of a midwifery group practice in the future. Conclusions. Gener al practitioners were generally positive about the quality of care pro vided by midwifery group practices but identified issues that require addressing in developing this model of care.