Obstetrics report conclusions “unsupported”

Obstetrics report conclusions “unsupported”

Tuesday, 5 October 1999

For immediate release
Dr William Ferguson
Obstetrics Spokesperson

Obstetrics report conclusions “unsupported”

Assertions that increasing numbers of medical interventions in births are due to “mothers' requests and expectations rather than clinical need” cannot be supported, according to the Royal NZ College of General Practitioners.

Obstetrics spokesperson Dr William Ferguson one of the country’s few remaining GP Obstetricians says no cause is apparent from the figures, made public in a Health Ministry report, and that the Ministry does not have enough evidence to assert, as it has done, that the cause is more women opting for such procedures through choice rather than through clinical necessity.

“This report simply presents a set of data from which it is basically impossible to draw any firm conclusions as to cause,” Dr Ferguson said. “The reasons are many and they are complex.

“The Section 51 changes in July 1996 instigated a shift away from the medical model of maternity care, to one in which General Practitioner Obstetricians have little or no role, and are replaced entirely by the midwife. A decline in the rate of medical interventions was no doubt one of the expected outcomes. Yet the reverse has occurred, and this requires careful analysis.

“Maybe previously, when 60 percent or more of women had a GP involved in their pregnancy, potential problems were dealt with before these types of interventions were required. But until a comprehensive study is undertaken, as was done when there were conflicting opinions on the rise in the number of asthma deaths, then it’s impossible to be certain of the causes,” Dr Ferguson admitted.

“What is undeniable is that many women are telling the National Health Committee, the National Council of Women, and the other various surveys, that the present model isn’t working; that most want shared care between a GP and a midwife. It is certainly the model that GPs want a collaborative approach with midwives where each professional complements the other’s skills and experience. But that is almost impossible to obtain now and, after the recent NHC report completely failed to recognise the value of GPOs, likely to become virtually unobtainable,” Dr Ferguson said.

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