Education And Debate

Controversies in Management: Should obstetricians see women with normal pregnancies? Obstetricians should be included in integrated team care

BMJ 1995; 310 doi: (Published 07 January 1995) Cite this as: BMJ 1995;310:36
  1. Patrick Walker, consultant obstetriciana
  1. a Royal Free Hospital, London NW3 2QG

    The expert maternity group which suggested that obstetricians should not see normal pregnancies1 was, perhaps, unrepresentative. About 700000 women each year in England and Wales are booked for care under a named consultant obstetrician. Yet the expert committee did not request formal input and had no representative from the Royal College of Obstetricians and Gynaecologists.2

    Normality with respect to pregnancy, especially first pregnancy, is a retrospective diagnosis.3 If it could be confirmed that a woman would not require medical advice or help at any stage in a pregnancy, an obstetrician might not be strictly necessary. But this is not possible. In addition, unless obstetricians attend normal pregnancies they will have nothing to judge against when they look after women whose pregnancies are progressing abnormally. Women with abnormal pregnancies must be looked after by a someone who is regularly exposed to the full range of physiological and pathological patterns of pregnancy and labour. Would you be confident to be looked after by a cardiologist who had not …

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