General practitioners' attitudes to the development of midwifery group practices

The report Changing childbirth (1993) has led to the development of midwifery-led schemes that aim to increase the continuity of maternity care. To determine the impact of midwifery group practices on the work of general practitioners (GPs) and their perceptions of midwifery group practice care. Postal questionnaires were sent to 58 GPs referring women to the care of midwifery group practices (group-practice GPs), and a shorter questionnaire was sent to the remaining 67 GPs (non-group-practice GPs) within the same postcode area as a comparison group. In-depth interviews were conducted with 12 GPs. 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% thought midwives discouraged women from visiting their GP for antenatal checks. Over 80% of group practice GPs believed that midwives had the skills to detect deviation from the normal, and 66% would confidently refer women to their care. However, only 14% of group practice GPs believed that their own role was clear, while 64% agreed that communication with group practice midwives was poor, and concerns were expressed about the level of consultation before establishing schemes. Of the non-group practice GPs, 87% said they would consider referring women to the care of a midwifery group practice in the future. General practitioners were generally positive about the quality of care provided by midwifery group practices but identified issues that require addressing in developing this model of care.