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GP obstetricians' views of the model of maternity care in N ew Z ealand
Author(s) -
Miller Dawn L.,
Mason Zara,
Jaye Chrystal
Publication year - 2013
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12037
Subject(s) - maternity care , general practice , thematic analysis , nursing , obstetrics and gynaecology , medicine , primary care , family medicine , qualitative research , pregnancy , health care , sociology , political science , social science , biology , law , genetics
Background The L ead M aternity C arer ( LMC ) model of maternity care, and independent midwifery practice, was introduced to N ew Z ealand in the 1990s. The LMC midwife or general practitioner obstetrician ( GPO ) has clinical and budgetary responsibility for women's primary maternity care. Aims To determine views of practising GPO s and former GPO s about the LMC model of care, its impact on maternity care in general practice, and future of maternity care in general practice. Methods 10 GPO s and 13 former GPO s were interviewed: one focus group ( n = 3), 20 semi‐structured interviews. The qualitative data analysis program ATLAS .ti assisted thematic analysis. Results Participants thought the LMC model isolates the LMC – particularly concerning during intrapartum care, in rural practice, and covering 24‐hour call; Is not compatible with or adequately funded for GP participation; Excludes the GP from caring for their pregnant patients. Participants would like a flexible, locally adaptable, adequately funded maternity model, supporting shared care. Some thought work‐life balance and low GPO numbers could deter future GP s from maternity practice. Others felt with political will, support of universities, and R oyal N ew Z ealand C ollege of G eneral P ractice and R oyal A ustralian and N ew Z ealand C ollege of O bstetrics and G ynaecology, GP s could become more involved in maternity care again. Conclusions Participants thought the LMC model isolates maternity practitioners, is incompatible with general practice and causes loss of continuity of general practice care. They support provision of maternity care in general practice; however, for more GP s to become involved, the LMC model needs review.