The Royal College of Obstetricians and Gynecologists (RCOG) has issued a report calling for fewer hospital births and more births in midwife-led units and even at home. It says the maternity care system in the UK needs a “radical rethink.”
Given the polarization of the home vs hospital birth debate in the US, it’s surreal to watch the Vice President of RCOG on TV saying things like, “not every mother needs a doctor” and pregnancy “is a perfectly normal physiological event.” But this is just what he’s saying.
There’s a maternity care crisis in the UK: money is tight, and the system is failing women in various ways. According to RCOG this new plan would cut spending and serve or all kinds of pregnant women from low to high risk. Currently 90% of the women in the UK give birth in hospitals. Under the new proposal, there would be fewer hospital births and more midwife-led units (either near a hospital or free-standing) and more home births.
Speaking to BBC Breakfast, RCOG vice-president David Richmond said, “roughly a third [of pregnant women] need to be looked after by doctors, roughly a third need to looked after by midwives, a third probably need to be looked after by both.” When challenged with the claim that pregnancy can go from low to high risk within minutes, he said, “we have the ability to predict to a certain degree [whether a doctor will be needed]. Not all units need doctors present, we need to concentrate our medical resource to where they are needed.” He also emphasized that midwives and doctors working together is vitally important for both the medical system and the health and well-being of mothers and babies.
The president of RCOG, speaking in a separate interview, emphasized the financial issues facing the UK maternity system. Both representatives argue that this is a logical way to revamp the system. I’d be curious to know more about how back-up emergency medical care would work in rural areas. And I’ll be interested to see how the debate unfolds in the weeks to come.
In the meantime, here’s to doctors for midwives!
photo: BBC News