GPs and maternity care
Getting GPs involved in maternity care again will require review of the current lead maternity carer (LMC) model, according to research by Drs Dawn Miller and Zara Mason (Women's and Children's Health) and Associate Professor Chrys Jaye (General Practice and Rural Health).
They found that both current and former GP obstetricians (GPOs) believe the current model is incompatible with general practice.
In 1990 the Nurses Amendment Act enabled independent midwifery practice. Then, in 1996, the LMC model introduced bulk funding for primary maternity care.
However, when developing this project in 2008, the research team could find only 38 GPs still registered as LMCs, says Jaye.
"The GPOs who staggered on and continued their GP practice do it at great cost. It is not a business decision."
Miller says key themes identified suggest that the model can isolate the practitioner (GPO or midwife), is inadequately funded for GPs, and shared care with a midwife is difficult. Reduced peer support and limited continuing medical education has compounded the problem.
But other research by Miller and Hanna Preston [as a medical student] suggests around 90 per cent of medical students are interested in providing antenatal, postnatal or shared care as a GP, and 64 per cent in providing intrapartum care. Government is providing some funding for GPs to undertake the Diploma of Obstetrics and Medical Gynaecology to train or retrain in obstetric care.
"From the diploma point of view, we are keen to enhance that, but work needs to be done on these other aspects of the model if GPs are going to get into it again."