Fenwick N, Morgan M, McKenzie C, Wolfe C
Department of Public Health Medicine, UMDS, London.
Br J Gen Pract. 1998 Jul;48(432):1395-8.
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.
《分娩变化》（1993年）报告推动了以助产士为主导的计划的发展，这些计划旨在提高孕产妇护理的连续性。
确定助产士团队执业模式对全科医生（GP）工作的影响以及他们对助产士团队执业护理的看法。
向58名转诊妇女至助产士团队执业护理的全科医生（团队执业全科医生）邮寄了问卷，并向同一邮政编码区域内其余67名全科医生（非团队执业全科医生）发送了一份较短的问卷作为对照组。对12名全科医生进行了深入访谈。
71%的团队执业全科医生和81%的非团队执业全科医生回复了问卷。三分之一的团队执业全科医生认为他们看望团队执业产妇的次数太少，50%的人认为助产士不鼓励产妇去全科医生处进行产前检查。超过80%的团队执业全科医生认为助产士有能力发现异常情况，66%的人会放心地将产妇转交给她们护理。然而，只有14%的团队执业全科医生认为自己的角色明确，64%的人认为与团队执业助产士的沟通不畅，并对建立计划前的咨询水平表示担忧。在非团队执业全科医生中，87%的人表示他们未来会考虑将产妇转至助产士团队执业护理。
全科医生总体上对助产士团队执业提供的护理质量持积极态度，但也指出了在发展这种护理模式时需要解决的问题。
