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Abstract

Background: In the United Kingdom General Practitioner (GP) involvement in maternity care has declined significantly over the past decade. This is particularly so in remote and rural areas where midwives have stepped up and taken over units to ensure that women in these areas continue to have a service. A recent report by the King’s Fund argues for a greater role for the GP in maternity care provision; however this raises questions about whether GPs have the skills and training to provide such care. Aim: To explore the views of general practitioners on the skills and training required to deliver safe and appropriate local intrapartum services in remote and rural settings. Methods: Mixed-method study consisting of qualitative interviews with a purposive sample of GPs in six remote and rural sites. To triangulate the interview findings and identify features that might have been missed in the interviews, a questionnaire was developed using initial key themes identified. Findings: Maternity care accounted for less than 10% of most remote and rural GPs’ workload, yet interviewees reported that their role required them to be competent in a wide range of procedures. This was seen as a major barrier to recruitment and retention in rural areas. Although self-reported competence and confidence was high, several GPs felt deskilled and felt that they were fighting a losing battle to maintain skills. GPs regarded isolation, need for comprehensive expertise, limited resources and transportation difficulties as factors affecting the decline in their contribution to remote and rural maternity care. Conclusion: Although rural GPs and midwives might traditionally have been in competition, providing a woman-centred service in remote areas may be easier to achieve through collaborative working. However, if GPs are to play a greater role, then they will be need to be prepared to make a strategic commitment to the maintenance of remote and rural maternity care. This will require innovative methods of training, special consideration of educational needs and incentives for practitioners to settle in rural areas, but it may already be too late for GPs to have a substantial input into maternity care.

Available Versions of this Item

• General Practitioner Involvement in Remote and Rural Maternity Care: Too big a challenge? (deposited 14 Mar 2011 14:54)