By Martin Johnston
Dr Di Nash is quitting obstetrics to spend more time in her garden.
"I'm completely demoralised by what's happening politically," the Auckland GP said yesterday in the wake of the National Health Committee review of maternity services.
The report said the flight of GPs from obstetrics was accelerating and unstoppable.
However,
most women were happy with the present system and there was no need for a big cash injection to try to reverse the trend.
Dr Nash, who has been in obstetrics for two decades, said it no longer paid well enough and she would not book any more women apart from possibly a few whose babies she had already delivered.
She could not afford to pay people to fix things around her home or do it herself since she was so often helping women give birth at nights and weekends, as well as running her Epsom practice.
But it was not just the money, she said. GPs' contribution to obstetrics was no longer valued. Health authorities and midwives misrepresented GPs as the ones who "run in and catch the baby."
She found the stance of the midwifery profession "exceptionally galling," as she had strongly supported its development.
Health and community groups have condemned the maternity services review and the Medical Association wants the Government to address the exodus of GPs.
The College of GPs dismissed the report owing to the lack - which the committee acknowledged - of adequate data on the clinical effects of the 1996 changes which introduced the "lead maternity caregiver" system.
A college spokesman, Dr William Ferguson, said many rural women were at risk if they suffered birth complications now that GPs were leaving obstetrics. In the cities, declining GP involvement was increasing the rate of unnecessary referrals to hospitals.
But the College of Midwives national director, Karen Guilliland, who was also highly critical of the report, said women would not be put in danger by the exodus of GPs, although some would be inconvenienced if they wanted a GP as lead caregiver.
She said a 1998 study found that the outcomes for mother and baby were better with a midwife than a GP.
Dr Ferguson said he was not aware of that study nor of any reliable research on the topic.
The Medical Association wants an urgent meeting with the Minister of Health, Wyatt Creech, to express its concerns about the maternity services review.
Mr Creech, who said a high level of women were satisfied with the system, was disappointed at the "din" from health workers over the review.
