Giving birth with the GP! Is it passé composé or is there still a future? The most intimate and life-changing experience a woman undergoes is being pregnant, expecting, and giving birth. By definition, ‘getting pregnant’ and ‘being pregnant’ is not a disease. A second axiom is that giving birth is a naturally normal physiological process. If evolution had gone differently, humans would not have become the most successful mammal.
The history of midwifery is complex and varied and varies from country to country. For our northern neighbors, giving birth at home is an ‘intangible heritage’ and is protected. Before gynecologists took over normal pregnancy and childbirth, the general practitioner played a crucial role that has now been completely lost. The personal relationship with the patient, her partner and family, and the knowledge of both medical and important psychological history, enabled them to not only provide appropriate care, but also manage the chronic diseases and were invaluable in providing emotional support to the pre -, peri- and postpartum.
General practitioners were at the center of women’s living environment. They were trained to supervise normal deliveries, training periods from the first day of the month to the last, 24 hours a day. Remember: they were doctors of medicine and obstetrics. Women were not to be redeemed, they gave birth and gave birth.
The unbridled growth of specialist gynecologists, originally rightly focused on the treatment of complications, has meant that they have come to play the leading role in normal low-risk pregnancy care. General practitioners are therefore no longer the primary care providers here.
The modern health system requires specific knowledge, especially of physiology, but also pathology, training, modern equipment and facilities that are not standardly available at the general practitioner. A paradox in this evolution is that hygiene and sterility, use of antibiotics, prenatal diagnosis, ultrasounds and new medication should have made it possible for low-risk pregnancies to return to primary care.
Our high-performance healthcare, funded by the patient-taxpayer, has ensured that there is a maternity with on-call specialists available on almost every street corner in Flanders. The accessibility, permanence and continuity make this care process particularly safe for mother and child. Mortality and morbidity in our region are among the lowest in Western Europe and have not decreased for 30 years despite increasing caesarean sections and interventions. This has given women the freedom and right to make their own choices!
In short, the question of whether giving birth with a GP belongs to the history books or still has a future is complex and depends on many factors. The benefits are clear, but they also come up against enormous prejudices. There are, of course, challenges to overcome. It is up to our healthcare system and our policy makers to determine how this approach can be integrated into broader obstetric care for the well-being of mother and baby. What is certain is that the choice of where and with whom and how the woman wants to give birth is a profound decision that must be respected and supported.
Obstetrics is a field that is continuously evolving. There is room for real collaboration, where we ensure that we do not trespass on each other’s territory, but that we do utilize the strengths of every healthcare provider, gynecologist, general practitioner and midwife: partners in crime for healthy pregnancy and delivery. Such an example is, for example, the ‘Le Cocon’ project in the Erasmus Hospital in Brussels.
For the time being, however, the last GP can turn off the lights in the maternity ward.
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2024-01-02 19:27:37
#obstetrics #lost #general #practitioner
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