Better midwifery

The most important message, in my opinion, from the Sarfati and Wenham study into maternity care is the need for a well-organised maternity system (Baby wars, Feb 22).

Midwifery-led care can certainly be optimal for normal birth, but only within a smoothly functioning referral system. Most midwives have enormous respect for the complementary skills of our doctor colleagues, but they are a scarce resource. There are currently only two specialist private obstetricians in Wellington.

In the days of obstetric GPs providing most care, the system was geared to this. Hospital midwives admitted women in labour and provided most care, with the GPs coming when called or at pre-arranged times to fit with their clinic obligations.

I well remember the queue of midwives at the delivery suite phone at 7am to inform many GPs of the progress of their patients admitted overnight. The GPs did not pay for the midwifery care provided to their patients.

Midwives are expert in normal pregnancy, labour and birth and are trained to identify and refer when there are deviations from normal. It appears to me that many adverse outcomes are the result of a lack of confidence or responsiveness in the referral system. I was privileged to serve families as a midwife for 20 years.

Jennifer Cox, Mt Cook