Total deaths given as 268, directly or indirectly linkd to
pregnancy, an increase of 40.
Is the triennial report on the web anywhere?
Why should an increase of such a size be seen?
I am inclined to blame a failure of cooperation and coordination
between the various agencies and people involved in maternal care.
I am inclined to single out the midwifery establishment, who at
least locally have acted unilaterally in changing arrangements,
rotating midwives through practices who therefore remain part of a
midwifery team but cannot integrate with the rest of the primary
healthcare team, introducing a new and vastly inferior pateint
carried record instead of the old triptych card - a paragon of
design itself, and with little consultation.
In that period the number of GPs, and therefore the probability of a
GP in the partnership, doing intrapartum obstetrics has decreased
still further until it is now unusual, and if the general level of
Obstetric ability and enthusiasm has been reduced in general
practice, let us reflect that training for it is conducted in units
managed by an uneasy truce between Obstetricians and Midwives, and
is almost universally agreed to range from poor to unfit for the
purpose.
Perhaps part of the rise reflects an increase in fatness, with
immobility leading to embolism.
Maternal care is a mess, and an unhappy mess, and the professional
bodies which have successfully seized control of it would have been
more ethically employed in getting on with their work.
--- OffRoad 1.9r registered to Adrian Midgley
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