Community obstetric care in West Berkshire.
OBJECTIVE
To assess the effects of a revised obstetric booking policy whereby all low risk pregnant women received their antenatal care entirely in the community.


METHODS
Comparison of the distribution of antenatal clinic attendances, transfers, and perinatal mortality rates for 1987 and 1989, before and after introduction of the revised policy.


METHODS
West Berkshire Health District.


METHODS
All women who delivered with a registrable birth in the district in 1987 (5817 women) and 1989 (5372).


METHODS
Attendances at community and consultant antenatal clinics; bookings transferred from community care to consultant care; perinatal mortality rates.


RESULTS
Of 5372 women delivering in West Berkshire in 1989, 3185 (58.3%) were originally booked for general practitioner-midwife care, of whom 1567 (49.2% of general practitioner-midwife bookings) were transferred to consultant care. 1618 women (30.1% of all women delivered) received their entire obstetric care from general practitioners and midwives. Attendance at hospital antenatal clinics was reduced by 16%. In 1989 the perinatal mortality rates (1987 values) for the district were 6.3 (7.6) per 1000 births overall; 8.2 (8.3) per 1000 consultant bookings; 5.0 (4.7) per 1000 for community bookings; and 10.2 (14.4) per 1000 for women transferred to consultant care.


CONCLUSIONS
Antenatal care of low risk pregnant women may safely be provided by their general practitioner and midwife.
Street
P
P
Department of Obstetrics and Gynaecology, Royal Berkshire Hospital, Reading.
Gannon
M J
MJ
Holt
E M
EM
D000293:Adolescent; D000328:Adult; D003153:Community Health Services / Q000458:organization & administration*; D004739:England; D005194:Family Practice; D005260:Female; D005313:Fetal Death; D006760:Hospitalization; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008880:Midwifery; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000458:organization & administration*; D012017:Referral and Consultation