title: GP obstetricians' views of the model of maternity care in New Zealand.
abstract: BACKGROUND
  The Lead Maternity Carer (LMC) model of maternity care, and independent midwifery practice, was introduced to New Zealand in the 1990s. The LMC midwife or general practitioner obstetrician (GPO) has clinical and budgetary responsibility for women's primary maternity care.
  
  
  OBJECTIVE
  To determine views of practising GPOs and former GPOs about the LMC model of care, its impact on maternity care in general practice, and future of maternity care in general practice.
  
  
  METHODS
  10 GPOs and 13 former GPOs were interviewed: one focus group (n = 3), 20 semi-structured interviews. The qualitative data analysis program ATLAS.ti assisted thematic analysis.
  
  
  RESULTS
  Participants thought the LMC model isolates the LMC - particularly concerning during intrapartum care, in rural practice, and covering 24-hour call; Is not compatible with or adequately funded for GP participation; Excludes the GP from caring for their pregnant patients. Participants would like a flexible, locally adaptable, adequately funded maternity model, supporting shared care. Some thought work-life balance and low GPO numbers could deter future GPs from maternity practice. Others felt with political will, support of universities, and Royal New Zealand College of General Practice and Royal Australian and New Zealand College of Obstetrics and Gynaecology, GPs could become more involved in maternity care again.
  
  
  CONCLUSIONS
  Participants thought the LMC model isolates maternity practitioners, is incompatible with general practice and causes loss of continuity of general practice care. They support provision of maternity care in general practice; however, for more GPs to become involved, the LMC model needs review.
authors: Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. dawn.miller@otago.ac.nz
authors: Dawn L
authors: DL
authors: Miller
authors: Zara
authors: Z
authors: Mason
authors: Chrystal
authors: C
authors: Jaye
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D017144:Focus Groups; D058006:General Practice / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008427:Maternal Health Services / Q000458:organization & administration*; D008875:Middle Aged; D008880:Midwifery / Q000458:organization & administration*; D009520:New Zealand; D009774:Obstetrics / Q000458:organization & administration*; D011247:Pregnancy; D036301:Qualitative Research