Shared Obstetric Care: The General Practitioner's Perspective

EDITORIAL COMMENT: We accepted this paper for publication since it is a useful review of, the objectives of shared obstetric care from the point of view of the general practitioner. The proportion of shared care patients in teaching hospitals in Victoria is very low in comparison with other States and it is certain to increase. It is probable that about 80% of patients are suitable for shared care if general practitioners are available, and this seems to be the case. The increasing litigation in obstetric practice will probably not detract from shared care as most litigation arises from problems that are perceived by the mother or her advisers to have occurred during labour or delivery. The authors rightly stress that shared care requires good communication between hospital and general practitioner, especially concerning the reporting of special tests. In the editor's opinion ultrasonography at 18 weeks' gestation should be a routine test in all shared care patients so that procedures requiring accurate knowledge of fetal maturity (e.g. repeat elective Caesarean section) can be planned appropriately. This also facilitates clinical diagnosis of the small for dates and large for dates fetus.