Management consultants claim that women can do most antenatal care themselves.

A report by a management consultancy firm has concluded that women can safely do most of their antenatal care themselves, freeing the midwife’s time and of course resulting in huge savings for the NHS. Apparently, the majority of antenatal care could be delivered by women themselves. They could check their own blood pressure and dipstick their own urine.  They could then input their data into an electronic record that could be read by the midwife.  The electronic record could also make clinical history taking by the midwife or obstetrician redundant: simply get the women to enter their own health histories, press a button, and hey presto!  The information is delivered to the midwife or obstetrician ahead of the appointment and this would save the health practitioner from actually asking the woman any questions.

Can anyone see any problems with this approach?  The management consulting form couldn’t: they thought it was a great idea.  But this indicates a complete lack of understanding of the value of health care delivery … by a health professional, rather than to a health professional.

Many women will be quite capable of recording their blood pressure, weight etc.  but are they trained and educated to interpret the results and to know if something is serious?  And, I hesitate to ask, who is checking in on the baby, monitoring growth, fluid volume, asking about movements and so on?

Additionally, asking a woman her health history face-to-face often reveals far more than asking her to complete an online questionnaire.

Women need continuity, a familiar face and consistency in their care.  They need to form a relationship with the midwife who’ll attend their birth.  It seems the management consulting form choose not to explore these points.  An investment in the health of mothers and babies seemed secondary to the short-term savings of HNS time and resources.

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