Letter: GPs' attitudes towards home births

Sir: Clodagh Corcoran's open letter ("Dear mothers-to-be", 17 January) gave the impression that women wanting to give birth at home would get short shrift from their GPs. Removing a woman - or her family - from a list simply because she asks for i nformation about home births is indefensible. However, GPs are under no obligation personally to provide maternity services for a patient. While they must, as Ms Corcoran points out, provide their patient with as much accurate and objective information a s possible, that information should properly contain guidance about possible risks to either mother or baby.

Even today, childbirth can still, rarely, be life-threatening. There is a small but significant possibility that something could go wrong and that emergency treatment would be needed immediately. In many parts of the country, this kind of back-up may simply not be available and a GP may feel that the risk of there being insufficient emergency care is too great.

In addition, many GPs are aware that their own skills as "GP obstetricians" have become eroded because of the very low level of home deliveries in recent years. A small number of GPs have responded to this anxiety by not being prepared to contract with awoman for a home delivery and, in a very few cases, fear of being called in an emergency has caused a GP to remove a patient from their list. This is not a satisfactory solution and the profession is negotiating with the Department of Health to produce a sensible contractual responsibility for GP maternity services.

GPs do want to give mothers-to-be as much choice as possible about the way in which they choose to have their baby, but that choice has to be an informed choice - one that takes into account both the benefits and the potential risks of any decision.

Yours sincerely, Judy Gilley Joint Deputy Chair, General Medical Services Committee British Medical Association London, WC1