Concerns over shortage of obstetric physicians

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Concerns over shortage of obstetric physicians

12th August 2011

A medical negligence expert has echoed concerns that too many women with underlying medical conditions are currently dying in childbirth due to a lack of appropriately trained doctors.

Jacqui Hayat, a partner at Fentons Solicitors LLP, was speaking after a new report by six obstetricians was published in the British Medical Journal. “Senior doctors have addressed a ‘worrying trend’ in the leading causes of maternal mortality rates and expressed real concern over the shortage of specialist obstetric physicians,” said Jacqui. “It is very alarming that there is a shortage of experts able to treat pregnant women with underlying health conditions.

“Although the overall maternal death rate has been declining, the numbers of women dying from non-birth related, treatable complications such as asthma, diabetes, heart failure and epilepsy continues to rise and it is of huge concern that these conditions are going undetected due to an insufficient number of specialist doctors.”

Between 2006 and 2008, the overall UK mortality rate was 11.39 per 100,000 maternities. There were 107 maternal deaths as a direct result of complications occurring during pregnancy. In the same period, there were 154 indirect deaths due to underlying health problems exacerbated by pregnancy.

“As birth rates continue to climb, doctors are seeing increasing numbers of older women getting pregnant, resulting in a higher risk of complications during pregnancy,” said Jacqui. “In addition, doctors are seeing a marked rise in the numbers of women with pre-existing, often complex, medical conditions becoming pregnant or seeking fertility advice.”

Most maternal deaths in the UK are now occurring in women with pre-existing medical or psychiatric conditions. The leading cause of maternal death remains cardiac disease, the second, neurological disease. In the last 20 years there has been a steep rise in the numbers of maternal deaths due to indirect causes.

Senior doctors have said the rise is due to a combination of increasing numbers of pregnant women with underlying health issues and a shortage of appropriately trained healthcare professionals able to successfully diagnose and treat such issues within the context of pregnancy.

“It is extremely worrying that pregnant women and their babies are dying due to a shortage of doctors able to correctly diagnose, investigate and treat underlying medical conditions,” said Jacqui. “It is now a matter of absolute urgency, that more training is implemented to increase the numbers of experts able to properly treat seriously ill pregnant women. It is unacceptable that women are dying as there aren’t enough doctors with obstetric experience or obstetricians with the appropriate experience in clinical practice.”

Jacqui said there is also real concern over the lack of experts in maternal care adequately trained in the clinical care of pregnant women. Obstetric experts with expertise in treating unborn babies and deliveries do not have sufficient knowledge in maternal health, while on the other hand general physicians who treat medical problems are lacking specialist knowledge of pregnancy.

“As more and more women delay starting families, have high blood pressure due to conditions such as obesity, or who become pregnant after major treatments such as transplant surgery,” she said, “then the need for greater numbers of specialist obstetric physicians is going to become ever more essential.

“We need greater numbers of obstetrics doctors trained in other specialist fields such as cancer, mental health and respiratory illnesses so they are able to differentiate between symptoms directly associated with underlying medical conditions and those endemic to pregnancy. Our priorities must remain focused on ensuring standards of patient care remain excellent so that expectant mothers can have absolute confidence in the quality clinical care and expert maternity services the NHS provides.”

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Fentons has a specialist department experienced in handling claims relating to medical negligence.

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Read more: BBC