The Royal College of Obstetrics and Gynaecology want to know what you lot think about...

[RowanMumsnet]

...well, a few things really

RCOG (which has helped MN out a lot with, among other things, our Miscarriage Campaign) is currently consulting on the topic of 'Tomorrow's Specialist'. They want to 'define the changing role of tomorrow's specialist within a team, which focuses on high quality women's healthcare, through innovative and rewarding ways of working, embracing training, lifelong learning and professional challenge.' (You can see more about the consultation here.)

I've been asked to go along to an evidence session on Friday and reflect Mumsnetters' views on the following:

1. Access to obstetric and gynaecology services: referral routes, doctors' roles, setting of consultations.
2. Career progression and development: the role of the specialist doctor remains them same throughout his/her career, unlike many other professions where the challenges do not stop at the specialist level. What do you think makes a career exciting, and how can those elements be incorporated into the specialist doctor's career plan?

Speaking as someone who's never so much as met a obstetrician or gynaecologist, it's fair to say I'm feeling a little underpowered on this one. So I'd be tremendously grateful if any of you - as either service users or professionals in related fields - could let me know your views.

Thanks
MNHQ

I think obstetricians should be encouraged to respect women's birthing bodies and not just view them as malfunctioning machines like some do. I agree with others that they should be required to observe home births and see what low risk birth entails and what is possible when a woman is not stressed by her environment. I think there are very serious issues around informed consent for obstetric procedures. The option to refuse should be respected and scare tactics and rhetoric about risking the baby should not be used. They should be upfront when a suggested course of action is because of hospital policy rather than clinical evidence (eg induction, AROM etc) and keep themselves up to date on latest research. just because they have always done things a particular way eg. valsalva pushing in 2nd stage doesn't make it right.

I have been referred and found no problem with that, though I was then rereferred for the birth which I didn't want as there was no evidence of problems and then I was given lots of undue pressure about being over dates.

I think all drs at consultant level are expected to keep abreast of current practice. There needs to be good provision for part time women to make it to consultant level to ensure there are women in the specialty. They could interest themselves more in the pyschological and spiritual side of birth and how their interventions, even when necessary, can leave women traumatised despite the 'healthy baby'.

I was consultant led for ds. wouldve been nice to actually meet her, not a series of underlings who scuttled to and fro so she wouldn't have to deign to see me.

when I had hyperemesis with ds @ 9/10 weeks I had to refer myself directly to hospital after GP told me ''everyone gets sick'' I rang the ward after testing my own ketones and they told me to come straight in - onto a drip for 4 days.

Not that inpressed by doctors TBH

I would like to have been listened to and treated like I had an idea of what was happening with my body.

Tempted to start this off by saying that 'I'm an educated woman etc, etc' but that would be insulting to anyone who feels they're not able to make an educated choice about their health care. EVERY woman should be treated with respect and dignity with healthcare choices explained at every step, in detail if needed.

With DC2, at term+3 with SPD (so severe that I needed a brace and crutches) I requested a 'sweep' at the obs&gynae wing of my local hospital to 'start me off'. They declined with no valid reason given other than it was a Friday.

Next time it's a home birth unless nature dictates otherwise.

There is nowhere near enough understanding of womens health needs, I have been trying for months to get a referral to a gynae and I have ended up having to go private for a referral and treatment even though I can not work because of my health problems. To often GP's are too willing to fob people off, self referral or drop in care would make a huge difference

I think it's all been said already but I would agree that obstetricians should be required to attend a number of "normal" births, at home or at a birth unit, to observe how birth should be, ie with no complications. I think too many always just see the worst side of birth and this can skew their decision making on things like when to do a c/s. The could do worse than read a bit of Ina May Gaskin while they are at it!

Oh yes and please could someone invent a better way of doing a smear test than the present method. Thanks. (not sure if that's in their remit but you can but ask).

Just to say I had a male Obs consultant and he was fab. As an 'old' first time mum he called me in at 20 weeks for appt. which was his standard practice. (I know cos the midwife thought it was odd so rang to find out why!) A wise move as it turned out and he then put me on fortnightly scans. He never spoke down to me and I felt reassured and able to ask questions throughout. Ended with ELCS but I was happy that was right decision.

I've read that the majority of Obs go for Elective sections. Can you tell me if they are predominantly NHS or privately funded and whether or not the mothers are made to go through counselling.

I am also interested in why private consultants agree to electives for no medical reason. Surely if vaginal births are in the best interest of the patient as the NICe guidelines state, there is something unethical about c/section for choice by payment?

Any feedback on how it went Rowan? I hope you survived .

Hello,

Thankfully it wasn't too scary and I did make it very clear that I personally know pretty much nothing, but that MNers between them represent both service-user and professional perspectives.

They were very interested in all the points about self-referral, and how difficult many of you seem to have found it to get referrals to specialists. They were also interested in the points about some post-partum mothers preferring to have the six-week check with a specialist rather than with a GP. I also brought up the point about how important many of you thought it was for obs specialists to keep their hands in with intervention-free births.

I think, broadly speaking, they are aware that the whole post-natal area leaves a bit to be desired (not just for RCOG but across all areas within the health service), and there's a possibility that we will work together to look into this in more detail. (Not promising anything for now, but a possibility!)

Thanks so much for all in the input, I would have looked a right lemon without it

MNHQ x

Thanks for letting us know Rowan

Thanks Rowan. It would be fantastic if we could get some action on postnatal care. I wrote a report on this for the RCM over a decade ago and so far as I can see it has got worse rather than better.

Oh that's interesting Devora - would be great to have a look at that, if you're allowed to share it?

Yes, it was published and is probably on their website. I'll check it out and send you the link.