ABSTRACT
The great increase in the number of hospital births was not without effect on the members of the medical profession concerned with the care of the pregnant and parturient woman in the home. In particular, general practitioners feared losing patients to hospitals. Midwifery practice was not overly remunerative, but it was believed to lay the foundation of family practice. 1 The BMA's own scheme for a national maternity service, published in 1929, stressed that the GP ‘should always be the bedrock on which the medical services of the country, including midwifery, must be built up’. It also minimised both the need for maternity beds (suggesting that only 3% of women needed hospital deliveries) and the role of the midwife. 2 Thus the GP's ideal maternity service differed greatly from that of the consultant. GPs feared the hospitalisation of childbirth because very few of them had a chance to follow their cases to hospital. One in five GPs had access to beds in cottage hospitals during the 1930s, but the new maternity units were being located in the larger general and teaching hospitals. One specialist's scheme for the maternity services proposed that obstetrics become a specialty, practiced only in hospital which would thus have excluded the GP altogether. F.J. Browne stated quite categorically that midwifery was incompatible with general practice because of the postgraduate training that he felt was necessary and the irregular hours demanded. Ministry of Health reports were readier to recognise the work done by the GP, but they too sounded a warning note: the GP must be well-trained and ready to pass on complicated cases to hospitals. 3
