A programme for shared maternity and child care.

One of the problems in running a practice is that of com? munication between the various participants?the patients, the doctor, and the ancillary staff. With shared obstetric care the problem becomes more complicated as the patient sees at least two doctors, two sets of nurses, and two secretarial departments. The use of the obstetric co-operation card has been a real breakthrough, as information is recorded and kept by the patient to be shown at her next attendance. There still, however, remains the problem about how ade? quate information is to be given to the patients. Many women do not seem to know when they are due to attend relaxation classes or receive maternity benefits. This may increase their anxiety, particularly during a first pregnancy. The co-operation card records what has already occurred but does not tell the patient what to expect during her pregnancy. We decided to draw up a timetable of expected events, which could be duplicated and given to each expectant mother at her first visit confirming the pregnancy. It was devised by the general practitioner in charge of ante? natal care in the practice, the obstetrician at the local district general hospital, and the health visitors and midwives. Copies were circulated for inspection and criticism to the local com? munity physician and the other midwives and gynaecologist. Finally, copies were distributed to each mother at her first attendance. They have proved popular with the patients and very useful to the practice staff and as a teaching aid to trainees. A copy of the timetable is shown below. Individual details differ in various areas and practices, but the general lay-out remains similar. We would welcome comments and suggestions, particularly as to whether the programme should be written in a more popular style.