Midwives,Home deliveries, and high risk pregnancies

I left this as a comment on Kevin MD's blog, here goes the link

http://www.kevinmd.com/blog/2009/05/doctors-and-midwives-need-to-cooperate-more.html

Just had to share this with my own readers

Here goes my comment:

I agree completely with Dr.Greg.I have seen midwives who have no idea of many obstetric complications and don't diagnose things early enough during routine Obstetric checkups and then take it till the last minute when all they know is that the delivery is not happening and there is some complication but they themselves have no idea what exactly and precisely the problem is.They do not have enough clinical acumen to pick up signs early and treat them and simply rely on luck often times which sadly is at the cost of the life of the mother and child. I myself have witnessed women come to emergency rooms and then die on the ER table there coz they kept trying to deliver till the last minute at the home and only came to ER coz the mother collapsed due to massive bleeding which is essentially too late to seek medical help .A mother's life is important, You cannot let her die due to problems that could have been easily managed had it been a hospital birth. Yes, midwives can play a role in routine check ups and doing home visits to ease the burden of Obstetricians in remote areas where not many Obstetricians are available, but having a hospital delivery is the safest.But then this is sensible only after the woman first visits at crucial points during a pregnancy and makes sure it is not an already predetermined complicated pregnancy. Please remember that even a seemingly normal case can become complicated during labor due to massive bleeding and what not. It is unfair to first mess up a case and then run to the Obstetrician in the last minute for help .