The medical world-in common with many other professions, has a language of its own, and theis very specialised. This even applies to the names given to various people (both doctors and nurses) with whom you will come into contact during pregnancy, delivery and babyhood days. Here is a quick run-down to help you sort out who is who.
An obstetrician is a doctor who, after taking a qualifying medical degree, has specialized and taken further qualifications in caring for pregnant women and their babies. He is the man you will see at intervals during your pregnancy when you attend for your routine antenatal checks. The obstetrician will always see you on your first visit, and will give you a complete examination to ensure that there is no reason why your baby should not be delivered normally.
Unless anything unforeseen happens often he will not see you again until the thirty-sixth week of pregnancy. Before one of his registrars or housemen (doctors carrying out their specialized obstetric training under the close supervision of the consultant)-will be available to carry out any unusual procedures, such asdelivery, a breech delivery or a Caesarean section, for example, which may be necessary when the time comes for your baby to be born.
A gynaecologist is a doctor who has specialized, and taken further degrees in, diseases which are particular to women, especially diseases which occur during the woman’s reproductive years. This work is combined with the work of the obstetrician so that the consultant you would see if, for example, you had any condition specific to your reproductive system, would be the same person under whose care you were placed when your baby was born. The road to becoming a consultant obstetrician/ gynaecologist is a long one-ten to Fifteen years after the initial six years of basic medical qualification.
Paediatricians are doctors who have specialized in the treatment of the diseases of children, after obtaining their basic medical qualification. The training to become a consultant paediatrician takes ten to fifteen years after qualification, and further post-graduate examinations must also be taken. Most paediatricians work in hospitals but, increasingly, as acute illness in children lessens, they are to be found working in the community, in child health clinics, medical centres, schools and assessment centres.
A neo-natologist is a paediatrician who specializes in the care of the newborn baby. As medicine becomes more complex, the areas of specialization increase and a doctor’s working life can easily-and usefully-be devoted to one small aspect of care. Perhaps the most vulnerable time in our lives is the first week of life.
In a relatively short space of time, our body is subjected to a completely new environment. Much change has to occur for lung and digestive systems, to mention just two facets, to work in an entirely different way. Problems can arise at this time, particularly if there are any congenital defects present. It is then that the highly specialized skills of the neo-natologist are needed, both for diagnosis and treatment.
Perinatology is concerned with the well-being of the baby during the actual birth process-that vital six to forty-eight hours upon which so much depends. All obstetricians and most paediatricians are concerned with the perinatal period. Any minor degree of oxygen lack or injury at any stage of birth can affect a child’s whole life.
During the course of labor the baby’s heart beat and other physiological functions are carefully monitored-frequently by a complex range of instrumentation. If any variations from the normal are observed, action will be taken to ensure the delivery of a healthy baby.
A general practitioner is a doctor who has decided to spend his working life in the community caring for the whole range of age groups in the family. After qualification, and a certain time spent in hospital medicine, he will become a trainee in an established partnership of doctors. After this time usually one to two years-he will become a junior partner in a group practice and will take the examination to become a member of the newly created College of General Practitioners UK).
An increasing number of doctors these days operate from a health centre. Here, under one roof, one can find the doctor’s consulting rooms, the health visitors and district nurses and, often, in larger practices, a small operating theatre and many other personnel such as speech therapists, physiotherapists, and so on.
This forms the basis of the primary care team, and it is here that all patients must first attend, when ill or in need of advice about their health. In practice, each doctor often has a particular area of interest. For example, one of the partners may have an especial interest in children; another may have an especially sympathetic way of dealing with the elderly.
Midwives are nurses who have undergone further: training in midwifery, that is, the delivery JE babies and their immediate post-natal care. To be a midwife, the nurse must have obtained her SRN (State Registered Nurse) qualification, and passed a further examination at the find of her midwifery course to become an SCM (State Certified Midwife).
The normal delivery of a baby in hospital is undertaken by a midwife or a pupil midwife under the immediate supervision of a trained midwife. If complications of any kind occur, such as the need to deliver a baby with the use of forceps, the midwife will call one of the obstetric team. The role of the midwife does not find with the birth.
She is responsible for the care of the baby and the mother until they leave hospital. So, as well as being fully conversant with the delivery of women, the midwife must also have a sound working knowledge of newborn babies. District midwives still exist, although in fewer numbers than when many mothers had their babies at home.
With today’s policy of early discharge from hospital (forty-eight hours) district midwives are busy with the home care of the new mother and the young baby. When the baby is 10 days old, however, the care of both mother and baby is handed over to the health visitor.
A health visitor is an SRN who has had midwifery experience and who has undertaken a further year’s training in all aspects of nursing and social care in the community. Her work ranges from the very young to the very old, and she is a mine of information on the social aspects of community care.
She will be in charge of the child health clinics and will run developmental assessment clinics in conjunction with either a general practitioner or a local authority community doctor. She will visit the homes of mothers with young babies and will be on call to them if any problems arise. Feeding, sleeping and behaviour problems are all within her scope.
Mothers rely on their health visitor’s expertise to help them over the potentially worrying days at home with their new baby. Most health visitors, these days, are attached to a group of local doctors and work closely with them. So when a mother chooses her doctor she will also be choosing her health visitor. As the babies grow into school children. the l health visitor will have much to offer by way of advice to both parents and school doctor and teachers. Her knowledge of the family can ease many stresses in the school situation.