Maternity

We wish to bring your attention to the issue of cover under the Medisec Master Policy (underwritten by Allianz plc) in relation to the provision of ante-natal care under the Mother and Infant Scheme. Please note that cover is in place under your policy for GP involvement in Combined Care Schemes provided that:

1. The antenatal and post-natal care provided is under the supervision of an obstetrician attached to a recognised Maternity Hospital.
2. The GP does not provide intrapartum care i.e. assistance at the birth. This is specifically excluded under their policy cover.
3. patient opts for a maternity hospital birth, care of which would be under the supervision of an obstetrician as at (i) above.

GPs are not covered under the Medisec Master Policy to sign up to the scheme if a patient is opting for a home birth. If a patient opts for a home birth during the scheme we advise that arrangements are made by your patient for alternative ante natal care immediately. In this regard:

• Refer your patient immediately to the maternity hospital where she would have been assessed initially.
• Telephone the patient and mid-wife, explain the situation and advise them of alternative services available via the maternity hospital.
• Write to the HSE and the patient confirming that you are not in a position to provide services under the scheme due to the patient’s home birth option.
• If the patient is not in agreement with the above and opts not to engage with alternative ante/post-natal care, all risks should be fully advised to the patient.
• Fully document all your actions and advice given and risks outlined to the patient on the patient’s file.
• NB - If a patient has opted for a home delivery, the Medisec policy does NOT cover any aspect of antenatal or postnatal care up to and including the postnatal two and six week check for both mother and baby. Where a home birth has taken place the postnatal care of the mother and baby must be referred back to the care of the local Obstetric and Neonatal service. If a GP undertakes to provide these services they are not covered under their Medisec policy.
• Members are covered to provide medical advice and/or treatment in circumstances of a bona fide medical emergency.

Please note for avoidance of any doubt that cover is not in place for members to provide ante natal care for any patients, including private patients, opting for a home birth.

Neo-natal care following homebirths

Cover is not provided for GPs to carry out the 2 and 6 week check for babies and the 6 week check for mothers in respect of delivery of care to babies or mothers in the neonatal period following a home birth, unless the mother or baby have been first checked by an obstetrician or paediatrician as appropriate and the GP is provided with evidence of such visit.  Essentially, once mother or baby have been screened by the relevant expert, in the same way they would in the context of a hospital birth, there is no barrier to the GP providing care to mother or baby as normal.  Cover has always been provided to GPs to see a mother or baby if they are sick.

If you have any queries in relation to the above please do not hesitate to contact one of our team.