Is Devonport doctor the last Kiwi GP delivering babies?
There's no money it in, so why do it?
That's a question often posed to Devonport GP Erica Lauder who still delivers babies for patients from her general practice. And the answer is unequivocal: "I love it. I love the babies and I love the families."
But she knows she is not just a minority – she wonders if she is the only GP in the country still offering this service to patients.
Neither the Royal NZ College of General Practitioners nor the Medical Association of New Zealand have a record of any GPs still doing this, "but there might be one in Cromwell" we were told. However, enquiries at that surgery were not forthcoming. Nor does the NZ Medical Council keep records of GPs delivering.
"There appears to be a clear downward trend in the number of pregnant women registered with GPs as LMCs at delivery. This phenomenon is being seen worldwide as GPs move out of involvement in deliveries."
Even 22 years ago, it was a novelty to have a GP delivering a baby, but there were still a few offering the service around the country. This changed dramatically in 1996 when the law was changed, allowing a "qualified birth attendant" rather than a doctor to attend a delivery.
Lauder, however, has never stopped delivering babies, even though she gets paid considerably less than a midwife. "This is because we are paid a set fee, and there is an assumption that a GP will spend less time on the delivery by using hospital midwives. But often I am there just as long as an independent midwife."
Lauder has been delivering babies as a practising GP for 33 years, starting in 1984 with her first practice in Papakura, where she regularly delivered 120 babies a year. This has included home deliveries from 1987 onwards. Today, she still delivers an average of 40 babies a year, most at North Shore Hospital, with some homebirths.
"I am now delivering the babies of babies I delivered," she says.
The GP admits it is hard to get away for weekends, or take any time off. And when she had her own babies (four over eight years), she took them with her to deliveries, so she could breastfeed.
"I was often delivering during the night and the babies would need feeding, so it was easiest to just bring them along and pop them in the corner," Lauder says. "While practising in Papakura, I took our first baby back to work at four weeks of age – everyone looked after him."
Lauder says there are huge benefits in having a GP deliver. "Knowing the history of a patient from pre-conception is really good for the continuity of care. And it's good to be able to look after the whole extended family, often including grandparents and cousins – I once delivered two first cousins on the same day.
"The patients really value it, and the post-natal depression rate of my patients is low. Clearly, it helps to know beforehand who might need extra care."
We catch up with Lauder when she is visiting her latest newborn baby. Abigail Foster (Abby) and husband Kishen Kommu have just had their first baby, a girl named Aria.
As a young child Abby watched Lauder deliver three of her siblings, two of them at home in Hunua – her mother Charlene Foster and brother Joe (whom Lauder delivered 23 years ago) are also visiting the day we call on the family.
Abigail says there was never any question she would not have Lauder as her primary caregiver. "Erica has been my doctor for 30 years and she was the only person I thought of going to when I became pregnant. I trust her 100 per cent.
"She is very easy-going and nothing was forced on me in terms of the birth plan. I was all about what I wanted to do."
Charlene Foster recalls her own birth experiences with Lauder delivering. "She has been my doctor and a friend since 1987. She is good at making any fears seem rational, while also getting rid of them."
Lauder, meanwhile, has no intentions of retiring from obstetrics in the forseeable future. And she is hoping any other GPs still delivering babies will get in touch.