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Sat, May 06, 2000 - Page 2 News List

Situation in maternity wards cause for concern

By Liu Shao-hua  /  STAFF REPORTER

Obstetricians and gynecologists running private clinics expressed their dissatisfaction of the government yesterday, which they say allows overcrowding of pregnant women in large-scale hospitals and leaves them out of work.

"Over 40 percent of these doctors [who own a clinic] are not delivering the new-born infants and seeing less than 30 patients per day," said Tsai Ming-shyan (蔡明賢), president at the Taiwan Association of Obstetrics and Gynecology (TAOG, 婦產科醫學會).

According to Tsai, there are 2,300 obstetricians and gynecologists in Taiwan. Two-thirds have their own clinics and the rest serve in the large-scale hospitals.

But, it is in the larger hospitals where delivery takes place, giving the majority of delivery work to one-third of the island's obstetricians and gynecologists.

According to a survey conducted by TAOG, Tsai said both the lack of opportunities to participate in deliveries of children and a lack of governmental subsidies for gynecologists has left many doctors frustrated.

The survey revealed that over 89 percent of these doctors said they would change their medical profession if they could choose again. In addition, "over 60 percent of those serving in hospitals are not satisfied with the current working situation and research quality," said Tsai.

Large-scale hospitals should limit the number of outpatients per day in order to spend more time and effort in research, Tsai said.

Tsai appealed to the Department of Health to figure out these problems. Otherwise, "the medical quality [of obstetrics and gynecology] will never be good," Tsai said.

Officials from the health department had a different interpretation of the phenomenon.

"The surplus of doctors is in accordance with the decrease of the birth rate," said the department's director-general of medical affairs, Tan Kai-yuan (譚開元).

"Since 1997 it has been estimated we only need around 1,400 obstetricians and gynecologists," Tan said, adding that a decrease in the need for obstetricians and gynecologists was a trend.

But social welfare scholars are more concerned about the quality of medical practice for pregnant women.

"Not only doctors in both hospitals and clinics complain about the situation, but also pregnant women themselves are not satisfied at the medical care and treatment they are receiving," said Wu Chia-ling (吳嘉苓), professor in sociology at Taiwan University.

Wu called current conditions "a complete failure."

Wu said some women would rather choose a homebirth than going to the hospital or clinic because of the lack of real interaction with doctors.

"A midwife system is a solution for the current predicament of doctors serving in the hospitals," said Wu. Midwives could share the caseload of natural deliveries with doctors and therefore give doctors more time for research, Wu said.

"Many developed countries like Scandinavian, Australia, New Zealand and Britain are implementing this kind of division of labor," Wu said.

"Doctors always come to the delivery room at the last minute. However, midwives accompany pregnant women through the whole process -- of the antenatal, delivery and postpartum stages," said Wu.

"For the sake of new-born infants' health, postnatal care and nursing are as important as the antenatal check. Midwives can also offer home nursing and care," said Kuo Su-chen (郭素貞), a professor at Taipei College of Nursing.

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