why is maternity care in the uk midwife vs doctor-led? why not both for everyone
NAD, but hoping to hear opinions from doctors and other healthcare professionals who know the system. One of the things that I find perplexing here as an immigrant from the EU is the structure of maternity care. Specifically, midwife vs doctor-led care. In my country of origin, we don't really have the separation of midwife-led and doctor-led care, and our delivery suites are all hospital-based, with full facilities available for each patient, similar to what you get if you go for an MLU. You are observed by both midwives and doctors during pregnancy and birth. Here though it seems like it's a fairly large trade off during delivery, where you get better facilities if you go for a midwife-led unit vs delivery suite, but worse access to monitoring, Drs, or pain relief, among other things.
There is constant quoting of research saying that midwife-led care leads to fewer interventions, but how much of it is correlation vs causation (fewer interventions resulting from them not being as easily accessible / available on MLUs; MLUs transferring anyone requiring an intervention out to the delivery suite etc.)? I have found it difficult to inform myself on the reasons behind MLUs existing, especially alongside actual delivery suites. Is it a money thing and the NHS simply can'tafford to provide the same level of care regardless if you're deemed high vs low risk? Would appreciate thoughts from people who know more about this as I feel like I am missing something.