The origins of women’s health before the establishment of Obstetrics and Gynaecology as a specialty was predominantly by women who were unqualified midwives, often without any medical training and steeped in folklore. One example of primitive treatments offered being venesection for symptoms of the menopause. As medicine evolved physicians became more involved in the process of delivering babies but antenatal care and gynaecological surgery did not exist.
Obstetrics and gynaecology was only recognised as a specialty in the mid-19th century followed soon after by the creation of the Royal College of Obstetricians and Gynaecologists (RCOG). As a specialty it encompasses two separate subspecialties and certification to practice in this speciality is provided as a dual accreditation. One of the lures of the specialty is its huge diversity offering both surgical and medical training. And though occasionally talks ensue about splitting the specialities in two separate training programmes, this has been resisted and rightly so. After all, how can childbirth be separated from other gynaecology conditions that women are faced with?
As medicine becomes more specialized, clinicians and healthcare professionals become skilled at their jobs, and deskilled in managing areas outside their expertise. For clinicians specialising in Advanced labour ward practice, Fetal medicine, High Risk pregnancy, Obstetric medicine and no longer practicing gynaecology, the management of complex gynaecological problems encountered commonly during pregnancy or in the postnatal period is sometimes outside the skill sets required of them whilst in training. Yet Obstetricians would be expected to manage women with complex gynaecological problems competently in the antenatal and postnatal period. This is a problem faced by Obstetricians worldwide and our book will appeal to clinicians across the globe as the only unique book catering to this area of medicine.
The Royal College of Obstetricians and Gynaecologist’s High Quality Women’s Health Care report (published 2011) proposed a number of changes needed in the education and training of doctors in the specialty of obstetrics and gynaecology. As a result of this, the Advanced Training in Obstetrics and Gynaecology document was published in August 2019 which addresses the purpose, learning outcomes and content of learning in addition to the core curriculum requirement for CCT. Neither the core curriculum nor the obstetric Advanced labour ward, Fetal medicine, High Risk pregnancy, Labour ward lead and Obstetric medicine (ATSM’s) include management of the complex gynaecological problems encountered commonly during pregnancy or in the postnatal period.
‘Gynaecology for the Obstetrician’ covers all gynaecological problems encountered during the antenatal, intrapartum and postnatal period which would assist the obstetricians with the required evidence-based knowledge, to provide high quality care to women thereby improving patient safety and outcomes whilst reducing complaints and litigation. Co-edited by us both, the conception arose when we were in the midst of Covid and we realised the need for a book on this subject. There are 14 chapters with leading experts in the respective fields contributing to each of the chapters. We hope this book will bridge the gap between the two specialities and give Obstetricians the confidence and knowledge to manage gynaecology problems encountered in pregnancy and postpartum.
Authors: Swati Jha and Priya Madhuvrata