The General and Family Medicine College (MGF) of the Ordem dos Médicos has expressed concern over a proposal reportedly allowing Maternal and Obstetric Health Specialist Nurses (EESMO) to supervise pregnant women without a family doctor. In their opinion piece, they acknowledge the skills of these professionals but emphasize the necessity of family doctor involvement alongside the family health team.
Recent trends in rising maternal and neonatal mortality demand responses grounded in scientific evidence, planned and discussed in appropriate forums, rather than isolated measures that could weaken clinical safety, the opinion states.
The MGF College reiterates the distinct roles of each profession, stressing that the future of maternal health in Portugal should be based on true complementarity and integration models focused on women, babies, families, and communities.
It is crucial to reinforce primary health care (PHC) as a pillar of pregnancy monitoring, avoiding the transfer of skills to hospital settings or creating inter-professional substitution models, the statement highlights.
The Ordem dos Médicos advocates for investment in structured and sustainable solutions to enhance human resources in PHC, hiring, and implementing retention measures for family doctors and nurses.
They argue that monitoring should be conducted in a shared and complementary manner, avoiding duplication, to promote greater system efficiency.
This integration can occur with varying professional ratios, depending on local particularities, provided the safety of care is ensured for all families, the statement underlines.
The specialists also emphasize the importance of equity in safety and access to consultations and diagnostic tests for all pregnant women and their families, and stress investment in digital innovation and telemedicine to bring care closer, reduce geographical inequalities, and ensure real-time specialist support.
The MGF College considers collaboration with the Ministry of Health and other professional bodies essential to build safe, equitable, and quality solutions. “We want to be part of the solution, placing PHC at the center of pregnancy monitoring in Portugal, in close collaboration with family health teams,” they assert, noting that only this way can inequalities be reduced, complications prevented, maternal and infant mortality decreased, and each pregnancy conducted with the dignity, safety, and quality that women and families deserve.
In their opinion, the specialists also caution about the “challenging maternal health context” faced by the National Health Service: “There is a population increase, a shortage of specialists in General and Family Medicine and in Gynecology and Obstetrics, and worsening maternal and neonatal mortality indicators.”
Additionally, the statement highlights that “as maternal age and comorbidities increase, along with migration, the complexity of low-risk pregnant women has been rising.”
Amid this scenario, there are growing concerns over the increasing number of pregnant women lacking adequate monitoring.
