SURPRISE, SURPRISE
Thank you for the totally unexpected Christmas gift. The tool kit I received for responding to NRM's Annual Checkup is always handy. I really do enjoy the National Review of Medicine and appreciate the effort that goes into selecting material and making it so readable. Hope you all have a great year.

Dr Harriet Train, Downsview, ON

MIDWIfE MYTH QUASHED
It is most regrettable that you should choose to start the News in Brief item "Deadly maternity hospital loses their right to train midwives," which appeared in the January 15 issue (Vol 3, No 1, page 5), by stating that physicians' mistrust of midwives may be justified. In the investigation at Northwick Park Hospital, the centre in London, UK, that prompted the story, there has been no suggestion that midwives were to blame. Indeed, the case that provoked the investigation was one of death due to post-partum hemorrhage following a cesarian section, hardly a midwifery procedure. In fact press reports specifically referred to "doctors who failed to recognize the severity of bleeding." The hospital itself believes that the underlying problems include an inadequate number of midwives rather than any lack of quality. The withdrawal of trainees occurred because it was believed that the environment didn't guarantee a sufficiently high quality experience for the midwifery students.

I'm sorry that your newspaper should continue to foster the myth that doctors and midwives still mistrust each other. There are many parts of Ontario, including the high-risk perinatal centre, McMaster Children's Hospital, where I work, many physicians and midwives work together and respect the values and expertise each offers to pregnant, labouring and post-partum mothers and their infants. At a time when the practitioners of obstetrics have become increasingly hard to find, I suggest we need to foster these good relationships, not prolong ancient turf protection.

Dr John Watts, Hamilton, Ontario