By Jane Elliott BBC News health reporter

Trainees need to see normal births

Britain faces acute shortages in obstetrics and gynaecology.

Numbers of new recruits have fallen dramatically in recent years and the problem is worst among male doctors.

The Royal College of Obstetrics and Gynaecology said graduates avoided the speciality because they feared getting the cold shoulder from parents.

Exclusion

Last year, 171 doctors became members of the Royal College of Obstetrics and Gynaecology - but only 12 were UK graduates and only three were men.

A study by the BMA of young graduates showed that in 1995, obstetrics and gynaecology was the main choice for 26 out of 545 doctors, who responded; in 1998 it had fallen to 16 out of 509 and by 2002 was down to only 6 out of 487.

I do get slightly irritated by 'middle-class mes', who say they only want to see the consultant without good cause Jenny Higham

Jenny Higham, a reader in obstetrics and gynaecology at Imperial College, London, said parents had a vital role to play in training future consultants.

She said she understood and respected a woman's right to refuse to have trainees there when they are giving birth.

But she added: "We have got to realise that there is a net effect of continual exclusion.

"That individual who declines will not feel it, but it will be felt in 10 years' time.

Not philanthropic

"Society as a whole appears to becoming less philanthropic, it is disheartening to go to a clinic and to have patients repeatedly say they do not want any student involvement.

"I do get slightly irritated by 'middle-class mes', who say they only want to see the consultant, without good cause. Training is a vital issue too."

She said that men in particular were feeling the brunt.

"Our students are not enjoying obstetrics and gynaecology and men don't feel it is welcoming.

"We can't underestimate the negative effect.

"Male students say that increasingly women patients decline to have them involved in their care, sometimes, but not always reflecting cultural issues, making them feel despondent and subsequently rejecting the specialty as a potential career option."

Choice

Dr Melissa Whitten, chair of the Royal College of Obstetrics and Gynaecology trainees' committee, said she loved the speciality, but that it needed to be properly promoted.

"The sheer breadth and flexibility of choice in this speciality, ranging from obstetric care to surgery, endocrinology to psychology has always been a reason to enter and continue in obstetrics and gynaecology.

I think there is probably a perception among medical students that you are more likely to get sued if you work in obstetrics and gynaecology Dr Melissa Whitten

"I was attracted by the diversity. I found the whole process seeing your first baby born and your first caesarean section is fascinating."

But she agreed that if trainees were to feel properly included, parents - and midwives - had a vital role to play in encouraging students into the birthrooms.

"It is important students see the processes of labour."

"If we work in obstetrics all we see are the problems of labour, we need educating about the normal stuff."

The college is now planning to liaise with medical schools to promote the speciality and with the Royal College of Midwives to ensure supportive work practices.

Melanie Every, of the Royal College of Midwives, said she was sure that if that situation was handled properly that many more parents would agree to have students at their births.

"I think the issue for midwives about having students in is they come in to help look after the mother, they do not just float in to watch the birth. They are there to help the women."