Family physicians provide maternity care in and around the maternity care shortage areas, particularly rural

Author:

Walter Grace1,Jetty Anuradha2ORCID,Topmiller Michael2,Huffstetler Alison2

Affiliation:

1. Georgetown School of Family Medicine Washington District of Columbia USA

2. The Robert Graham Center: Policy Studies in Family Medicine and Primary Care Washington District of Columbia USA

Abstract

AbstractPurposeThis study examined demographic, practice, and area‐level characteristics associated with family physicians’ (FP) provision of maternity care.MethodsUsing the American Board of Family Medicine Certification examination application survey data, we investigated the relationship between FPs’ maternity care service provision and (1) demographic (gender, years in practice, race/ethnicity), (2) practice characteristics (size, ownership, rurality), and (3) county‐level factors (percentage of reproductive‐age women, the number of obstetrician–gynecologists (OBGYNs) and certified nurse midwives (CNMs) per 100,000 reproductive‐age women). We performed summary statistics and multivariate logistic regression analyses.ResultsOf the 59,903 FPs in the sample, 7.5% provided maternity care. FPs practicing in rural were 2.5 times more likely to provide maternity care than those practicing in urban areas. FPs in academic (odds ratio [OR] 4.6, 95% confidence interval [CI] 4.1–5.1) and safety‐net settings (OR 1.9, 1.7–2.1) had greater odds of providing maternity care. FPs in the bottom quintile with no or fewer OBGYNs and CNMs had a higher likelihood of maternity care provision (OR 2.1, 1.8–2.3) than those in the top quintile, with more OBGYNs and CNMs.ConclusionsFPs in high‐needs areas, such as rural and safety net settings, and areas with fewer CNMs or OBGYNs are more likely to provide maternity care, demonstrating the importance of FPs in meeting the needs of women with limited maternity care access. Our study findings highlight the importance of considering the contributions of FPs to maternity care as the organizations prioritize resource allocation to areas of highest need.

Publisher

Wiley

Reference17 articles.

1. HoyertD.Maternal mortality rates in the United States.CDS;2021. Accessed March 27 2023.https://www.cdc.gov/nchs/data/hestat/maternal‐mortality/2021/maternal‐mortality‐rates‐2021.htm

2. U.S. Department of Health and Human Services Health Resources and Services Administration National Center for Health Workforce Analysis.National and regional projections of supply and demand for women's health service providers: 2013–2025.Bureau of Health Workforce.2016. Accessed April 12 2023.https://bhw.hrsa.gov/sites/default/files/bureau‐health‐workforce/data‐research/womens‐health‐report.pdf

3. Projecting US Primary Care Physician Workforce Needs: 2010-2025

4. The Essential Role of Family Physicians in Providing Cesarean Sections in Rural Communities

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