By Craig Griebel, MD
I provide obstetrical care as part of my role as faculty member in the family medicine residency at the University of Illinois College of Medicine Peoria (UICOMP). Approximately 8% of family physicians provide obstetrical care, and this percentage has been declining over the years.
Here in Peoria, many pregnant patients are having difficulty with access care, and this is a national trend. One recent commentary stated that, “Maternity care access in the United States is in crisis.”
At the residency, we have tried to assist pregnant patients with access to care, and our volume of pregnant patients continues to increase. It is projected that there will be a shortage of 9,000 obstetricians by 2030. This is likely to result in further problems in access to care for pregnant patients, particularly in rural areas. In addition, many rural hospitals have stopped offering obstetrical services. So even when clinicians are willing to provide obstetrical services, the local hospitals do not allow this as an option.
I understand that providing obstetrical care as part of the practice of family medicine is not for everyone. (As the statistics suggest, it is not part of practice for 92% of family physicians!)
As we move forward, however, I believe that that there will continue to be a need for family physicians to provide obstetrical care — and that this need will continue to grow. It is likely that this need will be particularly significant in the rural areas.
The challenges of providing obstetrical care are well known: lifestyle issues, malpractice insurance, arranging backup, among others. Family physicians, however, have tried to rise to the challenge of what their communities need, and this is one such challenge.
My advice:
If you are one of the 8% of family physicians who provide obstetrical care, keep it up!
I know that it can be challenging. I encourage you to work on your skills by maintaining your certification in the Advanced Life Support in Obstetrics (ALSO) course (offered every July here at UICOMP) and by attending the AAFP’s Family Centered Maternity Care conference. It is likely that you will be meeting a greater and greater need in your community as the years go by.
If doing deliveries is not for you, consider offering prenatal care in your office.
Many family physicians, particularly those in rural areas, provide prenatal care for their patients who are going to deliver elsewhere. This “shared care” model is an effective way for patients to get the prenatal care they need in a setting where they are comfortable.
If maternity care is not for you, you can still help by being supportive of your colleagues.
Give them words of encouragement and help to cover patients when they run to a delivery. Provide support at the administrative level within your healthcare system if you are involved with service development, credentialing, or recruitment.
In summary, I realize as a family physician who provides maternity care that I have been part of a shrinking minority over the years. I believe that the maternity care family physicians provide, however, is a vital service and will continue to be a vital service as access to maternity care continues to worsen.