Proportion of Family Physicians Providing Maternity Care Continues to Decline

As a specialty that provides comprehensive care, family medicine encompasses all aspects of women's health, including maternity care. Access to regular prenatal care and labor and delivery services are essential in preventing poor perinatal outcomes and improving early childhood development. Several studies over the past decade have reported declining contributions to maternity care by family physicians.^1,2

Seeking to update past findings, we analyzed data from a census of the American Board of Family Medicine diplomates who were applying for the Maintenance of Certification for Family Physicians examination during the years 2000 to 2010 (n = 7436, 8021, 9223, 9241, 9400, 7755, 8216, 9409, 9551, 9536, and 2433, respectively) to determine the mean percentage of practice time spent in maternity care across the study years and the percentage of family physicians who report providing any maternity care in each given year. The proportion of US family physicians who report providing maternity care declined from 23.3% in 2000 to 9.7% in 2010 (Figure 1). Of the family physicians who do provide maternity care, 10.1% of their time, on average (aggregated over 2000 to 2010), was spent doing so.

• Download figure
• Open in new tab

Figure 1.

Declining percent of family physicians providing maternity care. Source: American Board of Family Medicine Examination Application.

All family physicians are trained to provide maternity care; however, few report providing this care. Access to maternity care in rural and underserved communities, which is disproportionately provided by family physicians, is threatened.³ The decline in the maternity care provision by family physicians may signal an alarming overall decline in the scope of practice of family physicians.⁴ With malpractice costs, lifestyle concerns, lack of institutional and community support of family physicians delivering babies, and proposed changes to Residency Review Committee Family Medicine requirements, this proportion may continue to decline unless policies are put in place to encourage family physician provision of maternity care.

• Received for publication August 26, 2011.
• Revision received October 20, 2011.
• Accepted for publication November 14, 2011.