Maternity Care Services Provided by Family Physicians in Rural Hospitals

Article Figures & Data

Table 1.

Characteristics of All Responding Rural Hospitals by Provision of Maternity Care Services

Characteristic	All Responding Hospitals (N = 437)	Hospitals That Provide Maternity Care (n = 196)	Hospitals That Do Not Provide Maternity Care (n = 241)	P Value
Ownership				.21
Local government	26.8%	24.9%	28.3%
Nonprofit	58.8%	60.4%	57.5%
For-profit	7.3%	9.6%	5.4%
Mixed ownership	5.0%	4.1%	5.8%
No answer	2.1%	1.0%	2.9%
Rural-urban commuting area (code nos.)				<.001
Micropolitan (4–6)	24.4%	35.9%	14.7%
Small town (7–9)	44.3%	47.7%	41.4%
Rural (10)	31.4%	16.4%	44.0%
Hospital designated ascritical access	70.6%	55.3%	83.4%	<.001
Acute care beds (n)				<.001
1–25	71.8%	57.4%	83.8%
26–50	12.3%	13.2%	11.5%
51–100	8.8%	15.2%	3.4%
>100	7.2%	14.2%	1.3%

Table 2.

Characteristics of Physicians Providing Maternity Care by State and Overall

State	Hospitals Responding (n)	Family Physicians with Any Hospital Privileges (mean n) (P = .20)	Family Physicians Who Provide Maternity Care (mean n) (P = .001)	Obstetricians (mean n) (P < .001)	Midwives (mean n) (P = .14)	Family Physicians Who Perform Cesarean Deliveries (mean n) (P = .015)	Physicians Who Provide Maternity Care Who Are Family Physicians (%) (P < .001)	Family Physicians Providing Maternity Care Who Perform Cesarean Deliveries (%) (P < .001)
Colorado	12	8.2	2.4	2.4	0.9	1.5	46	56
Georgia	9	10.0	1.2	3.5	0.6	1.2	21	100
Indiana	10	6.4	2.3	1.0	0.1	0.9	73	51
Iowa	18	7.8	3.7	0.8	0.2	1.3	78	49
Kansas	22	4.6	3.1	0.5	0.1	2.1	88	68
Kentucky	4	6.7	1.0	2.8	0.5	0.8	29	75
Maine	5	6.2	2.6	1.2	0.2	0.6	71	18
Minnesota	22	7.0	4.3	0.6	0.4	1.9	87	45
Mississippi	5	6.2	2.2	2.8	0.2	2.2	40	100
Montana	9	6.6	3.0	1.2	0.3	2.4	75	83
North Carolina	8	4.8	0.9	1.6	0.4	0.9	38	79
Oregon	15	7.7	2.5	2.1	0.9	1.7	52	66
Pennsylvania	6	3.7	0.8	3.3	0.8	0.0	10	0
Tennessee	5	6.6	3.2	0.8	0.8	2.8	83	80
Texas	41	8.0	2.8	1.8	0.2	2.5	60	91
Total	196	7.0	2.8	1.6	0.4	1.8	63	66

Table 3.

Characteristics of Family Physician Provision of Maternity Care Services by Hospital Size

	Hospital Size				P Value
	1 to 25 Beds (n = 112)	26 to 50 Beds (n = 26)	51 to 100 Beds (n = 30)	≥101 Beds (n = 28)	P Value
FPs with hospital privileges	5.9	7.5	8.4	9.8	.001
FPs who perform vaginal deliveries	3.4	3.0	1.6	1.3	<.001
FPs who perform cesarean deliveries	2.0	2.2	1.1	1.2	.025
Obstetricians who deliver babies	0.7	1.2	2.8	3.9	<.001
Midwives who deliver babies	0.2	0.5	0.7	0.7	.004
Hospitals with any FP providing maternity care services (%)	94	84	60	36	<.001
Hospitals with any FP performing cesarean deliveries	78	64	43	32	<.001
FPs providing maternity care who perform cesarean deliveries (%)	63	71	70	80	.468
FPs who provide maternity care services, among all physicians (%)	81	65	34	15	<.001
Deliveries per year	139	278	412	643	<.001
Cesarean deliveries (%)	27	25	29	30	.18

Table 4.

Characteristics of Family Physician Provision of Maternity Care Services by Rurality

	Rural-Urban Commuting Area Grouping			P Value
	Rural (n = 32)	Small Town (n = 93)	Micropolitan (n = 70)	P Value
FPs with hospital privileges	4.7	6.9	8.1	.003
FPs who perform vaginal deliveries	2.8	3.3	2.0	.001
FPs who perform cesarean deliveries	1.9	2.0	1.4	.10
Obstetricians who deliver babies	0.5	0.9	2.8	<.001
Midwives who deliver babies	0.3	0.2	0.7	.002
Hospitals with any FP providing maternity care services (%)	94	89	61	<.001
Hospitals with any FP performing cesarean deliveries	75	76	46	<.001
FPs providing maternity care who perform cesarean deliveries (%)	70	63	67	.70
FPs who provide maternity care services, among all physicians (%)	84	76	37	<.001
Deliveries per year	116	177	464	<.001
Cesarean deliveries (%)	25	26	29	.051