Table 1.

Characteristics of Family Physicians Who Perform versus Do Not Perform Cesarean Sections as Primary Surgeon from the 2017-2022 ABFM Continuing Certification Questionnaire

	FPs Performing Primary C-Sections		FPs Doing Obstetric Deliveries but Not Primary C-Sections		FPs Not Doing Any Obstetric Deliveries
	N	%	N	%	N	%	p-Value
Total	589		1523		26,414
Individual Characteristics
Age
Under 40	103	17.5%	311	20.4%	3145	11.9%	<0.0001
40 to 49	301	51.1%	656	43.1%	10,640	40.3%
50 to 59	119	20.2%	393	25.8%	7556	28.6%
60 or Older	66	11.2%	163	10.7%	5073	19.2%
Gender
Women	239	40.6%	897	58.9%	12,142	46.0%	<0.0001
Men	349	59.3%	626	41.1%	14,272	54.0%
Non-binary	1	0.2%	0	0%	0	0%
Degree Type
MD	520	88.3%	1358	89.2%	23,364	88.5%	0.6897
DO	69	11.7%	165	10.8%	3050	11.5%
IMG
Yes	73	12.4%	121	7.9%	6337	24.0%	<0.0001
No	516	87.6%	1402	92.1%	20,077	76.0%
Race
Asian	36	6.1%	89	5.8%	4547	17.2%	<0.0001
Black	25	4.2%	47	3.1%	1658	6.3%
White	505	85.7%	1305	85.7%	18,228	69.0%
Other	23	3.9%	82	5.4%	1981	7.5%
Ethnicity
Hispanic/Latino	35	5.9%	81	5.3%	2002	7.6%	0.0020
Not Hispanic/Latino	554	94.1%	1442	94.7%	24,412	92.4%
Faculty at Medical School or Residency
Yes, core/salaried faculty	120	20.4%	645	42.4%	2329	8.8%	<0.0001
Yes, volunteer/clinical faculty	237	40.2%	423	27.8%	5388	20.4%
No	232	39.4%	455	29.9%	18,697	70.8%
Practice Characteristics
Site Size
Solo practice	30	5.1%	33	2.2%	2978	11.3%	<0.0001
2 to 5 Providers	162	27.5%	213	14.0%	9090	34.4%
6 to 20 Providers	261	44.3%	632	41.5%	8099	30.7%
>20 Providers	136	23.1%	645	42.4%	6247	23.7%
Principal Practice Site
Hospital/Health System Owned	184	31.2%	452	29.7%	9407	35.6%	<0.0001
Independently Owned	141	23.9%	228	15.0%	8293	31.4%
Managed Care/HMO	3	0.5%	32	2.1%	1745	6.6%
Academic Health Center/Faculty Practice	81	13.8%	473	31.1%	1600	6.1%
FQHC or look-alike	55	9.3%	190	12.5%	1727	6.5%
Rural Health Clinic	96	16.3%	51	3.3%	559	2.1%
Other	29	4.9%	97	6.4%	3083	11.7%
Specialty Mix of Principal Practice
Family medicine only	312	53.0%	904	59.4%	12,936	49.0%	<0.0001
Primary care specialty mix	134	22.8%	300	19.7%	7610	28.8%
Multiple specialties (not only primary care)	143	24.3%	319	20.9%	5868	22.2%
Presence of Midwife at Practice
Yes	104	17.7%	204	13.4%	1130	4.3%	<0.0001
No	485	82.3%	1319	86.6%	25,284	95.7%
Geographic Characteristics
Rurality of Practice Site^*
Urban	267	45.3%	1183	77.7%	22,847	86.5%	<0.0001
Micropolitan	54	9.2%	119	7.8%	1522	5.8%
Large Rural	230	39.0%	205	13.5%	1744	6.6%
Small Rural	38	6.5%	16	1.1%	301	1.1%
Census Region
Northeast	23	3.9%	154	10.1%	3787	14.3%	<0.0001
Midwest	212	36.0%	660	43.3%	6197	23.5%
South	162	27.5%	191	12.5%	9285	35.2%
West	192	32.6%	518	34.0%	7145	27.1%
Presence of General OB/GYN in county
None	193	32.8%	144	9.5%	1408	5.3%	<0.0001
5 or Fewer/10,000 reproductive age females in county	205	34.8%	507	33.3%	8453	32.0%
Greater than 5 / 10,000 reproductive age females in county	191	32.4%	872	57.3%	16,553	62.7%
Presence of Nurse Midwives
None	247	41.9%	248	16.3%	3560	13.5%	<0.0001
1 or Fewer / 10,000 reproductive age females in county	122	20.7%	360	23.6%	10,079	38.2%
Greater than 1/10,000 reproductive age females in county	220	37.4%	915	60.1%	12,775	48.4%
Primary Care HPSA
Full/Partial County	520	88.3%	1395	91.6%	24,243	91.8%	0.0103
No	69	11.7%	128	8.4%	2171	8.2%
Percent of reproductive age females in county
Under 18%	280	47.5%	328	21.5%	5515	20.9%	<0.0001
18% to 21%	213	36.2%	719	47.2%	13,400	50.7%
More than 21%	96	16.3%	476	31.3%	7499	28.4%
Social Deprivation Index^**
Under 25	201	34.1%	468	30.7%	6902	26.1%	<0.0001
25 to 75	305	51.8%	829	54.4%	14,040	53.2%
More than 75	83	14.1%	226	14.8%	5472	20.7%

Abbreviations: CS, Cesarean Section, FP, Family Physician, FQHC, federally qualified health center, HMO, health maintenance organization, HPSA, health professional shortage area, IMG, International Medical Graduate, OB/GYN, obstetrician/gynecologist.
↵*Rurality was defined using Rural-Urban Continuum Codes by county of primary practice site with urban codes 1-3, micropolitan 4-5, large rural 6-7 and small rural 8-9. The U.S. Department of Agriculture’s Economic Research Service, which created this scale, defines urban as codes 1-3 and rural as codes 4-9.
↵**Social Deprivation Index is a composite measure of area level deprivation based on income, education, employment, housing, household characteristics, transportation and demographics and is measured on a score of 0-100 with higher numbers suggesting higher deprivation.