Does provider choice matter? : Maternal experience with obstetricians, family medicine physicians, and midwives

Background: Past research suggests that family physicians and midwives approach maternity care differently than obstetricians, without significant differences in the rates of maternal or neonatal complications. Methods: Listening to Mothers III (LTM3) is a 2012 United States national survey of 2,416 mothers concerning their childbirth experiences in the year prior to the survey. It was conducted by Harris Interactive. The objective of this analysis is to determine whether a mother's original choice of maternity care provider profession (obstetricians, family physician or midwife), had any impact on the profession of the provider from who attended the birth and factors that may have influenced these patterns. Results from LtM3 are not available until March, 2013 so results from LtM2 are used below to illustrate possible analyses. Results: Eighty percent of women chose an obstetrician for their prenatal care, and 93.4% of these women were attended by an obstetrician at delivery. 8.3% of women chose a family physician for their prenatal care, and only 68.8% of these women were attended by a family physician at delivery (21.1% by an obstetrician). 9.4% of women chose a midwife for their prenatal care, and 67.6% were attended by a midwife at the time of delivery (26.2% by an obstetrician). Preliminary analysis of maternal risk profiles suggests not all the variation can be accounted for by maternal prenatal health. Conclusion: This analysis will identify transfer levels and the likely causes for mothers to switch from family physicians and midwives in prenatal care to obstetricians for birth.