Barriers faced by family physicians providing advanced maternity care: A qualitative study
Methods: We conducted semi-structured interviews with 51 family medicine (FM) maternity care providers and educators, including 21 FM-OB fellowship directors, 19 past fellows, and 10 FM residency directors of programs with advanced MC training. Interviews were recorded, transcribed, and analyzed using a deductive approach to qualitative content analysis and computer-assisted qualitative data analysis software (MAXQDA).
Results: Three primary challenges for FPs providing MC emerged from the interviews. 1) Training: most FM residency programs do not provide sufficient surgical OB training, so fellowship training is needed to enhance skills. 2) Credentialing: obtaining hospital privileges to perform cesarean sections is unpredictable and highly variable by institution. 3) Professional relationships: “turf battles” with other MC providers can limit FPs’ ability to provide care commensurate with their level of training.
Conclusions: As the predominant provider of MC in rural areas, FPs need to be enabled to provide advanced MC services. Strategies to accomplish this include: enhanced FM training in MC; institutional (hospital) and state/national level policy changes to address credentialing inconsistencies; and improved team-based care for pregnant women to ensure that every woman has access to high quality maternity care.
Learning Areas:Clinical medicine applied in public health
Ethics, professional and legal requirements
Other professions or practice related to public health
Provision of health care to the public
Describe three challenges faced by family physicians who provide advanced maternity care services. Identify three strategies to improve the ability of family physicians to provide advanced maternity care.
Keyword(s): Maternal and Child Health, Workforce
Qualified on the content I am responsible for because: I have been principal or co-principal investigator on multiple qualitative research studies focusing on maternal-child health issues and the maternity care workforce.
Any relevant financial relationships? Yes
|Name of Organization||Clinical/Research Area||Type of relationship|
|ABFM||Family Medicine||Employment (includes retainer)|
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.