Objective: To obtain descriptive data on deliveries performed by family physicians in Connecticut during 1 year.
Design: All family physicians in Connecticut who provided obstetric care were personally contacted to enlist their participation in a research network. All such physicians agreed to participate and were instructed to mail a 15-item delivery data card to the author following each delivery that they participated in during calendar year 1996.
Main outcome measures: Method of delivery, use of obstetric intervention (eg, oxytocin administration, episiotomy, and epidural anesthesia), and obstetric consultation rates.
Results: Thirty-two physicians, representing 9.0% of the family practice workforce in Connecticut, provided obstetric care. These 32 physicians, who practice in only 7 of the 31 acute care hospitals in the state, delivered 478 neonates during 1996. Most deliveries were by the spontaneous vaginal route, with forceps and vacuum used in 2.1% and 5.0% of vaginal deliveries, respectively. The primary cesarean section rate of these family physicians was low at 5.6% compared with a statewide rate for all providers (physicians and certified nurse midwives) of 12.4% (odds ratio, 0.42; 95% confidence interval, 0.28-0.63). Rates of certain obstetric interventions, such as oxytocin administration, epidural anesthesia, and episiotomy, varied greatly by hospital. Obstetric consultation rates also varied greatly among hospitals, ranging from 12.8% to 49.6%.
Conclusions: Family physician involvement in maternity care in Connecticut is low. This study confirms a low rate of instrument-assisted and cesarean delivery in births attended by family physicians. Use of obstetric interventions and obstetric consultation varies greatly within the state.