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. 2000 Mar;46:601-6, 609-11.

Family physicians in maternity care. Still in the game? Report from the CFPC's Janus Project.

A J Reid 1, I Grava-Gubins 1, J C Carroll 1
PMCID: PMC2144974  PMID: 10751999

Abstract

OBJECTIVE: To describe family doctors' contribution to maternity care in Canada and to observe the influence of age, sex, region of the country, and practice population on provision of maternity care. DESIGN: Survey: College of Family Physicians of Canada's Janus Project national family physician survey. SETTING: All 10 provinces and two territories. PARTICIPANTS: Random sample of family physicians and general practitioners, both members and non-members of the College. MAIN OUTCOME MEASURES: Proportion of family doctors participating in prenatal, intrapartum, postpartum, and newborn care, and proportion of doctors involved in intrapartum care by age, sex, location in Canada, and practice population. RESULTS: Overall response rate was 58%. Just over 50% of all family doctors in Canada are involved in some aspect of maternity care; 19% do intrapartum care; and 33% are involved in prenatal (shared) care. Similar proportions of men and women still do intrapartum care, but women care for more pregnancies than men. More family doctors serving rural areas are doing intrapartum care compared with doctors in urban areas, although those in urban areas tend to do more deliveries. The western provinces have the highest percentages of intrapartum caregivers. A gradual decline in percentage of intrapartum caregivers by age group increases among the 55- to 64-year-old cohort. Almost a quarter of women doctors younger than 35 years are doing intrapartum care. Most physicians doing prenatal (shared) care look after women until the third trimester. CONCLUSIONS: Family doctors are still providing a large proportion of maternity care in Canada. This contribution must be nurtured by the College through its Maternity and Newborn Care Committee and other contacts to encourage family doctors to continue offering this essential service to childbearing women in Canada.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Balaban D. J., Rosenthal M. P., Ungemack J. A., Carlson B. L., Zervanos N. J. Obstetric care among family physicians in Pennsylvania. Trends, association with residency training, and policy implications. J Fam Pract. 1990 Sep;31(3):281–286. [PubMed] [Google Scholar]
  2. Carroll J. C., Brown J. B., Reid A. J. Female family physicians in obstetrics: achieving personal balance. CMAJ. 1995 Nov 1;153(9):1283–1289. [PMC free article] [PubMed] [Google Scholar]
  3. Carroll J. C. Maternal serum screening. Can Fam Physician. 1994 Oct;40:1756–1764. [PMC free article] [PubMed] [Google Scholar]
  4. Etches D., Klein M., Handfield-Jones R. Advanced Life Support in Obstetrics. Practical approaches to obstetric emergencies. Can Fam Physician. 1998 Nov;44:2480–2481. [PMC free article] [PubMed] [Google Scholar]
  5. Iglesias S., Grzybowski S., Klein M. C., Gagné G. P., Lalonde A. Rural obstetrics. Joint position paper on rural maternity care. Joint Working Group of the Society of Rural Physicians of Canada (SRPC), The Maternity Care Committee of the College of Family Physicians of Canada (CFPC), and the Society of Obstetricians and Gynaecologists of Canada (SOGC). Can Fam Physician. 1998 Apr;44:831–843. [PMC free article] [PubMed] [Google Scholar]
  6. Klein M. C., Gauthier R. J., Robbins J. M., Kaczorowski J., Jorgensen S. H., Franco E. D., Johnson B., Waghorn K., Gelfand M. M., Guralnick M. S. Relationship of episiotomy to perineal trauma and morbidity, sexual dysfunction, and pelvic floor relaxation. Am J Obstet Gynecol. 1994 Sep;171(3):591–598. doi: 10.1016/0002-9378(94)90070-1. [DOI] [PubMed] [Google Scholar]
  7. Kruse J., Phillips D., Wesley R. M. Factors influencing changes in obstetric care provided by family physicians: a national study. J Fam Pract. 1989 May;28(5):597–602. [PubMed] [Google Scholar]
  8. Kruse J., Phillips D., Wesley R. M. Withdrawal from maternity care. A comparison of family physicians in Ontario, Canada, and the United States. J Fam Pract. 1990 Mar;30(3):336–341. [PubMed] [Google Scholar]
  9. Labrecque M., Baillargeon L., Dallaire M., Tremblay A., Pinault J. J., Gingras S. Association between median episiotomy and severe perineal lacerations in primiparous women. CMAJ. 1997 Mar 15;156(6):797–802. [PMC free article] [PubMed] [Google Scholar]
  10. Lane C. A., Malm S. M. Innovative low-risk maternity clinic. Family physicians provide care in Calgary. Can Fam Physician. 1997 Jan;43:64–69. [PMC free article] [PubMed] [Google Scholar]
  11. Levitt C., Kaczorowski J. Provision of intrapartum care by GP/FPs in Canada: an update. CMAJ. 1999 Mar 23;160(6):815–816. [PMC free article] [PubMed] [Google Scholar]
  12. Osmun W. E., Poenn D., Buie M. Dilemma of rural obstetrics. One community's solution. Can Fam Physician. 1997 Jun;43:1115–1119. [PMC free article] [PubMed] [Google Scholar]
  13. Reid A. J., Carroll J. C. Choosing to Practise Obstetrics: What factors influence family practice residents? Can Fam Physician. 1991 Sep;37:1859–1867. [PMC free article] [PubMed] [Google Scholar]
  14. Reid A. J., Carroll J. C., Ruderman J., Murray M. A. Differences in intrapartum obstetric care provided to women at low risk by family physicians and obstetricians. CMAJ. 1989 Mar 15;140(6):625–633. [PMC free article] [PubMed] [Google Scholar]
  15. Reynolds J. L. Reducing the frequency of episiotomies through a continuous quality improvement program. CMAJ. 1995 Aug 1;153(3):275–282. [PMC free article] [PubMed] [Google Scholar]
  16. Shapiro J. L. Satisfaction with obstetric care. Patient survey in a family practice shared-call group. Can Fam Physician. 1999 Mar;45:651–657. [PMC free article] [PubMed] [Google Scholar]
  17. Smith L. F., Jewell D. Contribution of general practitioners to hospital intrapartum care in maternity units in England and Wales in 1988. BMJ. 1991 Jan 5;302(6767):13–16. doi: 10.1136/bmj.302.6767.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Sullivan P., Buske L. Results from CMA's huge 1998 physician survey point to a dispirited profession. CMAJ. 1998 Sep 8;159(5):525–528. [PMC free article] [PubMed] [Google Scholar]
  19. Wilson L. M., Reid A. J., Midmer D. K., Biringer A., Carroll J. C., Stewart D. E. Antenatal psychosocial risk factors associated with adverse postpartum family outcomes. CMAJ. 1996 Mar 15;154(6):785–799. [PMC free article] [PubMed] [Google Scholar]
  20. Woodward C. A., Rosser W. Effect of medicolegal liability on patterns of general and family practice in Canada. CMAJ. 1989 Aug 15;141(4):291–299. [PMC free article] [PubMed] [Google Scholar]

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