Family practice obstetrics in a community hospital

Abstract

Objective: To review obstetric care provided by family physicians and to determine why they transfer patients to obstetricians.

Design: Retrospective chart review.

Setting: Obstetrics department of a regional non-academic community hospital

Patients: Of 683 women booked with family physicians for obstetrical care, 601 were admitted by family physicians and 82 were transferred to obstetricians before admission.

Main outcome measures: Risk score, induction, augmentation, consultation, forceps delivery, cesarean section, episiotomy, epidural anaesthesia, narcotic analgesia, neonatal birth weight and Apgar scores, and maternal complications.

Results: Family physicians' patients had good maternal and neonatal outcomes; spontaneous delivery rate was 82%; cesarean section rate was 9%. Women transferred from family physicians to obstetricians before admission for delivery had a cesarean section rate of 63%.

Conclusions: Family physicians provided total obstetric care to most women in this community and transferred patients to obstetricians for expected reasons. Community hospitals with family physicians highly involved in providing obstetric care are likely ideal institutions for training future family physicians.