A comparison of family physicians' and obstetricians' intrapartum management of low-risk pregnancies

Abstract

Background: We hypothesized that family physicians' style of intrapartum management was less interventional than the management style of obstetricians, and that this would not adversely affect maternal or neonatal outcomes.

Methods: A retrospective, matched-pair study design was used to compare low-risk women cared for by community family physicians with those cared for by obstetricians at a small teaching hospital. The subjects were matched on the basis of age and parity. We compared the rates of intervention between family physicians and obstetricians.

Results: We studied 351 matched pairs of women. The demographic characteristics of patients were similar as were the rates for most labor and delivery procedures. Family physicians had lower rates for induction, external and internal fetal monitoring, narcotic analgesia use, and postpartum oxytocin use. Women cared for by family physicians spent less time in the hospital, both during labor and postpartum.

Conclusion: This study supports the hypothesis that at our center family physicians intervene less than obstetricians in intrapartum management. Comparisons with similar studies conducted at other academic centers illustrate differences in styles of practice between institutions, not just between specialties.